Short-Term Changes in Weather Conditions and the Risk of Acute Coronary Syndrome Hospitalization with and without ST-Segment Elevation: A Focus on Vulnerable Subgroups.

Background and Objectives: Acute coronary syndrome (ACS), a prevalent global cardiovascular disease and leading cause of mortality, is significantly correlated with meteorological factors. This study aims to analyze the impact of short-term changes in meteorological factors on the risk of ACS, both with and without ST-segment elevation, and to identify vulnerable subgroups. Materials and Methods: Daily ACS admissions and meteorological variables were collected from October 2016 to December 2021. A generalized linear model (GLM) with a Poisson distribution was employed to examine how short-term fluctuations in meteorological parameters influence ACS hospitalizations. Subgroup analyses were conducted to identify the populations most vulnerable to climate change. Results: Multiple regression analyses showed that short-term fluctuations in atmospheric pressure (≥10 mbar) and air temperature (≥5 °C) seven days prior increased the number of ACS hospitalizations by 58.7% (RR: 1.587; 95% CI: 1.501-1.679) and 55.2% (RR: 1.552; 95% CI: 1.465-1.644), respectively, notably impacting ST-segment elevation myocardial infarctions (STEMIs). The least pronounced association was observed between the daily count of ACS and the variation in relative air humidity (≥20%), resulting in an 18.4% (RR: 1.184; 95% CI: 1.091-1.286) increase in the risk of hospitalization. Subgroup analysis revealed an increased susceptibility among men and older adults to short-term variations in weather parameters. Conclusions: The findings indicate that short-term changes in weather conditions are associated with an increased risk of ACS hospitalizations, particularly STEMIs. Male and older adult patients exhibit heightened susceptibility to variations in climatic factors. Developing effective preventive strategies is imperative to alleviate the adverse consequences of these environmental risk factors.

Postpartum Maternal Emotional Disorders and the Physical Health of Mother and Child.

Purpose: The purpose of this study is to identify the relationships between postpartum emotional manifestations and various neonatal variables, as well as variables within this category, in the context of hospitalization together after birth. Patients and Methods: Between 1 March 2020 and 1 September 2020, a cross-sectional research design was used including mother-child couples (112 mothers, 121 newborns - 13 twins/triplets). Results: Using a t-test for independent samples, we observed: a) the symptoms of depression were more severe in mothers of newborns hospitalized in neonatal intensive care units (NICUs) [t(110) = 4.334)], provided oxygen therapy [t(109.99) = 3.162], born prematurely [t(110) = 3.157], or with adjustment disorders [t(109) = -2.947] (p < 0.01); b) a similar, for anxiety as a state [t(82.38) = 5.251], t(107.29) = 4.523, t(110) = 3.416, t(109) = -3.268, p < 0.01], and as a trait was more common [t(80.79) = 4.501, t(108.790) = 4.669, t(109) = -3.268, p < 0.001] compared to other mothers. Using Pearson's test (p < 0.001), several very strong correlations were observed between neonatal variables, including number (no.) of days of hospitalization with birth weight (BW) (r = -0.802), head circumference (HC) (r = -0.822), and gestational age (GA) (r = -0.800) and the mother's postpartum anxiety as a state/trait (r = 0.770). Using Poisson regression, it was observed that anxiety as a state (Λ = 0.020, z = 4.029, p < 0.001) and as a trait (Λ = 0.800, z = 6.160, p < 0.001) stimulated the intensity of symptoms of postpartum depression (optimal models). Conclusion: Postpartum maternal psychological manifestations were associated with NICU hospitalization, pathology, and some neonatal therapies. We also noticed, that the duration of hospitalization, BW, HC, and GA, were correlated with maternal emotional disorders. Results will facilitate future optimization of birth management and postnatal care.

Influence of the Printing Angle and Load Direction on Flexure Strength in 3D Printed Materials for Provisional Dental Restorations.

The CAD/CAM techniques, especially additive manufacturing such as 3D printing, constitute an ever-growing part of obtaining different dental appliances and restorations. Of these, provisional restorations are of frequent use in daily dental practice and are the object of this study. Masticatory and parafunctional forces determine flexure on these prostheses. This study investigates the influence of the printing angle and loading direction of the applied force on the flexure strength of two commercially available printable resins-Detax Freeprint Temp and Nextdent MFH Vertex dental. Ten rectangular beam specimens printed at the angle of 0, 45 and 90 degrees were fabricated of each of these materials, with an addition of 10 at 0 degrees for the investigation of the load direction. Three-point bending tests were performed in a universal testing machine. Flexure strength, strain at break and Young's modulus were determined and a statistical analysis was performed on the obtained data. According to the statistical analysis, the flexural strength has a significance dependence with respect to degrees of orientation, for both investigated materials.

Facing COVID-19 Challenges: 1st-Year Students' Experience with the Romanian Hybrid Higher Educational System.

First-year students undergo several transformations like the transition from high school to university schedules, teaching methods, and discipline specificities to social changes that come with meeting new colleagues or moving to other locations far from family and friends. The COVID-19 outbreak brought additional concerns and uncertainties once educational systems implemented distance learning schemes for public health management. Nevertheless, higher educational organizations preferred to implement hybrid approaches for student engagement motivation and high dropout rate avoidance. In Romania, such an educational system has been applied with caution. Since the pandemic needs to be understood as an opportunity for adaptation and education improvements, the purpose of the present paper is to uncover lessons learned and to develop a systematized model based on students' perception regarding face-to-face, online and hybrid systems. For this reason, a grounded theory approach has been preferred. Thus, 149 Romanian students enrolled in the first year in engineering specialities with ages between 18-26 years both male (50.3%) and female (49.7%) have answered the research questions in an online environment due to pandemic restrictions. Based on the online asynchronous student interviews, 220 codes and a further 13 categories have been developed. After a pertinent analysis of the relationships between categories and relevant literature sorting, a theoretical model for the Romanian higher educational current pandemic situation has been proposed. The main face-to-face and online education characteristics are outlined, the hybrid approach becoming a bridge between the two systems. Management implications are outlined together with further research directions.

Is Fracture Toughness of PUR Foams a Material Property? A Statistical Approach.

The published data on the experimentally determined fracture toughness of foams are based on a small number of specimens, having a lack of statistical consistency. The paper proposes a statistical approach on the fracture toughness results of rigid polyurethane (PUR) foams of three different densities. Five types of fracture tests were considered. The results were statistically analyzed using six types of regressions and a meta-analysis to identify the factors influencing the fracture toughness. The statistical analysis indicates that the fracture toughness represents a material property because does not depend on the specimen type. The density plays a major role in the fracture toughness of PUR foams. The irregular shape of the cells induced small anisotropy for low-density foams (100 kg/m3 and 145 kg/m3). This effect could not be observed for the foam with 300 kg/m3 density, for which the cells have a more regular spherical shape. The statistical analysis indicates that the influence of the loading speed is very weak.

TI-RADS Diagnostic Performance: Which Algorithm is Superior and How Elastography and 4D Vascularity Improve the Malignancy Risk Assessment.

Given the increased prevalence of thyroid nodules in the general population (~50%), the real challenge resides in correctly recognizing the suspicious ones. This study proposes to compare four important Thyroid Imaging and Reporting Data Systems (TI-RADS) and evaluate the contribution of elastography and 4D Color Doppler assessment of vascularity in estimating the risk of malignancy. In the study, 133 nodules with histopathological examination were included. Of these, 35 (26.31%) proved to be malignant. All nodules were classified using the four selected systems and our proposed improved score. The American College of Radiology (ACR) and EU TI-RADS had good sensitivity (94.28%, 97.14%) and NPV (93.33%, 95.83%), but fairly poor specificity (31.81%, 23.46%) and PPV (35.48%, 31.19%), with an accuracy of 42.8% and 45.8%, respectively. Horvath TI-RADS had better accuracy of 66.9% and somewhat improved specificity (62.24%), but poorer sensitivity (80%). Russ' French TI-RADS includes elastography in the risk assessment strategy. This classification proved superior in all aspects (Se: 91.42%, Sp:82.65%, NPV:96.42%, PPV:65.30%, and Acc of 84.96%). The mean strain ratio (SR) value for malignant lesions was 5.56, while the mean SR value for benign ones was significantly lower, 2.54 (p < 0.05). It also correlated well with the response variable: histopathological result (p < 0.001). Although, adding 4D vascularity to the French score generated a similar calculated accuracy and from a statistical point of view, the parameter itself proved beneficial for predicting the malignancy risk (p < 0.001) and may add important knowledge in uncertain situations. Advanced ultrasound techniques definitely improved the risk estimation and should be used more extensively.

In vivo confocal microscopy quantification of reactive oxygen species: a working model in rat kidney.

Oxidative stress is a culprit responsible for the development of acute and chronic kidney diseases. We aimed to establish a working model for the dynamic in vivo assessment of reactive oxygen species (ROS) production in rat kidney. A randomized controlled study was performed in 36 adult male Wistar rats subjected to unilateral urinary obstruction (UUO) via ureteral ligation and compared to SHAM controls. Dihydroethidium (DHE) was injected in the femoral vein and in vivo confocal microscopy was performed in the 2nd, 6th and 10th day, respectively after surgery. Maximal ROS levels elicited by UUO were recorded on the 6th day. However, the absolute difference of the means of DHE fluorescence intensity between UUO and SHAM was the highest on the 10th day. Our working model can monitor ROS production at different time frames and our initial findings suggest that the surgery-related ROS levels decline after an initial increase in the first days, whereas the ones elicited by chronic ligation continue to raise.