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Abstract Nutcracker syndrome and Wilkie syndrome are rare and often diagnosed incidentally during imaging investigations for other conditions and, on occasion, together. In this paper, we present the case of a 36-year-old patient with quasi-permanent symptoms including epigastralgia, loss of appetite, early satiety, left lumbar colic pain, normal stool and dysuria. The clinical examination revealed a non-distended abdomen, sensitivity to palpation in the epigastrium and hypogastrium regions, frequent urination in small amounts, and a body mass index (BMI) of 15 kg/m2, indicating severe protein calorie malnutrition. Laboratory tests indicated persistent microscopic hematuria without proteinuria with repeated urinary infections. Abdominal-pelvic ultrasound with Doppler revealed a left renal vein dilated up to 10 mm in the left paraaortic region (Nutcracker syndrome) and distal duodenal obstruction with distension in the same region, which was also confirmed by gastroduodenoscopy (Wilkie syndrome). Abdominal‒pelvic computed tomography angiography revealed a malformed and dilated left renal vein that was compressed as a result of aorto-mesenteric obstruction and communicating with an aberrant left paravertebral and paraspinal network extending to L1 and L5 and thrombosis of the left ovarian vein. The patient benefitted from conservative treatment, which intended to correct the malabsorption syndrome with the help of a nutritionist, who suggested a personalized diet to help gain weight. As a result, the patient was able to avoid surgical treatment. The case is peculiar in that the patient presented with a very rare form of Nutcracker syndrome (posterior type) associated with another rare syndrome, Wilkie syndrome.

Recenzie: The European Atlas of ResilienceEditori: Alexandru Bănică, Mihail Eva, Corneliu Iațu, Peter Nijkamp, Gabriela Carmen PascariuIaşi: Editura Universității „Alexandru Ioan Cuza”, 2021ISBN: 978-606-714-665-3

The actions undertaken by Romania, as an active participant in the sustainable policies of the European Union in the field of waste management, aim to permanently minimize the amount of waste generated, recycling, reuse and higher valorisation to ensure a sustainable management of resources and environmental protection. Increasing the degree of valorisation and obtaining secondary raw materials through the management of waste resulting from mining and metallurgical activities, recognized by very large quantities generated and stored, is the objective of extensive research activities. This paper presents the results of the research carried out in order to valorise red mud and mine tailings wastes by incorporation into construction materials with the main aim of reducing the polluting effect of the waste but also the partial substitution of the basic raw materials from the classic construction materials (cement, clay). The new construction materials (mortars, respectively ceramic materials), by substituting the silico-aluminous component from the basic raw material of the classic construction materials were obtained. The properties of the new construction materials are similarly to the classic materials. The specific pollutants presents in the wastes was retained, which leads to the reduction of the impact on the environment. The impact generated by the implementation of the optimal technological solution was analysed, compared to the impact on the environment due to the storage of the two wastes and the impact produced during the manufacture of classic materials.

Aim of the study. Infrared thermography can be successfully used to obtain data about the functionality of the denture bearing mucosa of removable denture wearers. The purpose of the study was to test the distribution of the thermal field as concerns the symmetry and uniformity at the level of the support maxillary mucosa of mobile prosthesis wearers, with or without Candida-associated denture stomatitis (CADS). Materials and Methods. A cross-sectional study was conducted upon subjects with different prosthetic status (n=66) placed into five groups: G1- complete denture wearers on the maxillary arch with CADS (n=22); G2- complete denture wearers on the maxillary arch with recent prostheses (n=12); G3- complete denture wearers on the maxillary arch with old prostheses (n=12); G4 – edentulous subjects without maxillary dentures (n=10); G5- dentate subjects (n=10). Biological samples for Candida were taken from all subjects, with inoculations on Sabouraud Dextrose medium enriched with chloramphenicol and thermography with ThermaCAM PM350 at the level of the maxillary mucosa and of the inner sides of the upper dentures for the subjects distributed in G1-G3. Results. The proportion of subjects for which the distribution of the thermal field at the level of the mucosa showed neither symmetry nor uniformity was significantly higher for the cases with CADS compared to the other 4 groups (symmetry/uniformity: p < 0.0001); the share of subjects for which the distribution of the thermal field showed neither symmetry nor uniformity was statistically significantly higher among the edentulous with CADS, compared to the other 2 groups (symmetry p < 0.0001; uniformity p = 0.004). Although the statistical threshold was not reached, among all the clinical cases with intact maxillary mucosa, the most frequent disturbances of the thermal architecture were found among the wearers of long-standing maxillary prostheses. Conclusion. Asymmetrical temperature distribution on the maxillary denture bearing mucosa as detected from thermal images coincides well with infective-inflammatory conditions such as Candida-associated denture stomatitis but can also be frequently detected in healthy maxillary mucosa in wearers of old complete dentures.

Abstract Water is characterized by strong intermolecular hydrogen bonds (H-bonds) between molecules. The two hydrogen atoms in one water molecule can form H-bonds of dissimilar length. Although intimately connected to water’s anomalous properties, the details and the origins of the asymmetry have remained elusive. We study water’s H-bonds using the O-D stretching vibrations as sensitive reporters of H-bonding of D2O and HOD in dimethylformamide. Broader inhomogeneous linewidths of the OD band of HOD compared to the symmetric and asymmetric OD stretching modes of D2O together with density functional theory calculations provide evidence for markedly anti-correlated H-bonds: water preferentially forms one weak and one strong H-bond. Coupling peaks in the spectra for D2O directly demonstrate anti-correlated H-bonds and these anti-correlations are modulated by thermal motions of water on a sub-picosecond timescale. Experimentally inferred H-bond distributions suggest that the anti-correlations are a direct consequence of the H-bonding potential of XH2 groups, which we confirm for the ND2 group of urea. These structural and dynamic insights into H-bonding are essential for understanding the relationship between the H-bonded structure and phase behavior of water.

Abstract The long-term consequences of cancer and its therapy on the patients’ immune system years after cancer-free survival remain poorly understood. Here, we present an in-depth characterization of the bone marrow immune ecosystem of multiple myeloma long-term survivors, from initial diagnosis up to 17 years following a single therapy line and cancer-free survival. Using comparative single-cell analyses combined with molecular, genomic, and functional approaches, we demonstrate that multiple myeloma long-term survivors exhibit pronounced alterations in their bone marrow microenvironment associated with impaired immunity. These immunological alterations were frequently linked to an inflammatory immune circuit fueled by the long-term persistence or resurgence of residual myeloma cells. Notably, even in the complete absence of any detectable residual disease for decades, sustained changes in the immune system were observed, suggesting an irreversible ‘immunological scarring’ caused by the initial exposure to the cancer and therapy. Collectively, our study provides key insights into the molecular and cellular bone marrow ecosystem of long-term survivors of multiple myeloma, revealing both reversible and irreversible alterations in the immune compartment.

Abstract Background Worldwide, rural populations are recognized to be exposed to increased health challenges due to their living and working environment, socioeconomic status, and access to health services. According to the Romanian Country Health Profile 2023, approximately 46% of all deaths recorded in Romania in 2019 could be attributed to behavioral risk factors such as tobacco smoking, dietary risks, alcohol consumption and low physical activity. No data on rural versus urban areas are available to date, and research is needed to document health inequalities, identify barriers to health services, and explore solutions. Methods This study is an analysis of data collected during the Health Evaluation Survey carried out by the National Institute of Public Health in 2022 and aimed to reveal differences in health risk factors between rural and urban areas. The analysis was carried out under the methodological framework of the Health Evaluation Survey 2022, which is coordinated by the National Institute of Public Health. Results Our study’s objectively measured data revealed that the overall health profile of rural communities is characterized by lower education levels, lower incomes, and higher binge drinking rates than those of their urban counterparts. Additionally, rural inhabitants more often have high blood pressure, are more overweight and obese (per body mass index measurements) and have higher fasting plasma glucose. The health profile of the urban population revealed higher education levels and greater proportions of people with adequate monthly income, people with daily alcohol consumption, people who smoke, and people with hypercholesterolemia. Access to primary health care evaluated through proxy indicators was lower in rural areas but was relatively good overall. Conclusions Our analysis of the health profile of rural communities revealed a greater prevalence of obesity and overweight, especially among women, and an increased prevalence of heavy drinking among men. Access to primary health care evaluated through proxy indicators is lower in rural areas but is relatively good overall. Lower education levels and the possibility of lower health literacy underpin the need for targeted health education campaigns. Sustainable strategies for rural health need to be identified, especially in the field of health promotion and disease prevention programs. Trial registration This study is observational research involving human participants where no interventions were applied to the study population.

One of the hallmarks of Alzheimer’s disease (AD) is the deposition of amyloid-β (Aβ) within the extracellular spaces of the brain as plaques and along the blood vessels in the brain, a condition also known as cerebral amyloid angiopathy (CAA). Clusterin (CLU), or apolipoprotein J (APOJ), is a multifunctional glycoprotein that has a role in many physiological and neurological conditions, including AD. The apolipoprotein E (APOE) is a significant genetic factor in AD, and while the primary physiological role of APOE in the brain and peripheral tissues is to regulate lipid transport, it also participates in various other biological processes, having three basic human forms: APOE2, APOE3, and APOE4. Notably, the APOE4 allele substantially increases the risk of developing late-onset AD. The main purpose of this review is to examine the roles of CLU and APOE in AD pathogenesis in order to acquire a better understanding of AD pathogenesis from which to develop targeted therapeutic approaches.

Abstract Aims Systemic amyloidosis represents a heterogeneous group of diseases resulting from amyloid fibre deposition. The purpose of this study is to establish a differential diagnosis algorithm targeted towards the two most frequent subtypes of CA. Methods and results We prospectively included all consecutive patients with ATTR and AL evaluated between 2018 and 2022 in two centres in a score derivation cohort and a different validation sample. All patients had a complete clinical, biomarker, electrocardiographic, and imaging evaluation. Confirmation of the final diagnosis with amyloid typing was performed according to the current international recommendations. The study population included 81 patients divided into two groups: ATTR (group 1, n = 32: 28 variant and 4 wild type) and AL (group 2, n = 49). ATTR patients were younger (50.7 ± 13.9 vs. 60.2 ± 7.3 years, P = 0.0001), and significantly different in terms of NT‐proBNP [ATTR: 1472.5 ng/L (97–4218.5) vs. AL 8024 ng/L (3058–14 069) P = 0.001], hs‐cTn I [ATTR: 10 ng/L (4–20) vs. AL 78 ng/L (32–240), P = 0.0002], GFR [ATTR 95.4 mL/min (73.8–105.3) vs. AL: 68.4 mL/min (47.8–87.4) P = 0.003]. At similar left ventricular (LV) wall thickness and ejection fraction, the ATTR group had less frequently pericardial effusion (ATTR: 15% vs. AL: 33% P = 0.0027), better LV global longitudinal strain (ATTR: −13.1% ± 3.5 vs. AL: −9.1% ± 4.3 P = 0.04), RV strain (ATTR: −21.9% ± 6.2 vs. AL: −16.8% ± 6 P = 0.03) and better reservoir function of the LA strain (ATTR: 22% ± 12 vs. AL: 13.6% ± 7.8 P = 0.02). Cut‐off points were calculated based on the Youden method. We attributed to 2 points for parameters having an AUC > 0.75 (NT‐proBNP AUC 0.799; hs‐cTnI AUC 0.87) and 1 point for GFR (AUC 0.749) and TTE parameters (GLS AUC 0.666; RV FWS AUC 0.649, LASr AUC 0.643). A score of equal or more than 4 points has been able to differentiate between AL and ATTR (sensitivity 80%, specificity 62%, AUC = 0.798). The differential diagnosis score system was applied to the validation cohort of 52 CA patients showing a sensitivity of 81% with specificity of 77%. Conclusions CA is a complex entity and requires extensive testing for a positive diagnosis. This study highlights a series of non‐invasive checkpoints, which can be useful in guiding the decision‐making process towards a more accurate and rapid differential diagnosis.

Abstract Recent advances in spatial transcriptomics (ST) techniques provide valuable insights into cellular interactions within the tumor microenvironment (TME). However, most analytical tools lack consideration of histological features and rely on matched single-cell RNA sequencing data, limiting their effectiveness in TME studies. To address this, we introduce the Morphology-Enhanced Spatial Transcriptome Analysis Integrator (METI), an end-to-end framework that maps cancer cells and TME components, stratifies cell types and states, and analyzes cell co-localization. By integrating spatial transcriptomics, cell morphology, and curated gene signatures, METI enhances our understanding of the molecular landscape and cellular interactions within the tissue. We evaluate the performance of METI on ST data generated from various tumor tissues, including gastric, lung, and bladder cancers, as well as premalignant tissues. We also conduct a quantitative comparison of METI with existing clustering and cell deconvolution tools, demonstrating METI’s robust and consistent performance.

This article presents the world energy situation, the importance of energy transition, and it further designates hydrogen as a potential replacement for natural gas. Moreover, the paper specifies that the energy transition will be carried out gradually, sustained by conventional resources. Hydrogen can be mixed with natural gasses in current networks, but additional risks must be considered. These risks prove to be minimal in the distribution sector if the hydrogen fraction is kept within acceptable limits, and if optimal operation and safety measures are enforced. The behavior of the hydrogen-natural gas mixture, also called HENG , is studied based on distinguishing the physical and chemical properties of hydrogen and natural gas. In order to analyze the true behavior of the mixture in a distribution network, a numerical simulation was undertaken, whose analysis shows that there is a tight connection between the concentration of hydrogen in the system, consumption, and linepack , and the operational limits of the network must be established based on these data. Knowing the behavior, strategies and regulations can be drafted in order to safely exploit natural gas-hydrogen distribution networks. However, every distribution network has its own particularities, which is why additional studies both at theoretical as well as practical level, performed on real distribution networks, are needed.

An important indicator of the integrity of the biosphere is biological diversity. Rapid changes in global climate directly affect the biodiversity of ecosystems as a whole. Tuva is a region with unique land-scapes that determine the biodiversity of flora and fauna with globally significant endemic and rare species. The patterns of formation and development of communities of small mammals are considered; the role of factors of the physical-geographical environment, phylogeographic distribution of individual species and their phylogenetic relationships in the formation of certain communities is presented as part of the general law of the formation of biological diversity. The modifying influence of global and regional climate factors is shown, which leads to the exchange of communities within bioclimatic zones: the relative abundance and expansion of the range of humid territories increases; with the expansion of the pika's range, the ranges of specialized seed eaters also expand; an expansion of the ranges of forest species into the steppe zone and a reduction in the number of species in desert and dry steppe zones is recorded.

IntroductionNadofaragene firadenovec (Ad-IFNα/Syn3) is now approved for BCG-unresponsive bladder cancer (BLCA). IFNα is a pleiotropic cytokine that causes direct tumor cell killing via TRAIL-mediated apoptosis, angiogenesis inhibition, and activation of the innate and adaptive immune system. We established an immunocompetent murine BLCA model to study the effects of murine adenoviral IFNα (muAd-Ifnα) gene therapy on cancer cells and the tumor microenvironment using a novel murine equivalent of Nadofaragene firadenovec (muAd-Ifnα).MethodsTumors were induced by instilling MB49 cells into the bladders of mice; luciferase imaging confirmed tumor development. Mice were treated with adenovirus control (Ad-Ctrl; empty vector), or muAd-Ifnα (3x1011 VP/mL), and survival analysis was performed. For single-cell sequencing (scRNAseq) analysis (72h), bladders were harvested and treated with collagenase/hyaluronidase and TrypLE for cell dissociation. Single cells were suspended in PBS/1% FBS buffer; viability was assessed with Vicell cell counter. scRNAseq analysis was performed using 10X genomics 3’ sequencing. Raw RNAseq data were pre-processed using Cell Ranger single-cell software. Seurat (R package) was used to normalize and cluster the scRNA data. Pooled differential gene expression analysis in specific cell clusters was performed with DESeq2.ResultsWe identified 16 cell clusters based on marker expression which were grouped into epithelial (tumor), uroplakin-enriched, endothelial, T-cells, neutrophils, and macrophage clusters. Top differentially expressed genes between muAd-Ifnα and Ad-Ctrl were identified. Within the specific cell clusters, IPA analysis revealed significant differences between muAd-Ifnα and control. IFNα signaling and hypercytokinemia/chemokinemia were upregulated in all clusters. Cell death pathways were upregulated in tumor and endothelial clusters. T-cells demonstrated upregulation of the immunogenic cell death signaling pathway and a decrease in the Th2 pathway genes. Macrophages showed upregulation of PD1/PD-L1 pathways along with downregulation of macrophage activation pathways (alternate and classical). Multiplex immunofluorescence confirmed increased infiltration with macrophages in muAd-Ifnα treated tumors compared to controls. PD1/PD-L1 expression was reduced at 72h.DiscussionThis single-cell analysis builds upon our understanding of the impact of Ad-IFNα on tumor cells and other compartments of the microenvironment. These data will help identify mechanisms to improve patient selection and therapeutic efficacy of Nadofaragene firadenovec.

Coronary-pulmonary artery fistulas (CPAFs) are rare entities that can cause significant left-to-right shunting and complicate routine coronary artery bypass grafting. There are no best practice guidelines and a scarcity of reports regarding concomitant treatment of CPAF with coronary artery disease. We present a case of bilateral CPAFs in a 60-year-old man with symptomatic coronary artery disease treated successfully with coronary artery bypass, epicardial ligation, and transpulmonary closure of CPAF with patch reconstruction. This case highlights the importance of optimal myocardial protection and complete closure of the fistula to prevent risk of coronary steal.

Drug-induced gingival overgrowths (DIGO) represent a significant side effect of various pharmacological treatments, particularly anticonvulsants, immunosuppressants, and calcium channel blockers. This condition, characterized by the excessive growth of gum tissue, can lead to discomfort, aesthetic concerns, and periodontal complications. Understanding the molecular mechanisms underlying DIGO is crucial for developing effective preventive and therapeutic strategies. This review aims to provide an in-depth analysis of the cellular and molecular pathways implicated in DIGO, including the roles of fibroblasts, inflammatory mediators, and genetic predispositions. By elucidating the interactions between these factors, we seek to highlight potential targets for intervention. Additionally, the review discusses current research advancements and potential future directions in the study of DIGO. Through this comprehensive examination, we aim to enhance the understanding of the implications of these mechanisms.

Hypertension (HTA) is commonly treated with medications that can cause drug-induced gingival overgrowth (DIGO). This study investigates the mechanisms behind DIGO in hypertensive patients, focusing on the effects of calcium channel blockers, immunosuppressants, and anticonvulsants. We explore the cellular and molecular pathways involved, such as collagen synthesis, inflammation, and the role of integrins. Clinical implications include challenges in oral hygiene, periodontal health, and patient quality of life. Management strategies discussed include drug substitution, enhanced oral hygiene, and surgical options. Understanding the link between HTA treatment and gingival overgrowth can help healthcare providers better diagnose and manage this condition, improving patient outcomes and periodontal health.

Abstract Background Echocardiography is widely used to evaluate left ventricular (LV) diastolic function in patients suspected of heart failure. For patients in sinus rhythm, a combination of several echocardiographic parameters can differentiate between normal and elevated LV filling pressure with good accuracy. However, there is no established echocardiographic approach for the evaluation of LV filling pressure in patients with atrial fibrillation. The objective of the present study was to determine if a combination of several echocardiographic and clinical parameters may be used to evaluate LV filling pressure in patients with atrial fibrillation. Results In a multicentre study of 148 atrial fibrillation patients, several echocardiographic parameters were tested against invasively measured LV filling pressure as the reference method. No single parameter had sufficiently strong association with LV filling pressure to be recommended for clinical use. Based on univariate regression analysis in the present study, and evidence from existing literature, we developed a two-step algorithm for differentiation between normal and elevated LV filling pressure, defining values ≥ 15 mmHg as elevated. The parameters in the first step included the ratio between mitral early flow velocity and septal mitral annular velocity (septal E/e’), mitral E velocity, deceleration time of E, and peak tricuspid regurgitation velocity. Patients who could not be classified in the first step were tested in a second step by applying supplementary parameters, which included left atrial reservoir strain, pulmonary venous systolic/diastolic velocity ratio, and body mass index. This two-step algorithm classified patients as having either normal or elevated LV filling pressure with 75% accuracy and with 85% feasibility. Accuracy in EF ≥ 50% and EF

Aim of the study. The aim of the study was to evaluate the Romanian children’s perception regarding 2 of the most common oral pathologies, dental caries and gingivitis in correlation with oral health behaviours. Methods. This was a cross-sectional study. The answers to 2 questionnaires distributed to children 12-15 years old from 2 schools in Bucharest, Romania were analyzed. One questionnaire included questions related to oral pathology, and the other to oral health maintenance behaviour. In our dental research study we made use of descriptive statistics in order to summarize continuous and categorical variables. The test used to examine relationship between children’s perceptions and their behaviours was Roa-Scott chi-square test Results. All 137 children who participated in the study completed both questionnaires. Among them, 62% considered that a broken tooth is not a form of disease, but still 94.8% of them would go to the dentist. Regarding gingival bleeding, even if its presence as a sign of illness was not conclusive, most children (78.8%) considered that this sign requires medical attention. The frequency of sugar consumption in our study was low in 80.3% of children, and the frequency of brushing was more than once a day for 77.4% of subjects. Conclusions. Although most children perceived dental cavity as a disease and, gingival bleeding as not a sign of illness., there was a consensus regarding both conditions, that is, the necessity of dental treatment. Awareness of the need for dental treatment in case of signs for these two diseases is very important for promoting preventive dental programs for children.

Improving safety is a main objective for medical systems. To assist the modelling and formal analysis of medical systems, we define a language for multi-agent systems handling information, timed communication, and timed migration. We use a simplified airway laser surgery scenario to demonstrate our approach. An implementation in Maude is presented; we use the strategies allowed by Maude to guide the rules application in order to decrease substantially the number of possible executions and results in the highly nondeterministic and concurrent multi-agent systems. Finally, we present how the executable specifications can be verified with the model-checking tools in Maude to detect the behavioural problems or desired properties of the agents.

Abstract Obesity increases the morbidity and mortality of traumatic brain injury (TBI). Detailed analyses of transcriptomic changes in the brain and adipose tissue were performed to elucidate the interactive effects between high-fat diet-induced obesity (DIO) and TBI. Adult male mice were fed a high-fat diet (HFD) for 12 weeks prior to experimental TBI and continuing after injury. High-throughput transcriptomic analysis using Nanostring panels of the total visceral adipose tissue (VAT) and cellular components in the brain, followed by unsupervised clustering, principal component analysis, and IPA pathway analysis were used to determine shifts in gene expression patterns and molecular pathway activity. Cellular populations in the cortex and hippocampus, as well as in VAT, during the chronic phase after combined TBI-HFD showed amplification of central and peripheral microglia/macrophage responses, including superadditive changes in selected gene expression signatures and pathways. Furthermore, combined TBI and HFD caused additive dysfunction in Y-Maze, Novel Object Recognition (NOR), and Morris water maze (MWM) cognitive function tests. These novel data suggest that HFD-induced obesity and TBI can independently prime and support the development of altered states in brain microglia and VAT, including the disease-associated microglia/macrophage (DAM) phenotype observed in neurodegenerative disorders. The interaction between HFD and TBI promotes a shift toward chronic reactive microglia/macrophage transcriptomic signatures and associated pro-inflammatory disease-altered states that may, in part, underlie the exacerbation of cognitive deficits. Thus, targeting of HFD-induced reactive cellular phenotypes, including in peripheral adipose tissue immune cell populations, may serve to reduce microglial maladaptive states after TBI, attenuating post-traumatic neurodegeneration and neurological dysfunction.

This systematic review aims to explore the relationship between chronic inflammation of periodontal disease and neurodegenerative disorders (especially Parkinson's disease), focusing primarily on pathophysiological, clinical and immunological aspects. An exhaustive search on this topic was performed in several databases (including PubMed, Scopus and Web of Science) selecting articles published between 2006 and 2023. After reviewing the titles, abstracts and protocols of each study, 13 articles were extracted for detailed assessment. The main indicators in the study included clinical signs of gingival inflammation, bleeding on probing (BoP), bone loss (BL), periodontal probing depth (PPD), and clinical attachment loss (CAL). Additionally, levels of inflammatory markers such as epidermal growth factor (EGF), interleukin-8 (IL-8), interleukin-17 (IL-17), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) were monitored. The investigation also explored the presence of one of the main periodontal pathogens (Porphyromonas gingivalis) in the microbiota of Parkinson's disease patients. In conclusion, the data presented further support the intricated relationship between periodontal health and neurodegenerative processes, including aspects related to changes in clinical periodontal indices, immunological indices, as well as oral hygiene and patient medication.

Fish smoking is one of the oldest preservation methods and has traditional forms in most parts of the world, each with distinct variables. The presence of PAHs in smoked fish is of great concern for producers and consumers alike, as PAHs have great negative effects on human health. This study aimed to determine the physicochemical characteristics and polycyclic aromatic hydrocarbons (PAHs) content level in smoked rainbow trout Oncorhynchus mykiss (Walbaum, 1792) processed using a commercial portable grilling and smoking oven. Sawdust of hardwood (beech, cherry, sour cherry, walnut, and plum) and softwood (fir, willow) were used to produce aromatic essences. The principal component analysis (PCA) revealed that different tree species tend to accumulate different PAHs in different concentrations. In the case of the generalized additive model (GAM) analyzing fish meat, fir tree reduced the concentration of PAHs in fish meat. When GAM analyzed fish skin, cherry, sour cherry, and willow trees significantly reduced the concentrations of PAHs in fish skin compared to beech trees. Furthermore, the results regarding the skin of the fish suggest that it acts as a protective barrier, trapping smoke particulates and reducing the penetration of PAHs into the meat. The present method clearly shows that, at least in the case of Benzo[a]pyrene, it is safer than traditional methods of smoking. This highlights the need for further research into the physicochemical properties of fish tissue and their impact on PAH accumulation.

The near-Earth asteroid (98943) Torifune, previously designated 2001 CC _21 , is the flyby target of the Hayabusa2 extended mission, nicknamed Hayabusa2 # (Small Hazardous Asteroid Reconnaissance Probe (SHARP)). The ground-based telescope observations offer a key science input for the mission's scientific investigation. During 2022–2024, this asteroid was at visible apparent magnitudes brighter than 18.5, allowing for a detailed characterization using ground-based telescope observations. We determined its rotation period P = 5.021516 ± 0.000106 hr and its absolute magnitude H = 18.78 ± 0.14. The large number of light curves allows us to estimate its axis ratio, its convex shape, and its pole orientation, λ = 301 ^∘ ± 35 ^∘ , $\beta =8{9}_{-6}^{+1^\circ }$ , and ϵ = 5 ^∘ ± 3 ^∘ , respectively, which indicate a prograde rotation. We report the semiaxis of the equivalent ellipsoid, a = 0.42 ${}_{0.06}^{+0.08}$ km, b = 0.16 ${}_{0.04}^{+0.05}$ km, and c = 0.17 ± 0.03 km. Consequently, the volume-equivalent diameter is D _eq = 0.44 ± 0.06 km. Using observations conducted simultaneously with four broadband filters, we determined ( g − r ) = 0.663 ± 0.022 mag, ( r − i ) = 0.177 ± 0.012 mag, and ( i − z _s ) = −0.061 ± 0.032 mag. Additionally, we found that Torifune exhibits no detectable large-scale heterogeneity. We classified the object using a high signal-to-noise ratio spectrum (over the visible and near-infrared region) as Sq-type in the Bus–DeMeo taxonomy. We estimate a mineralogy similar to LL/L ordinary chondrites, with an ol/(ol+px) = 0.60, a Fa content of 28.5 mol%, and a Fs content of 23.4 mol%. The spectral data indicate a surface affected by moderate space weathering effects.

Background/Objectives: Multiligament knee injuries, involving damage to multiple stabilizing structures, present a significant challenge in orthopedic surgery, often resulting in knee instability and compromised function. While anatomic ligament reconstruction has been traditionally advocated, non-anatomic techniques may provide effective alternatives, particularly for patients with moderate functional demands who do not require high-level athletic performance. Material and methods: In this study, we assessed the outcomes of a non-anatomic, hybrid surgical approach involving combined arthroscopic and open non-anatomic ligament reconstruction in 60 patients with multiligament knee injuries. Using simplified reconstruction methods for the medial collateral ligament (MCL) and lateral collateral ligament (LCL), we tailored the procedures to the needs of active, non-professional patients. Functional outcomes were evaluated using the International Knee Documentation Committee (IKDC) Questionnaire, Lysholm Knee Scoring Scale, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Results: Postoperative improvements were significant, with the total IKDC score increasing from a median of 39.1 preoperatively to 75.9 postoperatively, Lysholm from 61.0 to 87.0, and KOOS from 47.6 to 85.7 (p < 0.01). The results demonstrated significant improvements across all scoring systems, with enhanced knee stability, reduced pain, and better quality of life. Conclusions: These findings support the feasibility of non-anatomic reconstructions as a practical solution for patients seeking a return to daily activities and recreational sports without the complexity of full anatomic reconstruction.

Electrical discharge machining is a non-conventional technology widely used to meet the rigors of industrial requirements imposed by the processing of emerging and advanced materials (e.g., geometrical complexity, high dimensional accuracy, and high surface quality). The electrode is one of the most important factors affecting the process performance in terms of production efficiency and machined surface quality. The aim of the current study is to analyze the influence of the electrode material (i.e., copper, tungsten, and brass) on the performance of electrical discharge machining of a C120 die tool steel, quantified by material removal rate, tool wear rate, and electrode wear ratio. The obtained results were statistically processed using the analysis of variance method, to identify the action model of the process control parameters in the perspective of obtaining superior productivity with minimal electrode wear.

Having a wide geographical distribution and, as an engineering species, actively transforming the landscapes they inhabit, ants have a significant impact on the environment, creating new biogenic landforms and changing a number of its parameters, including biotic ones. This review is devoted to the consideration of the diverse environment-forming activities of ants in different regions of the world. An analysis of the scientific literature carried out in this context revealed a clear disproportion between the fairly good knowledge of tropical regions and the insufficient knowledge of temperate latitudes. The environment-forming activity of ants actively populating grasslands removed from agricultural use: steppes, continental and floodplain meadows of temperate latitudes has been especially poorly studied, which determines the undoubted priority of this area of research.

Introduction: Articular cartilage injuries of the knee are a complex and challenging clinical pathology. Objectives: The purpose of this study was to establish consensus statements via a Delphi process on the nonoperative management of knee cartilage injuries. Methods: A consensus process on knee cartilage injuries utilizing a modified Delphi technique was conducted. Seventy-nine surgeons across 17 countries participated in these consensus statements. Eight questions were generated on the nonoperative management of knee cartilage injuries, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80% to 89% agreement, whereas strong consensus was defined as 90% to 99% agreement, and unanimous consensus was defined as 100% agreement with a proposed statement. Results: Of the 8 total questions and consensus statements on nonoperative management developed from 3 rounds of voting, 1 achieved unanimous consensus, 2 achieved strong consensus, 2 achieved consensus, and 3 did not achieve consensus. Conclusions: The statements that achieved unanimous or strong consensus related to indications, contraindications, and prognostic factors for nonoperative management of knee cartilage injuries. The statements that did not achieve consensus were primarily related to the use of non–weight-bearing, injections, and biophysical stimulation in the treatment of knee cartilage injuries.

Background/Objectives: Ongoing challenges in epilepsy therapy warrant research on alternative treatments that offer improved efficacy and reduced side effects. Designed to enhance mitochondrial targeting and increase bioavailability, mitocurcumin (MitoCur) was evaluated for the first time as an antiepileptic agent, with curcumin (Cur) and sodium valproate (VPA), a standard antiepileptic drug, included for comparison. This study investigated the effects on seizure onset, severity, and progression in a zebrafish model of pentylenetetrazole (PTZ)-induced seizures and measured the concentrations of the compounds in brain tissue. Methods: Zebrafish were pre-treated with MitoCur and Cur (both at 0.25 and 0.5 µM doses) and VPA (0.25 and 0.5 mM) and observed for four minutes to establish baseline locomotor behavior. Subsequently, the animals were exposed to a 5 mM PTZ solution for 10 min, during which seizure progression was observed and scored as follows: 1—increased swimming; 2—burst swimming, left and right movements; 3—circular movements; 4—clonic seizure-like behavior; 5—loss of body posture. The studied compounds were quantified in brain tissue through HPLC and LC-MS. Results: Compared to the control group, all treatments reduced the distance moved and the average velocity, without significant differences between compounds or doses. During PTZ exposure, seizure latencies revealed that all treatments effectively delayed seizure onset up to score 4, demonstrating efficacy in managing moderate seizure activity. Notably, MitoCur also provided significant protection against the most severe seizure score (score 5). Brain tissue uptake analysis indicated that MitoCur achieved higher concentrations in the brain compared to Cur, at both doses. Conclusions: These results highlight the potential of MitoCur as a candidate for seizure management.

Pulmonary hypertension is a complex condition that has distinct characteristics in pediatric populations. This review explores the important role of early childhood nutrition in the growth, progression, and management of pediatric pulmonary hypertension. Nutritional deficiencies, including those of vitamins C, D, and iron, are closely linked to worse outcomes in children with this disease, emphasizing the importance of early intervention to prevent malnutrition and promote growth. Emerging research revealed that promising nutrients like resveratrol, along with modulation of the gut and respiratory microbiomes, may offer therapeutic advances for managing pulmonary hypertension. However, the current literature is limited by a lack of pediatric-specific studies, with much of the data extrapolated from adult populations and animal models, especially rats. This review highlights the need for targeted research to develop effective nutritional interventions aimed at improving outcomes for pediatric patients.

The introduction of CAD/CAM technology in dentistry opened the way for the use of numerous materials for prosthetic restorations: dental alloys, ceramic masses, zirconia, PMMA, etc. One of the materials suitable for CAD/CAM technology is zirconia, used either ceramic-plated or full-contour, through its mechanical and optical properties. Zirconia, proves to be a real competitor for dental alloys used in porcelain fused to metal technology, with great results on posterior and frontal areas of dental arches. Prosthetic restorations made of zirconia in transit areas (including canines and premolars) exemplify the perfect combination between mechanical resistance and aesthetics of this material.

Restoring the morphology and functionality of dental arches affected by carious lesions and/or edentations using fixed prosthetic restorations has been a continuous challenge for dentists. Porcelain fused to metal prosthetic restorations using lost wax technique or modern digital methods have proven to be a useful tool in restoring aesthetics and mastication, aspects that lead to the social reintegration of patients. The natural aspect of the prosthetic restoration depends on the talent and inspiration of the dental technician as the art of layering of ceramic masses cannot be surpassed by new emerging technologies.

Lives lost, pain, families torn apart, people fleeing war, cities destroyed - all are part of the war triggered by Russia's invasion of Ukraine, an unprecedented humanitarian crisis. The ongoing conflict on Romania's border has profound economic consequences not only for the belligerent countries, but for the whole of Europe and the world's economies have not been spared from imported inflation and disruptions in world trade. In our research, we aimed to highlight the impact of this conflict on our country, causing an increase in inflation, fiscal pressure, budget deficits, public debt and it accentuated climate problems. In the current conjuncture, various adverse shocks can propagate through several channels, therefore in our research we will briefly present the most important of them. Russia's invasion of Ukraine and associated sanctions represent a broad global shock with divergent effects on economic activity (decline) and the inflation rate (increase).

Rapid changes in the sphere of science, technology or biology are determined by results of research - development and innovation activities. A quick adaptation through a change of vision and orientation of the organizational culture, we believe that it is necessary to implement at the managerial level some changes by applying the soft practices resulting from a hard approach (change of the managerial board and its introduction of one or more women). In this way, a positive influence can be generated on the ability to adapt the organizational culture to market requirements. The study carried out on a series of financial-banking institutions from Iași county sought to determine the particularities of the applied organizational culture, study them in the context of the national culture, delimit the elements that implemented or developed within the organizations bring a contribution to the specific activities of the culture change process organization of an entity.

Cenobamate is a novel third-generation antiepileptic drug used for the treatment of focal onset seizures and particularly for multi-drug-resistant epilepsy; it acts on multiple targets: GABAA receptors (EC50 42–194 µM) and persistent neuronal Na+ currents (IC50 59 µM). Side effects include QTc interval shortening with >20 ms, but not INa), hCav1.2 (α1c + β2 + α2δ1) (ICaL), hKv7.1 + minK (IKs), and hKv11.1 (hERG) (IKr). We found IC50 of 87.6 µM (peak INa), 46.5 µM (late INa), and 509.75 µM (ICaL). In experiments on Ncyte® ventricular cardiomyocytes, APD90 was reduced with 28.6 ± 13.5% (mean ± SD) by cenobamate 200 µM. Cenobamate’s marked inhibition of INa raises the theoretical possibility of cardiac arrhythmia induction at therapeutic concentrations in the context of preexisting myocardial pathology, in the presence of action potential conduction and repolarization heterogeneity. This hypothetical mechanism is consistent with the known effects of class Ib antiarrhythmics. In simulations with a linear strand of 50 cardiomyocytes with variable inter-myocyte conductance based on a modified O’Hara–Rudy model, we found a negligible cenobamate-induced conduction delay in normal tissue, but a marked delay and also a block when gap junction conduction was already depressed.

Background and Objectives: Odontogenic infections (OIs) can lead to severe complications, especially in elderly patients due to age-related physiological changes and comorbidities. This study aims to evaluate the predictive accuracy of inflammatory scores—APACHE II, CURB-65, SOFA, and NEWS2—in determining the severity of odontogenic infections among elderly patients (>70 years) compared to younger patients (Materials and Methods: A retrospective cohort study was conducted on patients diagnosed with an OI at the Maxillofacial Surgery Department between January 2018 and January 2024. Patients were divided into two groups: elderly patients (>70 years, n = 49) and younger patients (Results: Elderly patients exhibited significantly higher SS scores (mean 12.47 ± 2.93) compared to younger patients (mean 7.82 ± 2.17, p < 0.001). APACHE II, CURB-65, SOFA and NEWS2 scores were significantly elevated in the elderly group (all p < 0.001). The SOFA score demonstrated the highest predictive accuracy for severe OIs in elderly patients, with an area under the curve (AUC) of 0.89 (95% CI: 0.82–0.95). Subgroup analyses revealed that comorbidities such as diabetes mellitus and cardiovascular disease significantly influenced infection severity (p < 0.05). Conclusions: Inflammatory scores, particularly SOFA, are effective in predicting the severity of odontogenic infections in elderly patients. The integration of these scores into clinical practice may enhance early identification of high-risk patients and improve management strategies.

In reconstructive surgery, flaps are the cornerstone for repairing tissue defects, but postoperative monitoring of their viability remains a challenge. Among the imagistic techniques for monitoring flaps, the thermal camera has demonstrated its value as an efficient indirect method that is easy to use and easy to integrate into clinical practice. This provides a narrow color spectrum image that is amenable to the development of an artificial neural network in the context of current technological progress. In the present study, we introduce a novel attention-enhanced recurrent residual U-Net (AER2U-Net) model that is able to accurately segment flaps on thermographic images. This model was trained on a uniquely generated database of thermographic images obtained by monitoring 40 patients who required flap surgery. We compared the proposed AER2U-Net with several state-of-the-art neural networks used for multi-modal segmentation of medical images, all of which are based on the U-Net architecture (U-Net, R2U-Net, AttU-Net). Experimental results demonstrate that our model (AER2U-Net) achieves significantly better performance on our unique dataset compared to these existing U-Net variants, showing an accuracy of 0.87. This deep learning-based algorithm offers a non-invasive and precise method to monitor flap vitality and detect postoperative complications early, with further refinement needed to enhance its clinical applicability and effectiveness.

Background/Objectives: This study assessed the effects of formulation components on the long-term stability of a previously described tetraethyl orthosilicate-based drug delivery system. Early stability studies of a product concept are crucial not only to provide information on the overall system stability and individual components’ contributions to it, but also to identify opportunities for dosage form optimization and to define its use case. Methods: We assessed the time-dependent thixogel properties—specifically, mechanical strength, thixotropy, release of model drug, and dry substance—in both real-time and accelerated shelf-life determination set-ups. Results: Our findings indicate that the concentration and molecular weight of hyaluronic acid, one of the main constituents of the investigated thixotropic systems, are key determinants of formulation stability. We further showed that changes in both of these parameters reflect on the drug release properties and stiffness of the formulation and could inform subsequent product development based on several use cases. Conclusions: Overall, this study provides an understanding of some key factors that would need to be considered prior to and in the final product development process of thixogels in preparation for commercialization.

Systemic sclerosis (SSc) is a multisystemic autoimmune disorder in which cardiac involvement is frequent and portends negative prognosis. Left ventricular (LV) diastolic dysfunction is one of the most common cardiac alterations in these patients, and left atrial (LA) reservoir strain (ƐR) measurement using speckle tracking echocardiography has been proposed as a novel parameter for a better assessment of LV diastolic function. Therefore, the aim of this study was to test the prognostic value of ƐR in a large multicenter cohort of SSc patients. In total, 311 SSc patients (54 ± 14 years, 85% female) were included from two different centers. Echocardiography was performed at the time of first visit, including ƐR measurement. Over a median follow-up of 132 (interquartile range: 110 to 157) months, 67 (21.5%) patients experienced the outcome of all-cause mortality. Spline curve analysis identified an optimal cut-off value of 30% for ƐR, and patients with ƐR ≤ 30% showed a 10-year cumulative survival rate of 71% as compared to 88% for patients with ƐR > 30% (log-rank p < 0.001). At the multivariable Cox regression analysis, ƐR was independently associated with the endpoint (HR 1.830; 95% confidence interval (CI) 1.031–3.246; p = 0.039) together with age (HR 1.071, 95% CI 1.043 to 1.099; p < 0.001), sex (female) (HR 0.444, 95% CI 0.229 to 0.861; p = 0.016), and diffusing lung capacity for carbon monoxide (HR 0.969 95% CI 0.956 to 0.982; p < 0.001). ƐR is of independent prognostic value in SSc and might help optimizing risk stratification in these patients.

The increasing prevalence of autism spectrum disorder (ASD) underscores its significant impact on individuals and the importance of early intervention. ASD affects various aspects of life, including education, emotional development, and social interactions. Besides traditional therapeutic approaches, a novel strategy incorporating digital games has been introduced. Four games developed using Makey Makey and Scratch aim to enhance cognitive skills in children with ASD. This approach facilitates emotional and intellectual development, tracks progress, and offers personalized and engaging interventions. This study demonstrated significant improvements in memory and concentration among participants, with an average improvement of 23.38 points. The most notable enhancements were observed in children aged 10, who showed an average improvement of 25.67 points. Additionally, female participants exhibited a slightly higher average improvement compared to males. The Memory Maze game also effectively enhanced cognitive skills in children with different types of ADHD. Children with the Hyperactive–Impulsive type showed the highest average improvement, with 25.00 points, followed by those with the Combined type, with 24.15 points, and the Inattentive type, with 23.53 points. These findings highlight the potential use of these tools in both ASD and ADHD therapy, providing a structured and enjoyable learning environment that supports cognitive development and therapeutic outcomes.

Thiol-containing compounds, renowned as potent antioxidants, encompass various drugs and naturally occurring biological substances prevalent within the body. Aim of the study The study aimed to determine the level of inhibition of the photochemiluminescence reaction across therapeutic and physiological concentration ranges. Material and methods In order to quantify the in vitro antioxidant potential of these compounds photochemiluminescence technique was utilized. Eight bivalent sulfur compounds, predominantly derived from cysteine, were used: six with free SH groups (cysteine, homocysteine, N-acetyl-cysteine, captopril, glutathione, lipoic acid), one with a methylated SH group (methionine), and one with an oxidized SH group (cystine). Results After establishing a dynamic standard curve for UV-radiated oxidized luminol, the inhibitory effects of selected -SH containing compounds were investigated. It was observed that substances containing free SH groups diminished the intensity of light emission, contrasting with those containing blocked or oxidized thiols. The inhibition level appeared directly correlated with the antioxidant capacity of the compounds. Conclusions Glutathione demonstrated superior antioxidant activity across all tested concentrations.

In this paper, we use panel data containing all EU27 countries from the 2010 to 2022 period to investigate the impact exhibited by the shadow economy on the level of NPLs. Based on a Panel GMM approach we reveal a negative connection, indicating that Countries with larger informal sectors often exhibit lower reported NPLs, possibly due to less stringent oversight. Additionally, economic growth correlates negatively with NPLs, while rising unemployment is associated with increased NPL levels. However, factors like inflation, political stability, and government debt did not show significant correlations with NPLs in our analysis. The topic holds significant relevance for both macro-stability policymakers and commercial banks aiming to understand how changes in fiscal and budgetary conditions impact the quality of credit portfolios.

This paper delves into the subject of outlier detection techniques tailored for unique datasets related to residential energy consumption. Building upon the current state of research we introduce the Grubbs and Z-score methods and investigate a range of outlier detection strategies encompassing statistical, probabilistic, and machine learning algorithms. The findings underscore the importance of outlier detection in the Romanian residential energy sector.

The research aims to study the financial behavior of students from the Babeș-Bolyai University in the municipality of Cluj-Napoca and the factors that, according to the literature, are contributors to its formation and positive modeling. Several factors were studied using a quantitative paradigm: family financial socialization, the level of financial self-control, and exposure to financial education. The overall picture of the financial behavior of the students who took part in the research (Babeș-Bolyai University students filling a self-administered questionnaire) illustrates a relatively healthy financial behavior.

Background and Study Aim. Technical training in football plays an important part in scoring goals. Precise movements can become the key to victory in a match. Among the principal factors determining the accuracy of shooting or kicking the ball is balance. The study aims to determine the influence of dynamic balance on technical training in U13 football. Material and Methods. A group of 26 football players from Otopeni Sports Club (Romania), aged 12-13 years, in the U13 category, participated in this study. Dynamic balance was assessed using the Sensamove MiniBoard platform with tests including: Lateral bipedal balance (LBB), Vertical bipedal balance (VBB), and Vertical unipedal balance for both right (VBRL) and left (VBLL) legs. Technical training was evaluated using tests recommended by the Romanian Football Federation: instep kick from 9 m (Test 1, points), outside kick in 30 sec. (Test 2, points), and 20 m long pass (Test 3, points). Pearson’s correlation coefficient was used to analyze the relationship between dynamic balance (lateral and vertical bipedal, and vertical unipedal for both legs) and technical training in U13 footballers. Results. The analysis of the comparative results between LBB and VBB variables reveals better performances by 9.2% at VBB. There are lower values of the vertical deviations mean by 2.9 degrees forward at LBB and by -2.8 degrees backward. The mean of lateral deviations is lower by -2.7 degrees to the left at VBB and by 3.3 degrees to the right. The comparative results between VBRL and VBLL variables show better performances by 0.3% at VBRL. The values of the vertical deviations mean are lower by 0.5 degrees forward at VBRL and 0.3 degrees backward. The mean of the lateral deviations (left-right) have equal values. Analyzing the performances obtained in technical tests highlights 22.2% (estimated maximum score) at instep kick, 62.5% (individual maximum value) at outside kick and 34.5% (estimated maximum value) at 20 m long pass. The influence of dynamic balance on technical training shows 60.7% positive connections and 39.3% negative ones between LBB and VBB variables. As for VBRL and VBLL variables, there are 67.9% positive connections and 32.1% negative connections between them. Conclusions. The weighting of values at performance and maintaining in space was highlighted. The mean of front-back and left-right deviations in bipedal and unipedal balance has lower values. The technical performances obtained were compared with the estimated maximum score and the individual maximum value. An increased number of positive connections to balance performance variables and of negative connections to the mean of deviations was noticed. This fact contributed to determining the degree of influence on the investigated variables. The findings can serve as a recommendation for future research.

Reverse Hill-Sachs lesions (HSLs) often involve a greater percentage of the humeral head articular surface than posterior HSLs and frequently require surgical treatment in the setting of posterior shoulder instability. Multiple techniques have been described to treat these lesions depending on their size, acuity, and location. The (modified) McLaughlin procedure is widely used to treat smaller engaging lesions, whereas larger lesions involving a greater percentage of the humeral head articular surface require anatomic disimpaction, termed “humeroplasty.” Humeroplasty is traditionally performed via an open approach. This technical note describes an arthroscopic subdeltoid humeroplasty technique for the reduction and fixation of reverse HSLs in the beach-chair position.

BackgroundOsteoarthritis (OA) is a disabling condition that affects more than one-third of people older than 65 years. Currently, 80% of these patients report movement limitations, 20% are unable to perform major activities of daily living, and approximately 11% require personal care. In 2014, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommended, as the first step in the pharmacological treatment of knee osteoarthritis, a background therapy with chronic symptomatic slow-acting osteoarthritic drugs such as glucosamine sulfate, chondroitin sulfate, and hyaluronic acid. The latter has been extensively evaluated in clinical trials as intra-articular and oral administration. Recent reviews have shown that studies on oral hyaluronic acid generally measure symptoms using only subjective parameters, such as visual analog scales or quality of life questionnaires. As a result, objective measures are lacking, and data validity is generally impaired. ObjectiveThe main goal of this pilot study with oral hyaluronic acid is to evaluate the feasibility of using objective tools as outcomes to evaluate improvements in knee mobility. We propose ultrasound and range of motion measurements with a goniometer that could objectively correlate changes in joint mobility with pain reduction, as assessed by the visual analog scale. The secondary objective is to collect data to estimate the time and budget for the main double-blind study randomized trial. These data may be quantitative (such as enrollment rate per month, number of screening failures, and new potential outcomes) and qualitative (such as site logistical issues, patient reluctance to enroll, and interpersonal difficulties for investigators). MethodsThis open-label pilot and feasibility study is conducted in an orthopedic clinic (Timisoara, Romania). The study includes male and female participants, aged 50-70 years, who have been diagnosed with symptomatic knee OA and have experienced mild joint discomfort for at least 6 months. Eight patients must be enrolled and treated with Syalox 300 Plus (River Pharma) for 8 weeks. It is a dietary supplement containing high-molecular-weight hyaluronic acid, which has already been marketed in several European countries. Assessments are made at the baseline and final visits. ResultsRecruitment and treatment of the 8 patients began on February 15, 2018, and was completed on May 25, 2018. Data analysis was planned to be completed by the end of 2018. The study was funded in February 2019. We expect the results to be published in a peer-reviewed clinical journal in the last quarter of 2024. ConclusionsThe data from this pilot study will be used to assess the feasibility of a future randomized clinical trial in OA. In particular, the planned outcomes (eg, ultrasound and range of motion), safety, and quantitative and qualitative data must be evaluated to estimate in advance the time and budget required for the future main study. Finally, the pilot study should provide preliminary information on the efficacy of the investigational product. Trial RegistrationClinicalTrials.gov NCT03421054; https://clinicaltrials.gov/study/NCT03421054 International Registered Report Identifier (IRRID)RR1-10.2196/13642

Este consenso de nomenclatura y clasificación para la válvula aórtica bicúspide congénita y su aortopatía está basado en la evidencia y destinado a ser utilizado universalmente por médicos (tanto pediatras como de adultos), médicos ecocardiografistas, especialistas en imágenes avanzadas cardiovasculares, cardiólogos intervencionistas, cirujanos cardiovasculares, patólogos, genetistas e investigadores que abarcan estas áreas de investigación clínica y básica. Siempre y cuando se disponga de nueva investigación clave y de referencia, este consenso internacional puede estar sujeto a cambios de acuerdo con datos basados en la evidencia1.

Abstract Pulmonary hypertension (PH) is a progressive and invalidating condition despite available therapy. Addressing complications such as left main coronary artery compression (LMCo) due to the dilated pulmonary artery (PA) may improve symptoms and survival. Nevertheless, clear recommendations are lacking. The aim of this study is to analyze the prevalence, characteristics, predictive factors and impact of LMCo in a heterogenous precapillary PH population in a single referral center. Two hundred sixty‐five adults with various etiologies of precapillary PH at catheterization were reviewed. Coronary angiography (CA) was performed for LMCo suspicion. Revascularization was performed in selected cases. Outcomes were assessed at a mean follow‐up of 3.9 years. LMCo was suspected in 125 patients and confirmed in 39 (31.2%), of whom 21 (16.8%) had 50%–90% stenoses. Nine revascularizations were performed, with clinical improvement. The only periprocedural complication was a stent migration. LMCo was associated with PH etiology (p 0.003), occuring more frequently in congenital heart disease‐associated PH (61.5% of all LMCo cases, 66.6% of LMCo ≥ 50%). Predictors of LMCo ≥50% were PA ≥ 37.5 mm (Sn 81%, Sp 74%) and PA‐to‐aorta ≥1.24 (Sn 81%, Sp 69%), with increased discrimination when considering RV end‐diastolic area. LMCo ≥ 50% without revascularization presented clinical deterioration and worse survival (p 0.019). This analysis of a heterogeneous pre‐capillary PH population provides LMCo prevalence estimation, predictive factors (PA size, PA‐to‐aorta, RV end‐diastolic area and PH etiology) and long‐term impact. While LMCo impact on survival is inconclusive, untreated LMCo ≥ 50% has worse prognosis. LMCo revascularization may be performed safely and with good outcomes.

The COVID-19 pandemic has provided an opportunity to examine the impact of reduced human activity on air quality. This study assesses the levels of particulate matter (PM10) in three cities—Bucharest, Brașov, and Iași—during the pandemic restrictions in 2020, comparing them with data from the pre-pandemic period (2017–2019) and post-lockdown period (2021–2022). The results show a significant decrease in PM10 levels during the lockdown, which is closely associated with reduced traffic and mobility. Notably, while PM10 concentrations initially spiked at the beginning of 2020, they markedly declined following the enforcement of lockdown measures, during which mobility to workplaces in these cities decreased by about 60% in Bucharest, 50% in Brașov, and 45% in Iași. Health risks related to PM10 exposure were evaluated using the hazard quotient method, following EU and WHO guidelines. Despite the reduction in pollution levels in 2020, the findings suggest long-term human health risks for residents of these cities. This research highlights the critical need for sustainable strategies to address air quality issues in urban areas and protect public health.

In the aerospace industry, an important number of machined parts are submitted for high-performance requirements regarding surface integrity. Key components are made of materials selected for their unique properties and they are obtained by milling processes. In most situations, the milling process uses cooling methods because, in their absence, the material surface could be affected by the generated heat (temperatures could reach up to 850 °C), the residual stress, the cutting forces, and other factors that can lead to bad integrity. Cryogenic cooling has emerged as a pivotal technology in the manufacturing of aeronautical materials, offering enhanced properties and efficiency in the production process. By utilizing extremely low temperatures, typically involving liquid nitrogen or carbon dioxide, cryogenic cooling can significantly enhance the material’s properties and machining processes. Cryogenic gases are tasteless, odorless, colorless, and nontoxic, and they evaporate without affecting the workers’ health or producing residues. Thus, cryogenic cooling is also considered an environmentally friendly method. This paper presents the advantages of cryogenic cooling compared with the classic cooling systems used industrially. Improvements in terms of surface finishing, tool life, and cutting force are highlighted.