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Background. Nitrous oxide, a nonirritating gas commonly used as an anesthetic, is increasingly abused by the young population for its euphoric effects due to its seemingly harmless nature. However, its neurological impacts can vary in intensity and sometimes result in permanent damage. Accurate diagnosis and treatment hinge on identifying nitrous oxide use through anamnesis, clinical and paraclinical findings, as demonstrated in the following case report. Case report. A 27-year-old female with psychiatric history presented with progressive paresthesia and walking difficulty, admitting to recent nitrous oxide use, alongside other substances. Clinical examination revealed mild tetraparesis, coordination disturbances, generalized hyporeflexia, and sensory deficits. Electromyography showed severe sensory neuropathy, and spinal MRI indicated subacute combined degeneration (SCD) of the spinal cord. Laboratory tests revealed hyperhomocysteinemia and elevated methylmalonic acid levels, despite normal vitamin B12 levels. Treatment included intramuscular vitamin B12, folic acid, and neurotrophic agents, along with physical rehabilitation. Psychiatric symptoms, possibly exacerbated by nitrous oxide, and complicated adherence to therapy. Conclusions. This case underscores the neurotoxic potential of nitrous oxide, particularly its disruption of cobalamin metabolism, and highlights the need for thorough patient histories to uncover substance use contributing to neurological symptoms. Despite treatment, some neurological deficits may persist, emphasizing the importance of early intervention and comprehensive care strategies.

The art of teaching consists in adapting the structures, contents, teaching strategies, classroom management issues, as well as managing the conditions imposed by the contemporary contexts of society, the constant adaptation of the strategies, used by the teacher, to the needs of the children, while trying to find a balance between the traditional training method and the use of technology. The challenges brought by the context of the last years, in terms of the protection and safety of our health due to the COVID 19 pandemic, have put the education system to the test from all points of view: from a technological point of view, the lack or poor training of teachers in terms of digital competences, the poor functionality of certain school platforms used, etc. However, teachers have implemented ideas that give value to the teaching act, by reinventing themselves, striving to find innovative solutions so that the teaching activities can continue to take place. The aim of this paper is to identify the biggest challenges faced by Romanian teachers in preschool education in the pandemic context, understanding how they managed to adapt and what solutions they found and applied for carrying out the teaching activity. In this respect a questionnaire was developed and distributed among pre-school teachers during November 2021 – January 2022. The results of the research identified a series of difficulties faced by the participants, generated by a multitude of elements such as: lack of technological equipment, low digital skills, difficulties in organizing and supporting the learning activity. An essential aspect regarding the online teaching activity with kindergarten children was the reluctance and non-involvement of parents, many parents not agreeing with the use of the computer and the internet for a long time.

There is increasing pressure for all education institutions to undergo transformation, with education as needing to adapt in ways that meet the conceptual needs of our time. Reflecting this is the educators’ role in the classroom. The purpose of this scoping review is to provide a comprehensive overview of relevant research regarding the emergence of different kind of creative and innovative methods used by educators at all levels – and the links to including pedagogy. The scoping review is underpinned by the framework of Arksey & O`Malley (2005) that offers a new approach by including a consultation exercise in this sort of study that may enhance the results, making them more useful to policy makers, practitioners and service users. The results indicate that there is much indirect evidence emerging of improved academic performance and student and staff satisfaction with methodologies connected to or compared with what we call exposure methods. The literature points out, that exposure is coherent to aesthetic performance such as drama and applied aesthetics may lead to practical ethics. It is evident that methodologies connected to exposure have a significant impact on people involved – both educators and students.

Antecedentes: La trombosis arterial asociada a catéter en población pediátrica está infraestimada y no existe un tratamiento estandarizado. Objetivo: Describir la evolución de los niños que han presentado isquemia arterial aguda en alguna extremidad asociada al uso de catéter. Métodos: Se incluyeron pacientes con clínica de isquemia arterial aguda asociada a cateterismo arterial pese al uso de vasopresores. Se recogieron y analizaron las variables demográficas, clínicas, del acceso, tratamiento y complicaciones. Resultados: Se incluyeron 25 pacientes con una edad media de 2.4 años. En 22 pacientes (88%) la isquemia se localizó en miembros inferiores. Todos los pacientes presentaron clínica de isquemia arterial. En todos los pacientes se retiró el catéter y 21 pacientes recibieron anticoagulación. La mortalidad a los 30 días fue del 40%. Los 15 supervivientes evolucionaron favorablemente. Conclusiones: La evolución de la isquemia arterial aguda en población infantil va asociada a la evolución de su patología de base. El manejo conservador es una opción aceptable.

Background: Aneurysms of the internal carotid artery (ICA) are a rare finding, only accounting for 0.4-4% of all peripheral aneurysm and 1% of all carotid diseases. Objective: To evaluate the clinical findings of a carotid aneurysm, considering the patient’s background. Methods: A 54-year-old woman intense yoga practitioner presented with 3 weeks development of a pulsatile mass on the right side of the neck. No history of intravenous catheters, traumatism, or local infections. Ultrasound images revealed a 1.6 cm patent saccular aneurysm ICA dependent. During surgery, visualization of the aneurysm was seen without sign of endothelial damage. Results: Patient underwent elective resection with primary repair and was discharged 2-day postoperatively. Follow-ups revealed complete resolution of the symptoms with intraoperative tissue samples coming back without abnormalities. Conclusions: It is of utmost importance to inquire into the patient’s background and perspective in being able to find an etiological case in rare findings.

The new challenges faced by the future teachers make them assume a new role, that of reflective practitioner. Therefore, university programs should give future teachers the opportunity to engage in practical experiences that will stimulate their reflective skills and which can help create a strong and authentic teaching career. In this sense, a series of interventions, at a simulated level, were put into practice by the students in Pedagogy enrolled in year II at the University of Bucharest. After participating in the proposed activities, the students had to write a reflective essay. A series of focus-groups were organised in order to identify the students’ opinion towards the use of a reflective essay as a way of professional training. The results show that the reflective essay is a tool that plays a significant role in building better and more meaningful learning experiences and helps in providing evidence-based methodological decisions.

ABSTRACT Wastewater has a major role in antimicrobial resistance (AMR) dynamics and public health. The impact on AMR of wastewater flux at the community-hospital interface in low- and middle-income countries (LMICs) is poorly understood. Therefore, the present study analyzed the epidemiological scenario of resistance genes, mobile genetic elements (MGEs), and bacterial populations in wastewater around the Tamale metropolitan area (Ghana). Wastewater samples were collected from the drainage and canalizations before and after three hospitals and one urban waste treatment plant (UWTP). From all carbapenem/pan-aminoglycoside-resistant bacteria, 36 isolates were selected to determine bacterial species and phenotypical resistance profiles. Nanopore sequencing was used to screen resistance genes and plasmids, whereas, sequence types, resistome and plasmidome contents, pan-genome structures, and resistance gene variants were analyzed with Illumina sequencing. The combination of these sequencing data allowed for the resolution of the resistance gene-carrying platforms. Hospitals and the UWTP collected genetic and bacterial elements from community wastewater and amplified successful resistance gene-bacterium associations, which reached the community canalizations. Uncommon carbapenemase/β-lactamase gene variants, like blaDIM-1, and novel variants, including blaVIM-71, blaCARB-53, and blaCMY-172, were identified and seem to spread via clonal expansion of environmental Pseudomonas spp. However, blaNDM-1, blaCTX-M-15, and armA genes, among others, were associated with MGEs that allowed for their dissemination between environmental and clinical bacterial hosts. In conclusion, untreated hospital wastewater in Ghana is a hot spot for the emergence and spread of genes and gene-plasmid-bacterium associations that accelerate AMR, including to last-resort antibiotics. Urgent actions must be taken in wastewater management in LMICs in order to delay AMR expansion. IMPORTANCE Antimicrobial resistance (AMR) is one the major threats to public health today, especially resistance to last-resort compounds for the treatment of critical infections, such as carbapenems and aminoglycosides. Innumerable works have focused on the clinical ambit of AMR, but studies addressing the impact of wastewater cycles on the emergence and dissemination of resistant bacteria are still limited. The lack of knowledge is even greater when referring to low- and middle-income countries, where there is an absence of accurate sanitary systems. Furthermore, the combination of short- and long-read sequencing has surpassed former technical limitations, allowing the complete characterization of resistance genes, mobile genetic platforms, plasmids, and bacteria. The present study deciphered the multiple elements and routes involved in AMR dynamics in wastewater canalizations and, therefore, in the local population of Tamale, providing the basis to adopt accurate control measures to preserve and promote public health.

Even though the higher education model of universities in Romania corresponds to a Humboldtian model based on harmonizing teaching and research activities, in recent years, under pressure from the knowledge-based economy, research activity has tended towards an increased role. Therefore, the role of universities across Romania is beginning to shift towards an entrepreneurial one. This paper seeks to identify the strategies that universities are currently developing to sustain the process of knowledge transfer. To achieve the above aim, semi-structured interviews were conducted with 14 university managers from research-intensive universities. The data was analysed using a coding system that was developed based on the theoretical framework. The results indicate a tendency among Romanian universities towards a linear model of tackling knowledge transfer, meaning that the primary focus is on establishing networks and partnerships between researchers and other categories of end users and on developing cross-domain research teams among researchers from the same university.

Electrospun fibers with different concentrations of polyacrylonitrile (PAN) were synthesized and the results are reported in this study. The aim was to obtain carbon nanofibers for manufacturing gas diffusion layers for proton exchange membrane (PEM) fuel cells. The electrospun fibers obtained were carbonized at 1200 °C, 1300 °C, and 1400 °C, in order to have nanofibers with more than 96% of carbon atoms. The scanning electron microscopy (SEM) results revealed an increase in the diameter from 400–700 nm at 1200 °C to 1000–1400 nm at 1300 °C and 1400 °C. The Raman measurements disclose a higher degree of crystallinity for the sample carbonized at elevated temperatures. The surface area was estimated from the Brunauer–Emmett–Teller (BET) method and the results revealed an increase from 40.69 m2g−1 to 66.89 m2g−1 and 89.92 m2g−1 as the carbonization temperature increased. Simultaneously, the pore volume increased with increasing carbonization temperature. The Fourier-transform infrared spectroscopy (FTIR) spectra reveal that during carbonization treatment, C≡N triple bonds are destroyed with the appearance of C=N double bonds. Decreasing the ID/IG intensities’ ratio from ~1.07 to ~1.00 denotes the defects reduction in carbonaceous materials due to the graphitization process. Therefore, the carbon fibers developed in optimum conditions are appropriate to be further used to produce gas diffusion layers for Proton-exchange membrane fuel cells (PEMFC).

In this paper, we try to make a case for the risky approach of many decision-makers and pol- icy specialists to overuse authority and regula- tion-based tools, while neglecting the ones more focused on human capacity and persuasion. Especially in fields like education, we consider that the human factor should be at the core of any policy mix, and a tool like training and pro- fessional development should gain a more visible and persistent role in policy interventions. Firstly, we try to analyze the distribution of policy tools on the authority-complexity axes. The value we see in the mapping of policy tools is that it can be used for investigating and positioning the activity of a specific governing body or central gover- nance. Thus, a fundamental question remains as to what really influences the choice of policy tools or instruments, as a basis for better understand- ing the rationales behind a specific policy mix. We argue that policy failure could be ex- plained in many cases by the incapacity to ad- dress in a consistent and professional way the human capacities needed for implementation. Thus, training and professional development are, at least, poorly used from the perspective of the potential they have. As an argument, we tried to look at training and professional development in the specific area of teachers in pre-university education in Romania, situating it in the broader context of European policies in lifelong learning and participation of adults in continuing educa- tion and training, but also in the local policy en- vironment. The results of the research led us to the conclusion that educational policies should be among the first in the broader spectrum of public policies valuing and emphasizing learning, through training and professional development of the stakeholders involved in policy change together with adding more value to the Human Factor in educational policies.

This study provides an insight into the challenges faced in establishing a closer collaboration between educational research and its use in the policy-making process. It aims to identify the factors influencing transfer from research to policy-making and the policy-makers’ needs, expectations, and perception on the use of educational research. Thirteen semi-structured interviews were conducted with representatives of Romanian national and local institutions. Specific software was used to facilitate data management and coding. The results indicate that there is a disconnect between policy-makers’ expectations and the input they receive from the research community, as well as a lack of an institutional framework to facilitate communication and interaction between them. There are systemic blockages on both sides: politics and the cost of opportunity for decision-making, a high level of bureaucracy, limited resources and accessibility of results, a lack of financing and of institutionalized communication, as well as a lack of consultation and cooperation between the two parties. The results indicate a willingness on the policy-makers’ side to acknowledge the importance of using research to inform decisions and their role in facilitating this process. This implies that researchers have limited control over the subsequent stages and could indicate the early point in the research process when other actors should be involved in order to ensure the potential or actual impact of research on policy.

This paper attempts to highlight and examine the Romanian perspective regarding inclusive education by presenting some statistical data and the steps that have been made in order to make the switch from a school system lead by the segregation principle to a school system based on inclusive principles. Moreover, the attention focuses on schools` key actors, the teacher, more specifically on the initial teachers training programmes available in Romania. The starting point when it come to the initial teacher training programmes is based on the assumption that there is an acute need for training when it comes to the implementation of an inclusive educational system in Romania. Using a qualitative approach, we aimed at presenting specialists’ opinion on priority issues in policy development regarding the teacher training in the field of inclusive education, focusing on the premises for implementing a training system that is mandatory for every teacher in the inclusive education and on the aspects that relate to the rethinking of the teacher’s training process at a national level.

The root cap has a fundamental role in sensing environmental cues as well as regulating root growth via altered meristem activity. Despite this well-established role in the control of developmental processes in roots, the root cap’s function in nutrition remains obscure. Here, we uncover its role in phosphate nutrition by targeted cellular inactivation or phosphate transport complementation in Arabidopsis, using a transactivation strategy with an innovative high-resolution real-time 33P imaging technique. Remarkably, the diminutive size of the root cap cells at the root-to-soil exchange surface accounts for a significant amount of the total seedling phosphate uptake (approximately 20%). This level of Pi absorption is sufficient for shoot biomass production (up to a 180% gain in soil), as well as repression of Pi starvation-induced genes. These results extend our understanding of this important tissue from its previously described roles in environmental perception to novel functions in mineral nutrition and homeostasis control.

Based on the Michaelis-Menten kinetics model (Hofstee, 1952), this method allows calculation of the kinetic parameters (Vmax, Km) of phosphate uptake by Arabidopsis roots. This method is based on the quantification of phosphate uptake by Arabidopsis roots as described in Thibaud and Marin (2016), except that a range of phosphate concentration is applied in the incubation medium. Plants are grown in high or low Pi giving access to kinetic parameters corresponding to low and high affinity respectively. In high Pi, the high-affinity transporters are not induced giving access to the low-affinity transport only. When plants are grown in low Pi, high affinity transporters are active, and the corresponding kinetic parameters can be measured. The calculation of Km and Vmax values is based on the Michaelis-Menten kinetics model.

This method allows quantification of phosphate absorption capacity by Arabidopsis roots using very simple equipment, and can be scaled up or down.

Mutations in the FRY1/SAL1 Arabidopsis locus are highly pleiotropic, affecting drought tolerance, leaf shape and root growth. FRY1 encodes a nucleotide phosphatase that in vitro has inositol polyphosphate 1-phosphatase and 3',(2'),5'-bisphosphate nucleotide phosphatase activities. It is not clear which activity mediates each of the diverse biological functions of FRY1 in planta.A fry1 mutant was identified in a genetic screen for Arabidopsis mutants deregulated in the expression of Pi High affinity Transporter 1;4 (PHT1;4). Histological analysis revealed that, in roots, FRY1 expression was restricted to the stele and meristems. The fry1 mutant displayed an altered root architecture phenotype and an increased drought tolerance. All of the phenotypes analyzed were complemented with the AHL gene encoding a protein that converts 3'-polyadenosine 5'-phosphate (PAP) into AMP and Pi. PAP is known to inhibit exoribonucleases (XRN) in vitro. Accordingly, an xrn triple mutant with mutations in all three XRNs shared the fry1 drought tolerance and root architecture phenotypes. Interestingly these two traits were also complemented by grafting, revealing that drought tolerance was primarily conferred by the rosette and that the root architecture can be complemented by long-distance regulation derived from leaves. By contrast, PHT1 expression was not altered in xrn mutants or in grafting experiments. Thus, PHT1 up-regulation probably resulted from a local depletion of Pi in the fry1 stele. This hypothesis is supported by the identification of other genes modulated by Pi deficiency in the stele, which are found induced in a fry1 background.Our results indicate that the 3',(2'),5'-bisphosphate nucleotide phosphatase activity of FRY1 is involved in long-distance as well as local regulatory activities in roots. The local up-regulation of PHT1 genes transcription in roots likely results from local depletion of Pi and is independent of the XRNs.

This paper presents the scientists' interest in studying the topic of unfair trade practices in agro-food chains, trying to answer the questions how important is this topic in academic writing and how it interferes with other terms? Exploring and understanding fairness-enabling practices in the agro-food chain is essential to create a sustainable and resilient agro-food system. The objectives of the research are to identify the main unfair trade practices that impacts the agents along the agro-food chain and the solutions given by scientists to solve inequity. In order to achieve these goals, a systematic literature review of papers covering the topic of unfair trade practices in agricultural sector has been conducted. The results show that there is an increased and relatively recent interest in studying unfair trade practices in the agro-food sector, with a noticeable growth in research since 2018. The main research connections of this topic include sustainability, emerging technologies to improve fairness in supply chains, the role of governance, agro-food policy and producers' organizations in mitigating unfair trade practices, the impact of different crisis on supply chains and trade practices. The results are relevant for rising awareness of how unfair trade practices impact the agents of agro-food chains and for finding solutions to avoid or reduce them. [ABSTRACT FROM AUTHOR]

Abstract Background Identifying children and adolescents with cardiometabolic risk at an early stage is crucial for effective treatment and prevention. From a practical perspective, this could be accomplished by assessing the presence of abdominal obesity, which serves as a surrogate indicator of increased cardiometabolic risk and is easy to measure. However, the assessment of abdominal obesity via waist circumference has not yet become a standard procedure in pediatric healthcare. The present study aimed to analyze the secular trends in increased cardiometabolic risk, as indicated by waist circumference among Spanish children and adolescents. Methods This study included 4861 children and adolescents aged 8 to 16 years from two nationwide representative cross-sectional surveys, the EnKid study and the PASOS study, conducted in 1998–2000 and 2019–2020, respectively. Anthropometric variables were measured in both surveys by trained personnel. Three different waist-to-height (WHtR) cutoffs were used to define abdominal obesity as criteria for cardiometabolic risk. BMI categories were defined according to the IOTF and WHO growth charts. Results Abdominal obesity [waist to height ratio (cm/cm) > 0.49] significantly increased from 40.7 to 56.1% and 93.8 to 97.2% in participants with overweight and obesity, respectively, between 1998–2000 and 2019–2020 (p

IntroductionEwing Sarcoma (EWS) has been reported in seven children with Down syndrome (DS). To date, a detailed assessment of this solid tumour in DS patients is yet to be made.MethodsHere, we characterise a chemo-resistant mediastinal EWS in a 2-year-old DS child, the youngest ever reported case, by exploiting sequencing approaches.ResultsThe tumour showed a neuroectodermal development driven by the EWSR1-FLI1 fusion. The inherited myeloperoxidase deficiency of the patient caused failure of neutrophil-mediated cell death and promoted genomic instability.DiscussionIn this context, the tumour underwent genome-wide near haploidisation resulting in a massive overexpression of pro-inflammatory cytokines. Recruitment of defective neutrophils fostered rapid evolution of this EWS.

In metastatic breast cancer (MBC), blood is a source of circulating tumor cells (CTCs). CTCs may serve as a ‘‘real-time liquid biopsy” as they represent metastatic tumor genetics better than primary tumor. PIK3CA is one of the most important oncogenes in treatment-unresponsive breast cancers. The aim of this study was to detect PIK3CA mutations and hereditary cancer variants in CTCs from MBC patients. Forty-seven blood samples were obtained from 20 MBC patients from at least 1/3 consecutive time points. CTCs were quantified using the CellSearch system and isolated from 11/20 patients with ≥5/7.5 ml CTCs (14/47 blood samples) using the DEPArray system. DNA was extracted and amplified to perform Sanger sequencing on PIK3CA gene. Sequencing revealed a pathogenic PIK3CA mutation in 2/11 (18 %) cases. Subsequently, we evaluated a 26-target hereditary gene panel by Next Generation Sequencing and identified a concomitant pathogenic mutation in the TP53 gene in a patient with a PIK3CA mutation. No pathogenic germline variants were found. Our data support the conclusion that CTCs analysis may be used to identify mutations in patients to identify those more likely to metastasize.

Pollen and plant macrofossil analyses supported with radiocarbon dating were conducted on a Holocene core from the peat bog Beliya Kanton (1547 m a.s.l.) located in the Western Rhodope Mountains (South Bulgaria). In the early Holocene until ~10 000 cal. BP the mountain slopes were covered by Pinus , admixed with Betula , Juniperus and shrubland of Ephedra among herb communities dominated by Poaceae, Cichorioideae, Achillea , Artemisia , Brassicaceae species. Subsequently, the afforestation continued with the expansion of broadleaved oak forests with Tilia , Ulmus and Corylus which reached their maximum distribution ~8800 cal. BP. Gradually, these forests began to retreat, replaced at many places first by Corylus and later on by Picea abies , Abies alba and Fagus . The formation of the contemporary coniferous belt with the dominance of Pinus – Picea abies and fragmented mixed coniferous-deciduous communities in the late Holocene was attributed not only to climate change but also to diverse human interference in the natural forest cover. During the last 2000 years the continuous presence of Juniperus , Juglans , Rumex , Cirsium , P lantago lanceolata and Hordeum pollen indicated intensive stock-breeding, grazing and crop cultivation. The fragments of charred wood testify to tree felling and fire clearances on flat ground to obtain new pasture land.

IntroductionThe aims of this study were to compare several countermovement jump (CMJ) kinetic variables between professional (PRO) and semi-professional (SEMI-PRO) futsal players and examine the differences amongst playing positions.MethodsCMJ performance from 56 male futsal players (25.2 ± 4.8 years; weight: 74.4 ± 6.4 kg) was analysed. Players were separated into PRO (n = 29; 27.0 ± 4.4 years; 75.4 ± 6.0 kg) and SEMI-PRO (n = 27; 22.7 ± 4.3 years; 73.1 ± 6.8 kg), and according to playing position: defenders (n = 16; 25.4 ± 3.7 years; 75.2 ± 6.0 kg), wingers (n = 26; 23.5 ± 4.5 years; 72.0 ± 6.9 kg), and pivots (n = 14; 28.0 ± 5.6 years; 77.8 ± 4.3 kg). Linear mixed models and effect sizes were used for the analyses based on the mean of two jumps for each variable.ResultsPRO players presented a deeper center of mass (COM) displacement (p = 0.002, ES = 0.83), greater eccentric (Ecc) absolute (p = 0.019, ES = 0.61) and relative peak power (p = 0.046, ES = 0.52), and achieved greater Ecc peak velocities (p = 0.004, ES = 0.76) when compared to SEMI-PRO. Non-significant and trivial-to-small differences were observed in all the other CMJ variables according to the competitive level and playing position.DiscussionEcc capabilities (i.e., deeper COM displacement, greater Ecc absolute and relative peak power, and peak velocity) during vertical jump seem to differentiate PRO and SEMI-PRO players. However, CMJ variables do not discriminate amongst playing positions in futsal players.