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As a result of field surveys of the last years, the new site of Holercani-Hansca cultural group – Andreevca-I settlement has been found. The purpose of this research paper is the characteristics of the mentioned site and the interim results of its study. Results. Andreevca-I settlement is located in Orhei raion of the Republic of Moldova, at the lands of Chiperceni Community. The site is located 0.38 km northeast of the village of Andreevca and 0.28 km northwest of the pond of the village of Andreevca; on the left bank of the stream Vorotet. The settlement is located on a smooth slope. The land area of the settlement along the line North-West-South-East is 100x200 m. Fragments of ceramics, bones of animals, pieces of burnt clay, and different stones, some of them with traces of processing, were found on the plowed surface. The settlement is multilayered. The ceramics of the Late Bronze Age prevail in the materials of the settlement. It is associated with Holercani-Hansca cultural group (12th – 10th century BCE), interim between the cultures of the early Hallstatt, and the Late Bronze Age. According to O.G. Levitskiy, Holercani-Hansca group fills the gap between the cultural formations of Pre-Babadag and Tămăoani type and Balta group of sites of the Late Bronze Age. In addition, Hallstatt horizon with prevailing incised ceramics, which can be conventionally called Tămăoani-Holercani-Balta, is distinguished. Chronological framework of this horizon according to analogues of Balta group and Tămăoani can be the end of the 12th – 10th century BCE. The closest analogues to this cultural formation could be the cultures of the Lower Danube region – Sihleanu, Tămăoani, Pre-Babadag, Babadag-I, and early Belozerka culture sites, including Balta group of the Late Bronze Age. The role of Chisinau-Corlateni type sites, of which Holercani-Hansca group had got a number of material borrowings while forming its cultural entity, is doubtless.

BackgroundRabies is the oldest fatal zoonotic disease recognised as a neglected tropical disease and is caused by an RNA virus belonging to the genus Lyssavirus, family Rhabdoviridae.Methodology/principal findingsA deep molecular analysis was conducted on full-length nucleoprotein (N) gene and whole genome sequences of rabies virus from 37 animal brain samples collected between 2012 and 2017 to study the circulation of rabies virus (RABV) variants. The overall aim was to better understand their distribution in Moldova and north-eastern Romania. Both Sanger and high throughput sequencing on Ion Torrent and Illumina platforms were performed. Phylogenetic analysis of the RABV sequences from both Moldova and Romania revealed that all the samples (irrespective of the year of isolation and the species) belonged to a single phylogenetic group: north-eastern Europe (NEE), clustering into three assigned lineages: RO#5, RO#6 and RO#7.Conclusions/significanceHigh throughput sequencing of RABV samples from domestic and wild animals was performed for the first time for both countries, providing new insights into virus evolution and epidemiology in this less studied region, expanding our understanding of the disease.

This article puts in the scientific use results of rescue research of the mound (tumulus) no.1 from the village of Brânzenii Noi (Teleneşti District) and the mound (tumulus) no.1 from the village of Rogojeni (Şoldăneşti District). The vast majority of burials in the mounds studied belong to the Yamna culture, Early Bronze Age. One burial from the mound 1 in Brînzenii Noi refers to antiquities of the Noua culture, Late Bronze Age. In conclusion, the authors consider the issues of coexistence of the Late Yamna culture tribes with the bearers of the Catacomb culture in such a peculiar ecological niche as the floodplain of the Middle Răut.

This paper investigates the importance of Environmental, Social, and Governance (ESG) factors in investment policy during the COVID-19 pandemic and their contribution to long-term resilience and sustainability. By conducting a comprehensive literature review based on peer-reviewed articles, financial institution reports, and government policies, this study examines the financial resilience of ESG-oriented investments during the pandemic, the integration of ESG factors in investment policy, and post-pandemic trends in ESG investing. The paper also explores the role of ESG factors in fostering long-term resilience and sustainability and discusses challenges and opportunities for ESG investing during and after the pandemic. The findings suggest that ESG-oriented investments demonstrated financial resilience during the pandemic, and incorporating ESG factors in investment policy allowed investors to manage portfolio risk better. The growing interest in ESG investing will likely continue in the post-pandemic era, driven by the development of ESG-focused investment products, regulatory support, and greater collaboration between investors and companies. However, data quality, consistency, and greenwashing challenges must be addressed to ensure the integrity and effectiveness of ESG investing in the future. Further research is recommended to deepen our understanding of ESG investing and its potential to contribute to a more resilient and sustainable global economy.

Extraskeletal chondromas are rare benign neoplasms comprising mature hyaline cartilage. A distinctive feature of these tumors is that they develop in soft tissues away from bone and cartilage. Extraskeletal chondromas account for 1.5% of benign soft tissue tumors. They occur predominantly at 30-60, in males, and in the hand or foot. In only 4% of cases, the tumor is located not on the extremities. Patients predominantly complain of increased mass, rarely on pain or a pulling sensation. The literature on the chondromas of the anterior abdominal wall is scarce. We present a rare case of a large extraskeletal left inguinal chondroma in a 71-year-old patient. The mass was over 6 cm large, and this is the only case of inguinal chondroma described in the literature. The mass was resected with surrounding tissues (a surgical margin of 1 cm) under combined endotracheal anesthesia and the histology confirmed the tumor to be a chondroma.

Introduction: Technetium-99m (99mTc) is a short-lived nanocolloid nuclide widely used by oncologists to diagnose and identify cancer dissemination. Aim: The aim of the current study was to develop the technique of radiopharmaceutical preparation (RPP) of Technefit99mTc aimed at examining sentinel lymph nodes (SLN) before surgery. Materials and methods: We performed a series of trials (33 patients). Based on the information obtained from the portable gamma detector NEO2000 during surgery, a biopsy of the sentinel lymph nodes was carried out when RPP Technefit 99mTc accumulated in a specific lymph node. Results: We determined maximum activities, volume, and peculiarities of administration of radioactive colloid Technefit99mTc in order to examine and perform the biopsy of SLN in the patients with malignant tumors. The most informative results in terms of scintigraphy images of sentinel lymph nodes were revealed in the first trial of the research, with all 5 cases (100%) showing positive results. The first trial included Technefit intradermal-hypodermal injection into one point above the tumor node, RPP activity of 75 to 200 mBq at a room temperature of 21°C, without preliminary anesthesia with Novocain solution. Conclusion: We determined the most efficient dosages of activities, volume, and characteristics of radioactive colloid administration aimed at the examination and biopsy of sentinel lymph nodes using the radiopharmaceutical preparation Technefit 99mTc in patients with malignant tumors of different localizations, namely breast cancer and skin melanoma. In some cases, we did not find any signs of considerable lowering of the Technefit 99mTc activity, which shows that there is a very slow filtration of Technefit 99mTc through the pores of lymph capillaries.

In recent years, in the Republic of Moldova, there have been radical changes in the educational system, and one of them specifically aims at the access of young people with disabilities to university studies. This fact has substantially changed the perspective of the authorities, educational specialists, and society in general on disability and, implicitly, on its bearers. The transformation of high schools into inclusive pre-university education institutions brought with it the imperative need to ensure the holders of baccalaureate degrees access to university studies, which meant the launch of their massive transfer to the inclusive education system at the country level. It is a difficult process not only from a financial-economic point of view, although, most of the time, it is specifically referred to by those responsible at all levels, but also from a psychopedagogical, curricular, socio-community, etc. Broadly speaking, among all the problems a university faces, when it assumes the status of an inclusive institution, the material ones are the easiest to solve. Much more difficult is the change at the level of mentality, namely the success or failure of the implementation of inclusive education principles in universities ultimately depends on this aspect.

Introduction. Contemporary researchers have suggested and demonstrated the hypothesis that the elevated level of D-dimers, which is a valuable marker of coagulation and fibrinolysis activation, can predict the severity of COVID-19, pulmonary complications, and thromboembolic events before they occur. Material and methods. The bibliographic resources were analyzed and selected from databases such as PubMed, Hinari, SpringerLink, and Google Search using keywords such as “COVID-19,” “SARS-CoV-2,” “coronavirus,” “D-dimers,” “biomarkers,” and “severity prediction,” which were used in various combinations to maximize search efficiency. Therefore, the manuscript contains 51 representative articles for this synthesis article. Results. The D-dimer levels are significantly higher in patients with severe forms of COVID-19 compared to those with non-severe forms, in patients with acute respiratory distress syndrome compared to those without acute respiratory distress syndrome, and in deceased patients compared to those who have survived. D-dimers positively correlate with the degree of severity and the increased risk of progression to severe disease, inversely proportional to the survival rate. They can predict prognosis, determine therapeutic strategies, prevent complications, positively influence the disease’s course, and monitor the prognosis. Conclusions. D-dimers should be used as a pre-radiographic screening tool as early as possible after admission and as an indicator for risk stratification of venous thromboembolism in hospitalized patients with COVID-19. Based on the increase in D-dimer levels, adjusting therapeutic doses of anticoagulants is more beneficial for patients compared to administering prophylactic doses.

Sepsis is a global health challenge that causes more than 11 million deaths annually and represents a substantial medical and economic burden. With rising treatment costs and significant mortality rates associated with organ dysfunction and septic shock, research efforts have focused on investigating the mechanism of glycocalyx (GCX) degradation as well as its regenerative capacity. Therefore, GCX has become a target in therapeutic strategies.

The sciatic nerve is the largest nerve in the human body. It originates from L4-L5 and S1-S3 spinal segments of the spinal cord and travels posteriorly through the lower limb providing significant portion of innervation to this anatomical region. The surgical procedures at the infragluteal region and transgluteal approaches to the sciatic nerve involves different incisions, level of dissection and are based on good knowledge of regional anatomy. During anatomical dissection of a 75 years-old cadaver, the course of the branches of the sacral plexus, the features of their origin and innervation zones were studied. To our knowledge there is only one report of a similar variation when the sciatic nerve bifurcates and then merges until its division into the tibial and fibular nerves.

Thyroid cancer is an emerging problem worldwide. Patients undergo surgery based on the results of cytology classified according to the Bethesda System for Reporting Thyroid Cytopathology. However, patients with Bethesda III and IV often undergo surgery due to “suspicion” of malignancy. In reality up to 68% of cases do not require surgery as the mass is not malignant. Core-needle biopsy (CNB) is an emerging new diagnostic method that can be useful to diagnose thyroid malignancies. It is potentially useful in cases of Bethesda III and IV as the obtained tissue can undergo immunohistochemistry and genetic testing. We present a case of 58-year old female initially diagnosed with a thyroid mass suspicious for thyroid cancer who undergone CNB that demonstrated benign nature of the tumor and eventually undergone organ-sparing surgery.

Polyacrylamide hydrogel mammoplasty is a simple and relatively affordable surgery. However, this procedure is associated with a significant frequency of late complications, prompting its suspension in 2006. Despite this, patients continue facing long-term consequences. These include hydrogel migration, changes in breast shape and volume, granulomas, fistulas, and abscess formation. The clinical case described here presents the surgical treatment after augmentation mammoplasty with polyacrylamide hydrogel performed 35 years ago.

This article explores the factors influencing the selection and development of an emergency population alert system in the Republic of Moldova. An analysis of modern systems in Eurozone countries is conducted, along with a brief overview of their functioning. Here there are identified main factors influencing the choice of modern alert systems. The article also presents an analysis of the advantages and disadvantages of various alert technologies, at the same time it identifies the key requirements for the user interface, including the need for cross-platform software technology.

Magnetic properties of cast amorphous and nanocrystalline microwires have been reviewed considering their potential application. Microwires were produced from Co Fe Mn Cr Cu B and Si using the Taylor–Ulitovsky method. Technological aspects of the Taylor–Ulitovsky method for fabrication of glass-coated microwire with different structure are analyzed. Magnetic microwires demonstrate a large variety of magnetic behaviors, which is important for sensing applications. Depending on the chemical composition of the metallic core, for Co-, Fe- and Ni-based composition, the microwires’ properties are very different. The geometrical characteristics (diameter of metallic core and thickness of the glass) of the microwire depend on the physical properties of a metallic composition and of glass and the parameters of the heating inductor and the speed of obtaining a microwire. The diameter of metallic core in these microwires can range from 0.5 to 70 μm, and their thickness of the glass can vary from 1 to 50 μm.

Introducere. Afecțiunile musculo-scheletice (AMS) sunt cele mai frecvent raportate cauze ale bolilor profesionale. Deși profesorii afectați continuă să fie activi, mulți își încheie cariera didactică mai devreme din cauza acestor probleme de sănătate. Scopul lucrării a fost de a descrie „poziția neergonomică” la locul de muncă, afecțiunile musculo-scheletice și problemele de sănătate apărute la cadrele didactice din Republica Moldova. Material și metode. A fost realizat un studiu transversal pe un eșantion de judecată de 750 de profesori care lucrează în școlile din Republica Moldova. Indicatorii goniometrici ai posturilor de muncă au fost evaluați prin metoda fotografică și prin sincronizarea activităților ocupaționale. Prezența disconfortului musculo-scheletic și factorii asociați au fost evaluate cu ajutorul unui chestionar. Rezultate. Din cei 620 de participanți, 97% erau femei, vârsta medie – 46.6±3.77 ani. Dintre profesori, 87,5% adoptă o poziție de lucru neergonomică, datele goniometrice au arătat abateri de la unghiurile fiziologice articulare pentru radiocarpian, cot, șold, genunchi și tibio-tarsian. Unghiul de abatere a gâtului de la verticală a fost de 24,80°, abaterea umărului – 4,60°, iar abaterea trunchiului a depășit poziția fiziologică cu o medie de 17,50°. Bolile cronice ale sistemului locomotor au avut o prevalență de 37,3%, în timp ce artrita, artroza și alte modificări articulare distructive au avut o prevalență de 28,9%. Mai mult de 21,7% dintre respondenți au raportat durere la nivelul membrelor la sfârșitul zilei de lucru. Concluzii. Prevalența durerii musculo-scheletice, în special a „durerii cronice ale bolilor sistemului locomotor” (artrita, artroza, durerea la nivelul membrelor) a afectat mai mult de 1/3 dintre profesorii implicați în studiu. Aceste rezultate evidențiază nevoia implementării unor măsuri ergonomice preventive care să reducă expunerea, apoi riscul de AMS și, astfel, să minimizeze durerea cauzată de bolile cronice ale sistemului locomotor.

Introducere. Conform datelor OMS, cancerul reprezintă una din principalele cauze de deces în țările dezvoltate, cedând numai maladiilor cardiovasculare. Astfel, în fiecare an, pe glob decedează de cancer circa 10 mln de oameni. Se presupune că mortalitatea prin cancer în lume va continua să crească și până în 2030 numărul de decese de cancer va depăși cifra de 11 mln. Aproximativ 19% din toare cancerele sunt cauzate de factorii mediului ambiant, inclusiv și de condițiile de muncă nesatisfăcătoare. Se etimează că 1,3 mln. decese au loc în fiecare an din cauza factorilor profesionali. Obiective. Identificarea factorilor de risc cancerigeni ocupaționali primari și evaluarea impactului acestora asupra sănătății lucrătorilor. Material și metode. Acest studiu a folosit o metodologie de revizuire sistematică a literaturii pentru a identificarea și analiza factorii de risc asociați cu cancerul profesional și pentru a evalua strategiile preventive. Articolele au fost obținute din baze de date precum PubMed și Google Scholar publicate în ultimii 14 ani, folosind cuvinte cheie predefinite și operatori booleeni. Revizuirea a inclus studii publicate în ultimele decenii care se concentrează pe diverse industrii și expuneri profesionale. Rezultate. În UE și în alte țări dezvoltate, cancerul reprezintă un procent estimat la 53% din decesele profesionale; ca urmare, date fiabile privind expunerea profesională la factorii de risc de cancer sunt esențiale atât pentru siguranța și sănătatea lucrătorilor, cât și pentru o economie productivă și durabilă. În cazul cancerului, cauza bolii este multifactorială, iar, în prezent, există un număr mare de cancerigeni umani cunoscuți. Este bine cunoscut faptul că agenții cancerigeni profesionali rămân a patra cea mai frecventă cauză de cancer în lumea occidentală dezvoltată. Determinarea riscului de cancer profesional este complicată și mai mult de o serie de factori profesionali și neprofesionali, perioada de latență lungă pentru dezvoltarea cancerului și susceptibilitatea indivizilor la agenți cancerigeni, diferențele dintre cancerele profesionale și non-profesionale, etc. Concluzii. Argumentarea măsurilor de prevenție și promovarea sănătății populației active, precum și cunoașterea caracteristicilor cantitative ale relațiilor cauzale, au o importanță deosebită și va contribui la subestimarea bolilor profesionale.

Obiective. Leziunile traumatice prin cădere reprezintă o problemă semnificativă de sănătate globală, provoacă adesea dizabilități, mortalitate și morbiditate ridicată în întreaga lume. Căderile sunt a doua cauză de deces neintenționat la nivel mondial. Aproximativ o treime din persoanele vârstnice suferă o cădere cel puțin o dată pe an, iar această rată crește semnificativ pentru cei peste 80 de ani. Scopul prezentului studiu a fost de a identifica cauzelor producerii traumatismelor prin cădere și elaborarea măsurilor de prevenție a acestora la populația cu vârsta de 65 ani și peste, din Republica Moldova. Materiale și metode. În total, folosind bazele de date Google Scholar și PubMed au fost incluse în analiză 20 articole, selectate conform criteriilor de includere și de excludere. Datele din aceste articole, au fost evaluate, sintetizate și descrise narativ. Rezultate. Potrivit studiilor revizuite, printre factorii care pot duce la diverse traumatisme prin cădere la vârstnici se regăsesc: istoricul individual, slăbiciunea musculară și lipsa de echilibru, deficiențele vizuale, administrarea mai multor medicamente, precum sedativele, antidepresivele și antihipertensivele, deficiența de vitamina D, factori de mediu de interior și exterior, sau tulburările cognitive. Măsurile preventive pot reduce riscul de cădere, contribuind la un stil de viață independent și sigur pentru această comunitate. Concluzii. Studierea factorilor de risc, implicați în diverse traumatisme la vârstnici prin cădere ar putea ajuta factorii de decizie să adopte strategii și abordări eficiente pentru prevenirea și controlul acestora.

Poland’s syndrome is an uncommon congenital anomaly of unknown etiology, the main characteristic of which is the absence of the major pectoral muscle. Thorax and upper limb malformations also may be present. Poland’s syndrome has been observed in clinical cases connected to a variety of neoplasia, primarily hematological disorders. Patients with Poland’s syndrome who have developed breast cancer have been reported incidentally. Here we report a case of Poland’s syndrome associated with breast cancer.

This review will primarily focus on recent methods employed for the synthesis of a diverse array of chalcones with broad-ranging biological activities, with a particular emphasis on the past five years. The utilization of aromatic methyl ketones and their derivatives as starting materials for the synthesis of various heterocyclic compounds, such as chalcones, pyrazolines, dioxolanes, aminothiazoles, and more, holds significant importance in the field of synthetic organic chemistry. The synthesized heterocyclic compounds can serve as valuable subjects for testing to assess their biological activity.

Objectives. Carrying out SWOT analysis of undergraduate and postgraduate training programs to identify factors that may affect the quality, sustainability, and relevance of the program, with the aim of contributing to the training of occupational health and safety specialists. Material and methods. The SWOT analysis was carried out on four curricula, which were developed and applied in the period 2021–2023, within the Nicolae Testemitanu State University of Medicine and Pharmacy from the Republic of Moldova. Occupational health training programs are intended for students, residents, and physicians. Results. The SWOT analysis of the "Occupational Health" curriculum underscores its comprehensive approach to workplace health and the delivery of essential competencies. Strengths include clearly defined, relevant objectives, integration of related disciplines, and broad topic coverage. Nevertheless, challenges may arise from limited intersectoral collaboration and resource constraints. Opportunities lie in cross-disciplinary integration and industry partnerships, while threats stem from the rapidly evolving field and potential program stagnation. In the case of "Occupational Medicine and Occupational Diseases," it offers a practical approach but demands prerequisite knowledge and updates for sustained effectiveness. "Occupational Medicine" boasts diversity and accessibility but faces duration and funding challenges. "Workplace Health Promotion" addresses contemporary concerns but necessitates adequate funding and resources. Conclusions. Through a strategic approach and collaboration with stakeholders, the quality and relevance of the program can be ensured, contributing to the preparation of occupational health specialists for the current and future needs of the labor market.

Objectives. The transition from high school student to university student can lead to the modification of eating habits learned in the family. Sometimes the changes are not adapted to the body's needs, an aspect that must be closely followed. Material and methods. The study was carried out on a group of 162 young people from a high school and the faculty of medicine in Iasi. A weekly food consumption frequency questionnaire was applied. Results. The dominant intake of milk was once or 2-3 times a week (29.01%), with insignificant differences by collectivities. For meat products, there were 26.54% "no consumption" responses, but the calculated differences are statistically significant (p ˂ 0.05) and point to a decrease in consumption among university students. Eggs were present in the menus mostly 2-3 times (41.97%) per week, with significant differences by collectivities (p ˂ 0.05). Bread was present daily on the menus of half of the surveyed young people, with insignificant differences by collectivities. The dominant intake of potatoes was 2-3 times a week (47.53%), with statistically significant differences by collectivities (p ˂ 0.01), and for fruits, the dominant intake was daily in 29.01% of cases. The calculated differences are still statistically significant (p ˂ 0.01) and highlight the reduction in consumption among university students. Conclusions. There is a change in the students' diet, but it is not one that contributes to maintaining good health.

An operational hail suppression program has been based in Romania since 2005. The program is designed to reduce hail damage in the most vulnerable agricultural areas (protected areas) of the country. An exploratory analysis of volume-scan, S-band and C-band radars data, using a storm cell tracking software, was conducted to calculate six radar-derived parameters associated with hail from 51 seeded storms during the summers of 2017 to 2022. All selected hailstorms had a lifetime of more than one hour, which was divided into three stages: before seeding, during seeding, and after seeding. The statistical t-test was used to test the null hypothesis of no seeding effect. Comparing values before seeding and during seeding, the data support claims that seeding causes an increase in most of the analysed parameters. These can indicate the stimulation of the development of seeded clouds, due to the so-called dynamic effect. After seeding, a decrease in the values of all the parameters analysed was observed (with decreases in average values ranging between 10% to 15%). Furthermore, a spatial analysis of hail kinetic energy shows that areas with values over 300 J/m2 are lower in the protected areas compared to the neighbouring ones where the clouds have not been seeded.

Strategic management is a crucial element for the long-term success of any organization. It is a complex process involving a deep analysis of both external and internal environments, the formulation of strategies and action plans, their implementation, and the monitoring of outcomes. In this article, we will explore the key concepts and practices of strategic management, highlighting its importance in the context of contemporary business.

Extra-gastrointestinal stromal tumors arising from the pancreas are extremely rare. To date, just over 30 cases have been described in the world literature. A clinical observation of a 67-year-old patient with dull epigastric pain and a large cystic solid neoplasm instrumentally identified as an extra-gastrointestinal stromal tumor of the head of the pancreas is presented. The volume of surgical intervention consisted of pancreatogastroduodenectomy and right-sided hemicolectomy, since tumor invasion into the transverse mesocolon was detected intraoperatively. The final diagnosis of extra-gastrointestinal stromal sarcoma of the head of the pancreas with invasion into the mesocolon pT4N0M0, stage IIIb was made on the basis of histopathology and immunohistochemistry results. Extra-gastrointestinal stromal pancreatic tumors require careful differential diagnosis with other large abdominal masses. Timely diagnosis and use of modern treatment algorithms make it possible to avoid further disease progression.

Rezumat . Introducere. Erorile medicale reprezintă o problemă semnificativă. Învățând din erorile trecute, elaborând și aplicând măsuri preventive, putem obtine reducere a riscului de erori și a consecințelor lor în prestarea serviciilor medicale. Obiectiv . Elaborarea recomandărilor sub formă de măsuri sistemice pentru reducerea riscului de erori în furnizarea asistenței medicale. Material și metode. S-a realizat o sinteză a experienței în domeniul medical și juridic, analizând rapoartele auditurilor interne privind calitatea activității medicale și sursele actuale de literatură. Rezultate și discuții. Riscul de erori medicale continuă să fie unul dintre principalele riscuri în acordarea asistenței medicale, inclusiv asistența specializată. Literatura medicală a acumulat o mulțime de descrieri, clasificări și cauze ale acestor erori. Cu scopul de a reduce riscul de erori medicale în cadrul institutiei medicale, s-au elaborat o serie de recomandări sub forma unor măsuri sistematice planificate. Implementarea acestor măsuri a dus la o îmbunătățire a calității asistenței medicale, a contribuit la prevenirea erorilor medicale, caz în care persoanele care le-au comis pot fi trase la răspundere civilă și penală. Concluzii. Implementarea recomandărilor generalizate în acest studiu sub forma măsurilor sistematice planificate reduce eficient riscul erorilor medicale, frecvența și gravitatea consecințelor medicale-juridice asociate acestora. Cuvinte cheie: riscuri medicale, calitatea asistenței medicale, consecințe medico-juridice ale erorilor medicale.Summary . Systemic Approach to Reduce the Risk of Medical Errors. Background. Medical errors pose a significant problem. By learning from past mistakes, developing and applying preventive measures, we can reduce the risk of errors and their consequences in the provision of medical services. Objective of the study. Developing recommendations as systemic measures to reduce the risk of errors in providing medical care. Material and Methods. A synthesis was made of the experience in the medical and legal field, analyzing reports from internal quality audits of medical activities and relevant literature sources. Results and discussion. The risk of medical errors continues to be one of the main risks in the provision of medical care, including specialized assistance. The medical literature has accumulated a multitude of descriptions, classifications and causes of these errors. In order to reduce the risk of medical errors within the medical organization, a number of recommendations were developed in the form of planned systematic measures. The implementation of these measures led to an improvement in the quality of medical care, contributed to the prevention of medical errors, in which case the persons who committed them can be held civil and criminal liability. Conclusion. The implementation of the generalized recommendations in this study, in the form of planned systematic measures, effectively reduces the risk of medical errors, the frequency, and the severity of their medicolegal consequences.

În articol se discută importanța siguranței pacientului în cadrul unei organizații medicale. Prin intermediul unei revizuiri a literaturii și a interviurilor cu personalul medical, au fost cercetate provocările moderne și măsurile de asigurare a siguranței în domeniul medical, inclusiv cultura siguranței, educația și formarea personalului, utilizarea tehnologiei și participarea activă a pacienților. Rezultatele subliniază faptul că siguranța pacientului necesită o abordare sistemică și eforturi constante din partea tuturor participanților în organizația medicală.

Scopul. Studierea reacțiilor patologice din partea arterei brahiale (AB) la cercetarea funcției endoteliale vasculare (FE) cu aplicarea probei cu hiperemia reactivă (HR) și valoarea lor aplicativă în tratamentul pacienților cu formele grave a BPOC. Materiale şi metode. Au fost examinați 60 bărbați, vârsta medie 47,7±5,11 ani şi durata maladiei 13,0±5,4 ani, cu evoluție de gravitatea medie și gravă (conform criteriilor GOLD). Cercetarea neinvazivă a disfuncției endoteliale s-a efectuat cu utilizarea probei cu hiperemie activă, aplicând Duplex ultrasonor de rezoluție înaltă la aparatul „Logiq S8” („General Electric”, SUA) cu transductor liniar 8,0-10,0 MHz după metodă, propusă de David S. Celermajer [ ]. Diame- trul a. brahiale a fost măsurat inițial şi imediat după decompresie. Disfuncția endotelială se considera atunci când indicelefuncției endoteliale era sub 10%.Rezultate. Analiza datelor dobândite a relevat scăderea considerabilă a FE: indice FE a fost 7,14±11, 22% , cu variații între -15,0% și 29,4%. La 10 pacienți după probă cu HR a fost depistată reacția patologică din partea AB: în locul dilatării endoteliu-dependente solicitate, s-a observat reacția spastică sau negativă (în limitele între 0% și -15,0%). Paralel la toți 10 pacienți au fost vizualitate placi aterosclerotice solitare și pare în a. carotide cu stenoză lumenului în limitele 20-40% fără orice manifestări clinice. Nivelul colesterolului total și LDL-colesterol au fost crescute: 7,5±2,0 mm/l и 4,7±1,8 mm/l respectiv. Nici la unul din 10 pacienți în urma tratamentului ulterior de 5 săptămâni cu perindopril (doza medie 2,9±1,5 mg/zi) sau valsartan (doza medie 54,5±15,4 mg/zi) nu a fost relevate scăderea semnificativă a presiunii sistolice și medii în artera pulmonară.Concluzii. Reacțiile patologice din partea AB la estimarea FE cu aplicarea probei cu HR pot vi utilizate ca un crite- riu eficacității tratamentului ulterior a hipertensiunii pulmonare cu prestarium sau valsartan și pronosticul supraviețuirii pacienților cu formele grave a BPOC.

Această cercetare abordează problema aderenței la tratament a pacienților cu tuberculoză. Autorii au realizat o analiză complexă a cauzelor acestui fenomen și au propus o serie de soluții pentru a-l depăși. Studiul se bazează pe sintetizarea experienței proprii a autorilor, analiza sondajelor adresate pacienților și medicilor, precum și studiul surselor din diverse baze de citare științifică. S-a ajuns la concluzia că aderența scăzută la tratament a pacienților cu tuberculoză reprezintă o problemă serioasă, care necesită o abordare complexă și implicarea activă a tuturor părților vizate. Rezultatele lucrării pot fi utile ftiziopneumologilor, specialiștilor în domeniul sănătății, reprezentanților guvernamentali și organizațiilor non-guvernamentale care se ocupă de problema tuberculozei.

Articolul propune o analiză detaliată a percepției pe care o au medicii cu privire la erorile lor profesionale. Datele au fost colectate printr-un sondaj de opinie desfășurat printre medici. Articolul examinează factorii care contribuie la erorile medicale și modalitățile de a le reduce, punând accent pe îmbunătățirea sistemelor de raportare și creșterea conștientizării acestor probleme în cadrul comunității medicale.

Schwannomas are benign nerve sheath tumours that exhibit a slow rate of growth. In the vast majority of cases, schwannomas manifest as asymptomatic masses. The presence of symptomatic lesions may necessitate surgical removal. The incidence of schwannomas ranges from 4.4 to 5.23 cases per 100,000 population, accounting for approximately 7% of all primary tumours in the central nervous system. There is a limited number of case reports describing schwannomas outside the central nervous system. In rare instances, schwannomas may originate at the level of the thyroid gland. In such cases, incidental neck schwannomas may be mistaken for thyroid or parathyroid tumours. The increasing incidence of thyroid cancer draws more attention to all thyroid nodules, both benign and malignant. Thyroid nodules are detected in up to 65% of autopsies, with only 4–6.5% being malignant. Thyroid tumours are typically diagnosed by USG; however, they are often revealed incidentally during neck CT or MRI for other conditions. To rule out malignancy, tumour verification is required. The modern diagnosis of thyroid cancer is based on fine-needle aspiration (FNA) biopsy and cytology, which is classified according to the Bethesda classification system. However, not all FNAs are informative, and the differential diagnosis and treatment strategies in cases of unsatisfactory results are not standardized, leading to potential intraoperative challenges. We present a case study of a patient with a thyroid nodule that was ultimately diagnosed with a schwannoma of the neck according to core-needle biopsy.

This study examines the financial inclusion policies during pandemics, particularly focusing on their efficacy within emerging economies and areas dominated by informal sectors. The urgency and relevance of the topic are underscored by the heightened economic vulnerabilities these regions face during global health crises, such as the COVID-19 pandemic, which starkly amplify the necessity for robust financial inclusion to uphold economic resilience. The primary objectives of this paper are twofold: firstly, to critically assess the array of financial inclusion policies deployed during pandemics, and secondly, to pinpoint potential policy enhancements informed by contemporary research alongside successful international implementations. Employing a mixed-methods approach, the research synthesizes quantitative data on policy outcomes with qualitative insights from policy analyses and stakeholder interviews. This methodology allows for a nuanced understanding of the multifaceted impacts of financial inclusion initiatives and their adaptability to crisis conditions. Key findings highlight the pivotal role of digital financial services, effective public-private collaborations, and the establishment of adaptive social support mechanisms in promoting financial inclusivity amidst pandemic-induced economic disruptions. These strategies emerge as crucial levers for advancing financial inclusion, providing valuable lessons for crafting policies that are resilient, targeted, and capable of fostering sustainable economic growth and stability in the face of ongoing and future global challenges. The study's insights offer critical guidance for policymakers and financial institutions seeking to enhance financial inclusion frameworks, thereby contributing to the development of more inclusive, equitable, and resilient financial ecosystems worldwide.

Ipoteza de profitare de imposibilitatea victimei de a-și exprima voința deja este avută în vedere în art. 171 și 172 din Codul penal al R. Moldova. De aceea, nu este necesară completarea Codului penal al R. Moldova cu articole similare cu art. 2181 și 2191 din Codul penal al României. O astfel de completare ar dubla prevederile art. 171 și 172 din Codul penal al R. Moldova în respectiva ipoteză. Soluția este aplicarea eficientă a art. 171 și 172 din Codul penal al R. Moldova în cazul în care făptuitorul profită de imposibilitatea victimei minore de a-și exprima voința.

This study examines the inequalities identified in the tax system of the Republic of Moldova, analysing, for the most part, the single rate of 12%, which, moreover, contributes to the accentuation of social and economic disparities, because with the introduction of the proportional system of taxation, there has been an increase in the level of inequality in the country. The author points out that a flat rate significantly benefits those with higher incomes, as the percentage applied is uniform for all taxpayers. The arguments put forward to prove this theory are based on analysis of tax data. Thus, those with higher financial incomes are advantaged, while those with lower incomes – bear a proportionately higher burden. The article highlights the need for an overhaul of the tax system to eliminate this inequality and promote a fairer distribution of the tax burden in order to reduce social inequality.

Introduction: Renal lobulation (also known as fetal or embryonic lobulation) is a rare variation during development in which renal lobules have a visible anatomical space between them, and this can be seen in 0.5–4% of adults. Material and methods: this study was conducted on 54 human kidneys from patients who died due to causes unrelated to renal pathology which were fixed in a 10% formaldehyde solution and then carefully dissected. Results: The group with fetal lobulation (n = 16) was associated with a length M = 9.89 (SD = 0.6, p = 0.15). By comparison, the kidneys without lobulation (n = 38) were associated with a numerically longer length M = 10.29 (SD = 0.607, p = 0.098). To test the hypothesis that lobulation is associated with a statistically significant different length a Mann–Whitney test was performed, which indicated that the length of the kidneys is smaller in scase of lobulation U = 198, Z = −2.04, p = 0.04. Cross-tabulation also demonstrated that kidney lobulation may be influenced by the presence of polar arteries with r = 0.41 (p < 0.02). The likelihood ratio was 7.28, df 1, p = 0.003, with an odds ratio of 6.857 (CI 95% = 1.84–25.61). Logistic regression analysis demonstrated that kidneys with lobulation were 6.85 times more likely to have polar arteries than kidneys without lobulation. Conclusions: the data from our research indicate that even though no pathological conditions have been linked with lobulated kidneys, the incidence of vascular variations (specifically polar arteries) is higher when there is persistent fetal lobulation.

Aim: The aims of this study were to evaluate the demographics and crash profiles of road traffic-related traumatic brain injury (TBI) patients treated at two emergency departments in the Republic of Moldova, and to identify areas for prevention. Materials and methods: A prospective study was conducted using data from the medical records of a pilot TBI registry from the emergency departments of two large hospitals in Moldova. The study sample included patients with TBI related to road traffic mechanisms from March 1 to August 31, 2019. Results: During the study period, 368 patients were included in the TBI registry, with 113 (30.7%) of them having TBIs caused by traffic. Children under the age of 18 (44.2%), people aged 30-49 (18.6%), and males (71.7%) were the largest proportions of the road traffic-related TBI patient population. Most (78.8%) of the TBI injuries occurred in a transportation area (street, road, highway, etc.), among children under age of 18, while walking (36.7%) or riding in a passenger vehicle (68.4%). Pedestrians (42.5%) accounted for the most cases, followed by passengers (33.6%) and drivers (23.9%). Over two-thirds of all cases were tested for alcohol. Most cases were in June (20.4%) and between 2 pm and 6 pm (29.2%) within the research period. Conclusions: This is the first study to examine the road traffic-related traumatic brain injuries in the Republic of Moldova, which underlines the high burden of injuries among males, children, and the middle-aged population. Results from this study will help to support the development of a country’s national TBI registry and can argue for the running of comprehensive measures in road injury prevention targeted to the most affected populations

Data-driven computational analysis is becoming increasingly important in biomedical research, as the amount of data being generated continues to grow. However, the lack of practices of sharing research outputs, such as data, source code and methods, affects transparency and reproducibility of studies, which are critical to the advancement of science. Many published studies are not reproducible due to insufficient documentation, code, and data being shared. We conducted a comprehensive analysis of 453 manuscripts published between 2016–2021 and found that 50.1% of them fail to share the analytical code. Even among those that did disclose their code, a vast majority failed to offer additional research outputs, such as data. Furthermore, only one in ten articles organized their code in a structured and reproducible manner. We discovered a significant association between the presence of code availability statements and increased code availability. Additionally, a greater proportion of studies conducting secondary analyses were inclined to share their code compared to those conducting primary analyses. In light of our findings, we propose raising awareness of code sharing practices and taking immediate steps to enhance code availability to improve reproducibility in biomedical research. By increasing transparency and reproducibility, we can promote scientific rigor, encourage collaboration, and accelerate scientific discoveries. We must prioritize open science practices, including sharing code, data, and other research products, to ensure that biomedical research can be replicated and built upon by others in the scientific community.

Objectives. To systematically review the complex relationship between cardiovascular comorbidities and lung cancer, focusing on their impact on patient prognosis, treatment outcomes, and quality of life, with special emphasis on non-small-cell lung cancer (NSCLC). Methods. A comprehensive literature search was conducted across databases such as PubMed, MEDLINE, and Google Scholar. A total of 137 studies examining the following aspects were included: Prevalence of cardiovascular comorbidities (e.g., coronary artery disease, heart failure, arrhythmias, valvular disease, thromboembolic events) in lung cancer patients; Prognostic implications of cardiovascular comorbidities across different stages of lung cancer; Impact of cardiovascular complications arising from cancer treatments (chemotherapy, radiotherapy); Assessment of quality of life in lung cancer patients with cardiovascular comorbidities. Results. The prevalence of various cardiovascular comorbidities in lung cancer patients across different stages remains high. Prognostic impact of pre-existing cardiovascular comorbidities, especially in early-stage lung cancer remains negative. Cancer therapies can exacerbate existing cardiovascular conditions or induce new complications, significantly reducing the quality of life in patients with both lung cancer and cardiovascular comorbidities. Conclusions. To mitigate the risk of cardiovascular complications in lung cancer patients with comorbidities, a comprehensive approach is necessary. This includes proactive cardiovascular risk assessment and management throughout all stages of lung cancer treatment, the development of treatment strategies tailored to individual patient risk profiles, and continued research into the underlying mechanisms of cardiovascular complications in lung cancer.