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Talida Georgiana Cut,1– 5 Veronica Ciocan,4,6 Dorin Novacescu,3,5 Adrian Voicu,7 Adelina Raluca Marinescu,1,2 Voichita Elena Lazureanu,1,2 Camelia Oana Muresan,4,6 Alexandra Enache,4,6 Raluca Dumache4,6 1Department of Infectious Diseases, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 2Victor Babes Clinical Hospital of Infectious Diseases and Pneumophtisiology Timisoara, Timisoara, Romania; 3Doctoral School Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 4Center for Ethics in Human Genetic Identifications, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 5Academy of Romanian Scientists, Bucharest, Romania; 6Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania; 7Department of Medical Informatics and Biostatistics, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, RomaniaCorrespondence: Veronica Ciocan, Department of Forensic Medicine, Bioethics, Deontology and Medical Law, Victor Babes University of Medicine and Pharmacy Timisoara, Timisoara, Romania, Tel +40722944453, Email veronica.ciocan@umft.roPurpose: The systemic inflammatory response related to COVID-19 can be easily investigated in living patients. Unfortunately, not every biomarker is suitable for postmortem analysis since several factors may interfere. The aim of this study was to summarize key histopathological findings within each organ system due to COVID-19 and to assess if serological inexpensive and widely available biomarkers such as CRP, IL-6, fibrinogen and d-Dimers, associated with adverse outcomes in COVID-19, can be implemented in a post-mortem assessment.Patients and Methods: A total of 60 subjects divided in 2 groups were included. All subjects died outside a hospital setting and therefore did not receive specific or symptomatic therapies that could have modulated the inflammatory response. The first group included 45 subjects in which mandatory autopsy was performed in order to establish the cause of death and macroscopic examination of the lungs was highly suggestive of SARS-CoV-2 infection. As controls (Group 2), 20 subjects who died from polytrauma in high velocity car accidents and suicide were selected. Bronchial fluids collected during the autopsy procedure were used for the RT-PCR diagnosis of SARS-CoV-2 and serum samples were sent for analysis of IL-6, CRP, d-Dimers and fibrinogen.Results: Compared with the control group, the subjects of the COVID-19 group were older (59± 19.5 vs.38± 19.15 years, p=0.0002) and had more underlying comorbidities such as hypertension (60% vs 35%, p=0.06) or were overweight (53.3% vs 30%, p=0.08). The levels of CRP, IL-6, fibrinogen and d-Dimers in postmortem plasma samples were significantly higher in COVID-19 subjects than in control group (p< 0.0001). Moreover, the level of IL-6 was significantly higher in overweight patients (r=0.52, P< 0.001). In all COVID-19 subjects, the histological examination revealed features corresponding to the exudative and/or proliferative phases of diffuse alveolar damage. Large pulmonary emboli were observed in 7 cases. Gross cardiac enlargement with left ventricular hypertrophy was observed in 19 cases. The most frequent pathological finding of the central nervous system was acute/early-subacute infarction.Conclusion: Due to the complexity of the inflammatory response, we postulate that a combination of biomarkers, rather than a single laboratory parameter, might be more effective in obtaining a reliable postmortem COVID-19 diagnosis.Keywords: COVID-19, postmortem, diffuse alveolar damage, interleukin-6, C reactive protein

Using a model of inputs-environment-process-outcomes, our focus is the students' point of view on writing the master's thesis in accounting. We analyze the factors that influence the complexity of a thesis and the satisfaction of students with it. We used the answers received on two matched questionnaires distributed during the second semester of the academic year 2021-2022. The results of the path analysis show that planning and involvement in research and university support can increase the effectiveness of students' time management and improve satisfaction with the research outcome. Resource use increases the thesis complexity, too. The paper comprises a couple of implications: first, the quality of the thesis depends to a great extent on the initial planning phase, indicating that university support is crucial during preliminary work; second, university management must ensure the existence of necessary resources, which are a complex mix of supervision, collaboration, guidelines, and scientific sources.

An impressive number of researchers have studied the resilience of communities, which is not surprising considering that the community represents an entire world that can be approached through different angles and lenses by different scientific areas. Soon digital space was perceived as a new playground for deception, and Metaverse may be the next target due to the increased exposure of users and their information to vulnerabilities and risks. This article explores the key strategies presented in the literature to combat online disinformation within the Metaverse, indicating the most effective suggestions to enhance community resilience. Emphasis is placed on the importance of equipping community members with tools and strategies to ensure physical well-being and quality of life. Additionally, individuals should learn and apply concrete strategies to maintain comfort and safety in virtual environments, which can be metaphorically referred to as "techniques of digital self-defence in the Metaverse”. To facilitate the education of individuals for this purpose, a prototype application where concrete scenarios can be provided for testing has been proposed.

Abstract The digitization of medicine will play an increasingly significant role in future years. In particular, telemedicine, Virtual Reality (VR) and innovative Artificial Intelligence (AI) systems offer tremendous potential in imaging diagnostics and are expected to shape ultrasound diagnostics and teaching significantly. However, it is crucial to consider the advantages and disadvantages of employing these new technologies and how best to teach and manage their use. This paper provides an overview of telemedicine, VR and AI in student ultrasound education, presenting current perspectives and controversies.

Abstract Background Cardiac arrest remains a global health issue with limited data on long-term outcomes, particularly regarding recurrent cardiovascular events in patients surviving out-of-hospital cardiac arrest. (OHCA). We aimed to describe the long-term occurrence of major cardiac event defined by hospital admission for cardiovascular events or death in OHCA hospital survivors, whichever came first. Our secondary objective were to assess separately occurrence of hospital admission and death, and to identify the factors associated with major event occurrence. We hypothesized that patients surviving an OHCA has a protracted increased risk of cardiovascular events, due to both presence of the baseline conditions that lead to OHCA, and to the cardiovascular consequences of OHCA induced acute ischemia-reperfusion. Methods Consecutive OHCA patients from three hospitals of Sudden Death Expertise Center (SDEC) Registry, discharged alive from 2011 to 2015 were included. Long-term follow-up data were obtained using national inter-regime health insurance information system (SNIIRAM) database and the national French death registry. The primary endpoint was occurrence of a major event defined by hospital admission for cardiovascular events and death, whichever came first during the follow-up. The starting point of the time-to-event analysis was the date of hospital discharge. The follow-up was censored on the date of the first event. For patients without event, follow-up was censored on the date of December, 29th, 2016. Results A total of 306 patients (mean age 57; 77% male) were analyzed and followed over a median follow-up of 3 years for hospital admission for cardiovascular event and 6 years for survival. During this period, 38% patients presented a major event. Hospital admission for cardiovascular events mostly occurred during the first year after the OHCA whereas death occurred more linearly during the all period. A previous history of chronic heart failure and coronary artery disease were independently associated with the occurrence of major event (HR 1.75, 95%CI[1.06-2.88] and HR 1.70, 95%CI[1.11-2.61], respectively), whereas post-resuscitation myocardial dysfunction, cardiogenic shock and cardiologic cause of cardiac arrest did not. Conclusion Survivors from OHCA must to be considered at high risk of cardiovascular event occurrence whatever the etiology, mainly during the first year following the cardiac arrest and should require closed monitoring.

Abstract Background We assessed the effect of noninvasive ventilation (NIV) on mortality and length of stay after high flow nasal oxygenation (HFNO) failure among patients with severe hypoxemic COVID-19 pneumonia. Methods In this multicenter, retrospective study, we enrolled COVID-19 patients admitted in intensive care unit (ICU) for severe COVID-19 pneumonia with a HFNO failure from December 2020 to January 2022. The primary outcome was to compare the 90-day mortality between patients who required a straight intubation after HFNO failure and patients who received NIV after HFNO failure. Secondary outcomes included ICU and hospital length of stay. A propensity score analysis was performed to control for confounding factors between groups. Exploratory outcomes included a subgroup analysis for 90-day mortality. Results We included 461 patients with HFNO failure in the analysis, 233 patients in the straight intubation group and 228 in the NIV group. The 90-day mortality did not significantly differ between groups, 58/228 (25.4%) int the NIV group compared with 59/233 (25.3%) in the straight intubation group, with an adjusted hazard ratio (HR) after propensity score weighting of 0.82 [95%CI, 0.50–1.35] (p = 0.434). ICU length of stay was significantly shorter in the NIV group compared to the straight intubation group, 10.0 days [IQR, 7.0-19.8] versus 18.0 days [IQR,11.0–31.0] with a propensity score weighted HR of 1.77 [95%CI, 1.29–2.43] (p

Additive manufacturing facilitates the production of parts with tailored mechanical properties, yet achieving specific stress–strain responses remains a significant challenge due to the intricate relationship between printing parameters and material behaviour. This study introduces a novel approach utilising long short-term memory (LSTM) models to predict parameter configurations for material extrusion additive manufacturing (MEX) parts, aiming to meet specific stress–strain requirements. The proposed framework transforms raw tensile test data for LSTM compatibility, yielding a coefficient of determination of 0.8648 and a mean square error of 0.1348 in inverse prediction tasks. Additionally, validation with new data resulted in an error percentage below 2%. Our approach enables the efficient design of customised parts with accurate mechanical properties, reducing the need for extensive experimentation and allowing adaptation to various additive manufacturing processes.

“EU Citizenship Law” by Niamh Nic Shuibhne explores the legal framework and developments shaping European Union citizenship. The 640-page book emphasizes the value of solidarity, examining how EU citizenship promotes cooperation and mutual assistance among Member States to address shared challenges and build a cohesive Union. Key topics include the balance between solidarity and financial responsibility, evolving interpretations by the EU Court, and the impact on social cohesion and integration. Concluding with a reflection on EU citizenship's imperfect yet extraordinary nature, Shuibhne underscores its potential to enhance legal protections and uphold European values. This comprehensive work is an essential resource for law students and practitioners across the EU and those aspiring to membership.

Objectives. This study is relevant to understanding the quality of life (QOL) among elderly individuals in Romania. With an increasing aging population, it is crucial to examine the factors contributing to older adults' well-being and life satisfaction. By investigating the connections between the meaning of life, QOL, and life satisfaction, this study sheds light on the subjective experiences and perceptions of elderly individuals residing in private homes and institutions. Material and Methods. The sample included 200 individuals aged sixty or older from Bucharest, evenly distributed between the two groups. Regression analysis, using perceived social support as a mediator and life satisfaction as the dependent variable, utilized the "presence of meaning" subscale from Steger's Meaning in Life Questionnaire. IBM S.P.S.S. software facilitated data analysis, employing Kruskal-Wallis and Pearson correlation tests alongside descriptive statistics. Education, health, children count, and residence's impact on meaning in life were explored. Results. A significant positive influence of "presence of meaning" and "perceived social support" on life satisfaction was found, explaining 44.8% of its variance. Sobel's mediator test confirmed the significant role of perceived social support in mediating the link between the presence of meaning and life satisfaction. Meaning varied significantly across education levels, with higher education correlating with greater meaning. Institutionalized and childless individuals reported lower meaning compared to those at home and with children. Furthermore, positive correlations emerged between meaning and self-rated health and the EQ Index reflecting health preferences. Stronger personal meaning related to better self-rated health and higher EQ Index scores. Conclusions. This study underscores personal meaning's predictive value, the mediating role of perceived social support in life satisfaction, and the influence of education, living situation, children count, and perceived quality of life on meaning perception among older adults. These findings enhance comprehension of factors impacting satisfaction and meaning perception in this demographic group.

Quality in education represents a predictor of education for sustainability development. This article aims to measure: (a) the level of satisfaction perceived by students regarding the development of the didactic communication process (OS1) (b) the assessment of the importance given by the student to the organizational and didactic practices necessary to increase the quality of university education (OS2). The research is quantitative, and its specific tools were designed considering the following variables: (a) dependent variables: satisfaction, and knowledge, and (b) independent variables: indicators of effective communication quality, teacher competencies, effective learning practices, quality of training, importance and performance in training professional and transversal skills, indicators of conflict of interest and ethical dilemmas. The data processing aimed at determining the average scores for each dimension investigated and their ranking was based on the values obtained for each provided subsample. The resulting values have an average score of 1.45 and 1.34, respectively, revealing a relatively small distance between those two dimensions. This leads us to appreciate that students know the role, place and importance of the learning environment in increasing academic performance. Providing support services for students is also perceived as important since the average score obtained is 1.23 - not far from the average of those related to the learning environment. Didactic communication contributes to the efficiency of the didactic process; it is appreciated that empathy, personal integrity and expressiveness are the attributes that any teacher must possess; compliance with the rules can be considered a pillar of academic quality and academic success. At the ranking level, those dimensions rank first in importance, followed by “learning autonomy” (second place), ensuring an adequate learning environment (third place) and providing support services for students (fourth place).