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Failure Mode and Effects Analysis (FMEA) is a method of analysing potential failures of a product or process, in order to plan the necessary measures to prevent their occurrence. Being a critical analysis method, FMEA has extremely precise objectives: determining the weak points of a technical system; searching for the initiating causes of component dysfunction; determining the needs of technology upgrading and modernization of production; increasing the level of communication between work compartments, people, hierarchical levels; analysis of the consequences on the environment, the safety of operation, the value of the product; providing corrective actions to remove the causes of defects; providing a plan to improve product quality and maintenance. The FMEA must be used from the design phase before the product is made.This paper describes a study about the improving the quality process for an axis for packaging using FMEA method. The potential causes of the defects have been studied and improvement measures have been proposed. Among these we mention: implementation and monitoring of the preventive maintenance program; providing specific compliance; self-control, flow or sample control; periodic training and retraining; upgrading existing equipment, acquisition of more advanced software. [ABSTRACT FROM AUTHOR]

As COVID-19 had been posing unprecedented challenges, the economic agents as well as the individuals had to adapt to a new lifestyle. The preventing measures against the spread of the virus determined an increase in e-commerce activity in general, and in mobile commerce in particular. In this regard, sellers redefined their strategies revolving around smartphone applications for online shopping, which will gradually become the global shopping standard. Therefore, the aim of this paper is to evaluate the current situation of e-commerce, focusing on the main transformations since the beginning of the pandemic. The methods used in the paper consist in both qualitative research of the literature regarding e-commerce and a quantitative analysis that captures two aspects: on one hand it highlights the change determined by the pandemic in online commerce, and on the other hand it shows an X-ray of the EU states positioning in terms of e-commerce evolution. The latter consists in a comparative Hierarchical Cluster Analysis that aims to provide an image on the situation of EU states, before and after the pandemic has been installed. The Cluster Analysis was carried out in SPSS software and it is based on a series of chosen indicators from Eurostat database. This comparison provides an image of how changes among the clusters take place in terms of e-commerce indicators. It is noted that in countries where the digitization was more developed, the value of the change in online commerce was less considerable, comparing to the Eastern and Balkan states, which had a more significant increase. However, there are significant limitations based on the small number of indicators taken into consideration in this paper. Future work needs to be done in order to explore new ways to address the challenges identified in the development of e-commerce and online shopping.

Virtualized offline services are available at remote locations all over the world, due to digitization which has conquered the world of information. Considering the unstoppable evolution of technology, new challenges for cybersecurity appeared. Traditional security solutions are not facing the complicated threats of new technologies anymore. Cybersecurity is not anymore about the protection of an individual device against ransomware or a basic attack. Certainly, to protect against cyber-attacks become more and more difficult than a decade ago. It supposes the protection of the virtual resources and of the entire networks. Considering innovation and high tech vectors, the first objective of this article is to present the evolution of cybersecurity tools. The hypothesis of the article is that high tech favors cyberattacks, without a strong cybersecurity policy adopted by companies and governments. Cyber-attacks have the power to destabilize governments or political systems and to increase the risk of external and internal conflicts. If the security policy is not adapted to the market, companies risk a lot because they can lose all – business performance, money or brand perception.

Objective: Hypertensive pregnant women who do not respond to treatment with labetalol to control blood pressure (BP), but require vasodilatory therapy, progress rapidly to severe hypertension. This could be delayed by early recognition and individualized treatment. In this study, we sought to create prediction models from data at presentation and at 1 h and 24 h after commencement of treatment to identify patients who will not have a sustained response to labetalol and therefore need vasodilatory therapy.Methods: The study population comprised 134 women presenting with hypertension at a UK hospital. Treatment with oral labetalol was administered when BP was > 150/100 mmHg or > 140/90 mmHg with systemic disease. BP and hemodynamic parameters were recorded at presentation and at 1 h and 24 h after commencement of treatment. Labetalol doses were titrated to maintain BP around 135/85 mmHg. Women with unresponsive BP, despite labetalol dose maximization (2400 mg/day), received additional vasodilatory therapy with nifedipine. Binary logistic and longitudinal (mixed-model) data analyses were performed to create prediction models anticipating the likelihood of hypertensive women needing vasodilatory therapy. The prediction models were created from data at presentation and at 1 h and 24 h after treatment, to assess the value of central hemodynamics relative to the predictive power of BP, heart rate and demographic variables at these intervals.Results: Twenty-two percent of our cohort required additional vasodilatory therapy antenatally. These women had higher rates of severe hypertension and delivered smaller babies at earlier gestational ages. The unresponsive women were more likely to be of black ethnicity, had higher BP and peripheral vascular resistance (PVR), and lower heart rate and cardiac output (CO) at presentation. Those who needed vasodilatory therapy showed an initial decrease in BP and PVR, which rebounded at 24 h, whereas BP and PVR in those who responded to labetalol showed a sustained decrease at 1 h and 24 h. Stroke volume and CO did not decrease during the acute phase of treatment in either group. The best model for prediction of the need for vasodilators was provided at 24 h by combining ethnicity and longitudinal BP and heart rate changes. The model achieved a detection rate of 100% for a false-positive rate of 20% and an area under the receiver-operating characteristics curve of 0.97.Conclusion: Maternal demographics and hemodynamic changes in the acute phase of labetalol monotherapy provide a powerful tool to identify hypertensive pregnant patients who are unlikely to have their BP controlled by this therapy and will consequently need additional vasodilatory therapy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.Resumen Objetivo: Las embarazadas hipertensas que no responden al tratamiento con labetalol para el control de la presión arterial (PA), pero que requieren terapia vasodilatadora, evolucionan rápidamente hacia una hipertensión severa. Ésta se puede retrasar mediante un diagnóstico precoz y un tratamiento individual. En este estudio se ha tratado de crear modelos de predicción a partir de datos al inicio del tratamiento y al cabo de 1 hora y de 24 horas después del mismo, para identificar a las pacientes que no mostrarán una respuesta constante al labetalol y que por lo tanto necesitarán terapia vasodilatadora. MÉTODOS: La población de estudio incluyó 134 mujeres con hipertensión en un hospital del Reino Unido. El tratamiento con labetalol por vía oral se administró cuando la PA fue >150/100 mm de Hg o >140/90 mm de Hg con enfermedad multisistémica. Se registró la PA y los parámetros hemodinámicos tanto al inicio como al cabo de 1 h y de 24 h después del inicio del tratamiento. Las dosis de Labetalol se ajustaron para mantener la PA en torno a los 135/85 mm de Hg. Las mujeres cuya PA no produjo respuesta, a pesar de haberles administrado la dosis máxima de labetalol (2400 mg/día), recibieron terapia vasodilatadora adicional con nifedipino. Se realizaron análisis de datos mediante logística binaria y longitudinal (modelo mixto), para crear modelos de predicción con los que pronosticar la probabilidad de la necesidad de terapia vasodilatadora en mujeres hipertensas. Los modelos de predicción se crearon a partir de datos al inicio y al cabo de 1 hora y 24 horas del tratamiento, para evaluar el valor de los parámetros hemodinámicos principales con respecto a la capacidad predictiva de la PA, la frecuencia cardíaca y las variables demográficas en estos intervalos.Resultados: El 22 % de la cohorte necesitó terapia vasodilatadora adicional antes del parto. Estas mujeres tuvieron tasas más altas de hipertensión grave y neonatos más pequeños en edades gestacionales más tempranas. Las mujeres que no respondieron al tratamiento fueron con más frecuencia de raza negra, tuvieron la PA y la resistencia vascular periférica (RVP) más alta, y la frecuencia cardíaca y el gasto cardíaco (GC) más bajos al inicio del tratamiento. Aquellas que necesitaron terapia vasodilatadora mostraron un descenso inicial de la PA y la RVP, que se recuperó al cabo de 24 h, mientras que la PA y la RVP en las que respondieron al labetalol mostraron una disminución constante al cabo de 1 h y de 24 h. El volumen sistólico y el GC no disminuyeron durante la fase aguda del tratamiento en ninguno de los grupos. El mejor modelo para la predicción de la necesidad de vasodilatadores se obtuvo a las 24 h mediante la combinación de la etnia con los cambios longitudinales de la PA y la frecuencia cardíaca. El modelo alcanzó una tasa de detección del 100% para una tasa de falsos positivos del 20% y un área bajo la curva de características operativas del receptor de 0,97. CONCLUSIÓN: Los datos demográficos maternos y los cambios hemodinámicos en la fase aguda de la monoterapia con labetalol constituyen una herramienta poderosa para identificar a las pacientes embarazadas hipertensas con pocas probabilidades de que se les pueda controlar su PA mediante esta terapia y que por lo tanto necesitarán terapia vasodilatadora adicional. : 、(blood pressure,BP),。。,1 h24 h,。 : 134。BP>150/100 mmHgBP>140/90 mmHg。1 h24 hBP。,BP135/85 mmHg。BP,()。logistic(),。1 h24 h,,BP、。 : 22%。。,BP(peripheral vascular resistance,PVR),(cardiac output,CO)。BPPVR,24 h,1 h24 hBPPVR。CO。24hBP。100%,20%,0.97。 : ,BP。. [ABSTRACT FROM AUTHOR]

Even if international law manifested initially as quite reluctant in the acceptance and, especially, the massive international liability for environmental damage, since the second half of the twentieth century were adopted several international legal instruments of general and special nature which include regulations on environmental protection measures, but also on the liability of those guilty of altering it. [ABSTRACT FROM AUTHOR]

The maritime zones recognized under international laws - are formed from the high seas, with the riches at the bottom of the oceans and seas from this perimeter - which is regulated by international conventions, whose infringement may lead to the application of sanctions in conformity with the dispositions stipulated, or, in the lack of such dispositions, to taking other measures, such as repression or retaliation, which are considered, in the public international law, as being general sanctions included in the category of countermeasures. At high seas serious acts of a criminal character are also committed, such as: piracy, illicit traffic of narcotics and psychotropic substances, etc., thus all states must cooperate in view of repressing these acts and sanctioning the culprits. [ABSTRACT FROM AUTHOR]

Even if in the remote past, international right manifested itself quite reluctant in accepting and, in materializing the international state liability, for damages brought to the environment, in the second half of the 20th century, in this domain several legal international universal or regional instruments were adopted, implying a general or special character, the problem of environment protection becoming one of the major preoccupations of the international community, which was faced with the catastrophic effects of some events which had a devastating result upon the environment, such as: the accidents of the Torry Canyon tanker vessels in the year 1967, Exxon Valdez in the year 1992, Prestige in the year 2002, the accident from the Sandoz plants in Switzerland and, not least, the nuclear accident at Chernobyl (Ukraine) since 1986. [ABSTRACT FROM AUTHOR]

Delocalization of production and diversification of the sources of offer in the global market place the issue of protection of consumer rights in major consumption centres, namely the European Union in a new light. A review of policies for the protection of consumer rights in the EU, USA and China, reveals major differences regarding the protection of consumer rights and the existence of gaps, and in particular the implementation of effective legislation in this regard. As such, the risks associated with imports have become a major concern in the European Union. The consumer has – one can say – a central role in the globalization process, which justifies the measures aimed at its protection. Although worldwide there are major differences in the degree of market regulation in matters of protection of consumer rights, the trend is the continuous adaptation of the offer to the requirements of global demand. However, one can still find significant gaps which translate into risks specific to the consumers in developed countries, namely in the EU. An important issue arises from this radical change of the localization of production centres in relation to the main consumption centres. While in the developed world, consumer rights protection has reached high levels both by creating an appropriate legislative framework and through consumer awareness and activism regarding their rights, in areas where much of the offer comes from the Western market (China, India, etc.) modern mentality on the protection of consumer rights is just emerging. A major requirement is therefore the provision of a status of the consumer compatible with the benefits and risks of globalization, a status defined by safety and protection of imports. This paper confirms the thesis that, ultimately, the main factor counteracting the risks in matters of protection of consumer rights is the consumer, its awareness of its rights.

The educational system is one of the important factors in creating and developing the competitive forces of a country. The higher education provides the socio-economic environment with two basic services: teaching and research. The duality marks an entire history for higher education, but nowadays a new dilemma has emerged: economic efficiency (the university as an economic provider of services) versus academic competitiveness (the university as a research forum). In addition, a new challenge seems to be altering the future of higher education, these stemming from the massive increase in the demand for university teaching services: elite higher education, thus efficient, highly competitive academically (competitiveness), or mass higher education, adapted to the demand, with the primary role of harnessing knowledge though professional training (effectiveness).

If in the first stages of the internalization of business, logistics had a minor influence in the international success of the company. In a globalized economy, strategy and the logistics costs are essential factors for competitiveness. Nowadays, logistics determines the place which a country or a company holds in the worldwide competitive hierarchy. The new Incoterms – 2010 – establish – in the field of commercial practices this reality: performance is now assessed in global terms (not national), competition is global, not international. Ultimately, the new Incoterms encourage/stimulate the orientation of firms towards increasing competitiveness by employing an appropriate logistics strategy; the degree to which firms will manage – as quickly as possible – to be integrated in this new trend will also be the measure of their competitive capacity in the newly emerged context. The category of global firms should not include just the large transnational corporations, but also the medium and small enterprises that operate exclusively or mainly on the global market. Within this plan there can be created and developed competitive advantages which are primarily based on the reaction speed to the changes in progress, the capacity to adapt to new things and the availability for intercultural communication. These last conditions represent characteristics of the Romanian business approach.

In a globalised economy transport is one of the most important factors linking the national economies and maritime transport is the main way to deliver goods in international trade. For any international company, choosing the appropriate transportation as part of the logistic solution is vital for its competitiveness. In the context of the economic crisis, CEE strategic location factors play an important role for regional companies which adapt and change their logistic services by developing new scenarios for the shipping industry in order to obtain a better position on the global market. In addition to a favourable geographical location CEE has several other important arguments, like sufficient harbours for developing container terminals to launch extensive container transport transit. The most important recent trends in logistics are shown, as well as the framework of the EU maritime transport.

Introduction: Fetal growth restriction (FGR) is associated with poor perinatal outcomes. Screening and prevention tools for FGR, such as uterine artery Doppler imaging and aspirin, underperform in high-risk groups, compared with general antenatal populations. There is a paucity of sensitive screening tests for the early prediction of FGR in high-risk pregnancies., Materials and Methods: This was a prospective observational study based in a dedicated antenatal hypertension clinic at a tertiary UK hospital. We assessed maternal demographic and central hemodynamic variables as predictors for FGR in a group of women at high risk for placental insufficiency due to chronic hypertension (n = 55) or a history of hypertension in a previous pregnancy (n = 71). Outcome variables were birthweight z-score as well as development of FGR (defined as birthweight below the 5th or 3rd centile). Maternal hemodynamics were assessed using a noninvasive transthoracic bioreactance monitor (Cheetah NICOM)., Results: The mean gestation at presentation was 13.6 (range: 8.5-19.5) weeks. Sixteen women delivered babies below the 5th centile. Ten of these were below the 3rd centile. Independent predictors of birthweight z-score were body surface area, peripheral vascular resistance and white ethnicity (R(2) = 0.26, p < 0.0001). Independent predictors of FGR were maternal height and cardiac output. The area under the receiver operator characteristic curve for prediction of FGR was 0.915 (95% CI 0.859-0.972) and 0.9079 (95% CI 0.823-0.990) for FGR below the 5th and 3rd centiles, respectively., Conclusion: In women with chronic hypertension or a history of hypertension in a previous pregnancy, maternal size and cardiac output at booking provide a sensitive screening tool for FGR., (© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.)

There is more than ample evidence that Hans Reiter, whose name has been eponymously linked to a rheumatologic syndrome, was a Nazi war criminal. He was responsible for heinous atrocities that violated the precepts of humanity, ethics, and professionalism. The authors suggest that Reiter's legacy is sufficiently tainted that the professional and ethical position of the medical community should be to no longer afford him this recognition. He should be remembered symbolically to remind us of our moral and professional responsibilities to prevent the kind of "experiments" he perpetrated as Director of the Nazi office for such matters. Medicine is a moral enterprise. Physicians serve to promote the welfare of their patients. Hans Reiter and others like him who have behaved in such a manner have acted beyond the pale of acceptable human behavior. These crimes by Reiter and others like him were transcendently aberrant and evil. We regard Reiter and others like him as tainted. We see no acceptable rationale to preserve any professional memory of Reiter and others like him within our medical culture except as a symbol of what our societal values obligate us to reject. We suggest reverting to or substituting other terms for the syndrome (such as spondyloarthropathy, spondyloarthritis, oligoarthritis, inflammatory oligoarthritis, reactive arthritis, [oligo-] arthritis with conjunctivitis/urethritis/diarrhea, etc) until pathophysiologic or other insights lead to better ones. (It should be noted that the description of this syndrome was not original to Reiter and that current nomenclature is probably in need of revision in any case because the terminology and classification is outdated and clinically imprecise.) We offer these recommendations because we cannot forget. We cannot forget that Reiter and others like him represented an abhorrent evil. We cannot forget that Reiter and others like him desecrated the traditions of our civilization. We cannot forget that Reiter and others like him violated the precepts of the Hippocratic oath. The legacy of Hans Reiter should be that we remember only this and resolve that such transgressions never again occur., (Copyright 2003, Elsevier Science (USA). All rights reserved.)

Study Objective: Serum markers of smooth muscle destruction have been shown to be elevated in ectopic pregnancy, but they remain of questionable clinical utility. Our goal was to determine the clinical utility of 3 markers of smooth muscle destruction: creatine phosphokinase (CPK), smooth muscle heavy-chain myosin (SMHC), and myoglobin., Methods: This was a prospective cohort study, with consecutive enrollment of all women in the first trimester of pregnancy who presented to our urban emergency department with complaints of lower abdominal pain, vaginal bleeding, or both. Patients were excluded from the study if there was a history of recent surgery or major trauma. Data analysis included receiver operating characteristic (ROC) curve, 95% confidence intervals (CIs), and a regression model., Results: A total of 378 patients were enrolled, with 61 patients diagnosed with an ectopic pregnancy, and 317 patients placed in the non-ectopic pregnancy group with other diagnoses. ROC curve analysis revealed an area under the curve of 0.56 (95% CI 0.51 to 0.61) for CPK, 0.63 (95% CI 0.59 to 0.68) for SMHC, and 0.58 (95% CI 0.53 to 0.63) for myoglobin. A regression model analyzing the effects of race, maternal age, estimated gestational age, and serum levels of human chorionic gonadotropin beta-subunit found no significant confounders., Conclusion: Although there is a statistically significant elevation in the serum levels of SMHC, the range of values seen is too large to allow SMHC to be a useful screening tool.