Prevalence and association of oral manifestations with disease severity in patients diagnosed with COVID­19: A cross­sectional study.

Systemic disorders may exhibit early signs when conducting an oral examination. Since the onset of the COVID-19 pandemic, several studies have been published detailing the direct impact of the virus on the oral cavity. The present study aimed to determine whether indeed there are any significant disparities in oropharyngeal manifestations between individuals infected with severe acute respiratory syndrome coronavirus 2 and a control group, and whether the virus has the ability to invade and reproduce inside oral keratinocytes and fibroblasts, resulting in the development of oral ulcerations and superficial lesions. The present study provides an overview of the symptoms that occur at an early stage of the illness, and the most commonly affected regions of the oral cavity, including the tongue, lips, palate and oropharynx are examined. In the present retrospective study, 52 patients infected with COVID-19 were recruited between April, 2021 and October, 2022. In addition, 52 individuals who tested negative for the virus were recruited as the control group. The study was conducted through a thorough examination and questionnaire provided to all participants. The results revealed that among the cohort of patients from the COVID-19 group examined (n=52), a proportion (mean, 16.15) displayed oral manifestations. Specifically, 75% of the patients in the COVID-19 group described oral cavity pain, and 69% of these patients had changes in teeth color or dental caries. In summary, in relation to the control group, the prevalence of oropharyngeal symptoms was generally lower compared to the COVID-19 group, apart from oral cavity pain (30.8%), tonsillitis (17.3%), bleeding (34.6%), teeth color changes (36.5%), recurrence (15.4%) and abscesses (7.7%). Thus, on the whole, the patients without COVID-19 had fewer oral manifestations.

Challenges and perceptions of e-learning for educational sustainability in the "new normality era".

Background: All universities were faced with the challenges of e-learning when they suddenly had to switch to distance learning in March 2020 due to COVID-19 regulations. Several challenges may arise when implementing e-learning, including an insufficient budget or problems with adoption. Nevertheless, the role of digitalization is to ensure the university's long-term sustainability. Indeed, the future of e-learning depends on future generations, which increasingly accept new technologies. Objectives: This study aimed to analyze the factors that stimulate university students' acceptance of technology. Methodology: The study population comprised Romanian university students who took online courses during the COVID-19 pandemic. A questionnaire survey was employed to gather primary data. The surveys were distributed between January and February 2022. In particular, 1,875 questionnaires were received from students, who were the focus of this study (the results for teachers were presented in previous research). To process and interpret the data, the method of modeling with structural equations (SEM) was used. The data collected were processed using SPSS and AMOS. Findings: The results indicate that external factors do not influence perceived usefulness. Accordingly, students consider that the perceived ease of use does not influence the behavior intention to use new technologies. Conclusion: The results linked e-learning satisfaction to academic success and Romanian students who utilized e-learning during the pandemic. In addition, the results indicate that external factors do not influence perceived usefulness. Accordingly, students consider that the perceived ease of use does not influence the behavior intention to use new technologies. The results validated the basic variables of the TAM model. Implications: The study presents a series of theoretical, practical, and societal implications that can guide universities in adopting sustainable development goals.

Risk factors in non­surviving patients with infection with carbapenemase­producing Enterobacterales strains in an intensive care unit.

Carbapenemase-producing Enterobacterales (CPE) are Gram-negative bacteria that belong to the Enterobacterales family and produce enzymes known as carbapenemases, which inhibit carbapenems, cephalosporins and penicillins. Carbapenem-resistant Enterobacterales (CRE) are resistant to carbapenems, cephalosporins and penicillins via mechanisms that may or may not produce carbapenemases. The identification of carbapenems is critical for the initiation of proper antibiotic therapy. The present case-control, retrospective study included 64 patients with CPE strains admitted to an intensive care unit between September, 2017 and October, 2021; of these, 34 patients with CPE succumbed and 30 control patients with CPE strains survived. CPE strains in the deceased patients were caused by Klebsiella spp. in 31 cases (91.2%) and Escherichia coli in 3 cases (8.8%). The univariate analysis revealed that the predictive factors associated with mortality in patients with CPE were admission with coronavirus disease 2019 (COVID-19) (P=0.001), invasive mechanical ventilation (P=0.001), and treatment with corticosteroids (P=0.006). The multivariate analysis revealed that admission with COVID-19 [odds ratio (OR), 16.26; 95% confidence interval (CI), 3.56-74.14; P≤0.05] and invasive mechanical ventilation (OR, 14.98; 95% CI, 1.35-166.22; P≤0.05) were associated with mortality as independent risk factors. Admission with COVID-19 increased the risk of mortality 16.26-fold and invasive mechanical ventilation increased the risk of mortality by 14.98-fold. On the whole, the present study demonstrates that the length of hospital duration in patients who acquired CPE did not influence mortality, whereas infection with COVID-19 increased and invasive mechanical ventilation were associated with an increased risk of mortality.

Boutonneuse Fever in Southeastern Romania.

Boutonneuse fever (BF) is an eruptive disease and is classified as a spotted fever, which is endemic in the Mediterranean basin (i.e., Marseille fever or Mediterranean spotted fever) and the Black Sea, caused by Rickettsia conorii, with dog ticks being a vector (i.e., Rhipicephalus sanguineus). In Romania, although the first reported outbreak of BF occurred during the summer of 1931 in Constanta, the disease was discovered in 1910. Although the disease has occurred most frequently in the two counties of the Dobruja region (Constanta and Tulcea), a region of the Balkan Peninsula, during the last few years, other counties in southeastern Romania have started to report BF cases. In a period of 9 years, 533 cases were registered in Constanta county, while in a period of 11 years, 339 cases were registered in Bucharest county. In this review, we describe the bacterial tick-borne disease caused by R. conorii in southeastern Romania, focusing on its history and epidemiology, pathophysiology, clinical aspects, diagnosis, treatment and preventive measures in the context of climate changes. Although R. conorii is the principal etiologic agent of BF in southeastern Romania, we should take into consideration that other Rickettsia spp. could be present and involved in disease transmission.

Continuous Glucose Monitoring in Transient Neonatal Diabetes Mellitus-2 Case Reports and Literature Review.

Neonatal diabetes mellitus is a rare genetic disease that affects 1 in 90,000 live births. The start of the disease is often before the baby is 6 months old, with rare cases of onset between 6 months and 1 year. It is characterized by low or absent insulin levels in the blood, leading to severe hyperglycemia in the patient, which requires temporary insulin therapy in around 50% of cases or permanent insulin therapy in other cases. Two major processes involved in diabetes mellitus are a deformed pancreas with altered insulin-secreting cell development and/or survival or faulty functioning of the existing pancreatic beta cell. We will discuss the cases of two preterm girls with neonatal diabetes mellitus in this research. In addition to reviewing the literature on the topic, we examined the different mutations, patient care, and clinical outcomes both before and after insulin treatment.

Development of Gut Microbiota in the First 1000 Days after Birth and Potential Interventions.

The first 1000 days after birth represent a critical window for gut microbiome development, which is essential for immune system maturation and overall health. The gut microbiome undergoes major changes during this period due to shifts in diet and environment. Disruptions to the microbiota early in life can have lasting health effects, including increased risks of inflammatory disorders, autoimmune diseases, neurological disorders, and obesity. Maternal and environmental factors during pregnancy and infancy shape the infant gut microbiota. In this article, we will review how maintaining a healthy gut microbiome in pregnancy and infancy is important for long-term infant health. Furthermore, we briefly include fungal colonization and its effects on the host immune function, which are discussed as part of gut microbiome ecosystem. Additionally, we will describe how potential approaches such as hydrogels enriched with prebiotics and probiotics, gut microbiota transplantation (GMT) during pregnancy, age-specific microbial ecosystem therapeutics, and CRISPR therapies targeting the gut microbiota hold potential for advancing research and development. Nevertheless, thorough evaluation of their safety, effectiveness, and lasting impacts is crucial prior to their application in clinical approach. The article emphasizes the need for continued research to optimize gut microbiota and immune system development through targeted early-life interventions.

The role of universities' sustainability, teachers' wellbeing, and attitudes toward e-learning during COVID-19.

In recent years, universities worldwide have experienced rapid changes with an immense impact, which have been influenced by technological progress and the social trends of digitalization. Like all other revolutionary changes, digital transformation involves intense adjustment/readjustment. University sustainability must be the active concern of all higher education institutions. Thus, the present research aims to analyse teachers' acceptance of new technologies and the impact on their wellbeing and university sustainability. The main objective was to analyse the acceptance of technology in special the e-learning opportunities and the wellbeing of teacher in an emergent country like Romania. To achieve our goal, we created a questionnaire based on the literature, and with the help of the technology acceptance model, we tested our hypotheses. The results indicate several discontents on the part of teachers concerning adapting to new technologies and even a personal discomfort in adapting to these new technologies. Thus, we can note that wellbeing significantly influences job satisfaction and teachers' involvement in sustainable development.

Comprehensive Assessment of Tailing Dumps' Impact on Water Quality of Rivers, Lakes, and Wells from Mining Areas.

This study is the third in a series of investigations conducted by the authors, and certainly the most comprehensive research regarding the former uranium, copper, and charcoal mines from a particular geographical area of Romania. In this respect, the present scientific incursion focused on two areas containing former extraction uranium ore sites, Ciudanovita and Lisava, as well as copper ore from Moldova Noua and charcoal mines from Anina, Banat Region, Romania. It highlighted that, for the first time, the heavy metal concentration was correlated with the values of physicochemical indicators of water (i.e., EC, DO, pH, resistivity, salinity, and ORP), by using multivariate analysis, to shape a regional based model on spatial distributions and the variability of toxic contaminants from the hydrographic basin of Banat, Romania, as a consequence of former uranium, copper, and charcoal mines. In this regard, 11 metals including Al, Cr, Mn, Fe, Ni, Co, Cu, Zn, Sr, Cd, and Pb from different water samples (well, spring, river, and lake), collected from three mining areas (uranium, copper, and coal mines) were investigated. Non-carcinogenic and carcinogenic health risks of seven heavy metals were assessed using the EDI, DIM, and THQ. The obtained THQ values were within the acceptable limits for cancer risks for adults, but as regards children, eight samples out of 18 proved toxic. However, the HRI and THQ average values for Cd (0.265 adults/0.996 children) and Pb (0.025 adults/0.095 children) for children were 3-4 times higher than those for adults. This is a source of concern as their prevalence in well water exposes children and residents in the Banat Region to the risk of various types of cancers.

Conceptual Model for Integrating Environmental Impact in Managerial Accounting Information Systems.

The main research objective is to develop a conceptual accounting model to reflect the environmental impact generated by the economic activity of Romania's entities. In order to identify the current stage of the use of environmental accounting by the Romanian economic entities, the questionnaire used was based on a random sample of 377 entities whose economic activity has a significant impact on the environment. The results suggest the need to develop a model for integrating environmental impact into accounting. The model is based on the description of the technological process and determination of the environmental impact on each activity, stage, or procedure of the technological process, which enterprise will integrate its monetary value in the cost of production and will reflect it in the management accounting system, using specific environmental accounting instruments. The model involves five stages, and by combining internal and external information provided by environmental management accounting is a relevant source for substantiating decisions to promote environmental responsibility in Romanian companies.

Patients with renal cell carcinoma nodal metastases can be accurately identified: external validation of a new nomogram.

Outcome of patients with renal cell carcinoma nodal metastases (NM) is substantially worse than that of patients with localized disease. This justifies more thorough staging and possibly more aggressive treatment in those at risk of or with established NM. We developed and externally validated a nomogram capable of highly accurately predicting renal cell carcinoma NM in patients without radiographic evidence of distant metastases. Age, symptom classification, tumour size and the pathological nodal stage were available for 4,658 individuals. The data of 2,522 (54.1%) individuals from 7 centers were used to develop a multivariable logistic regression model-based nomogram predicting the individual probability of NM. The remaining data from 2,136 (45.9%) patients from 5 institutions were used for external validation. In the development cohort, 107/2,522 (4.2%) had lymph node metastases vs. 100/2,136 (4.7%) in the external validation cohort. Symptom classification and tumour size were independent predictors of NM in the development cohort. Age failed to reach independent predictor status, but added to discriminant properties of the model. A nomogram based on age, symptom classification and tumour size was 78.4% accurate in predicting the individual probability of NM in the external validation cohort. Our nomogram can contribute to the identification of patients at low risk of NM. This tool can help to risk adjust the need and the extent of nodal staging in patients without known distant metastases. More thorough staging can hopefully better select those in whom adjuvant treatment is necessary. (c) 2007 Wiley-Liss, Inc.

Distribution of prostate specific antigen (PSA) and percentage free PSA in a contemporary screening cohort with no evidence of prostate cancer.

OBJECTIVE: To explore the distribution of total prostate specific antigen (PSA) and percentage free/total PSA (%f/tPSA) in healthy volunteers with no clinical evidence of prostate cancer, who participated in prostate cancer screening. SUBJECTS AND METHODS: PSA and %f/tPSA values from 2323 men, who participated in one of three annual prostate cancer screening events between 2004 and 2006, were tabulated according to age strata of 40-49, 50-59, 60-69 and 70-79 years. Local regression smoothing plots provided a graphical display of the relation between age and PSA or %f/tPSA, respectively. All PSA and %f/tPSA analyses were repeated for each age category after excluding, respectively, the top and the bottom 10% of PSA and %f/tPSA values. RESULTS: Within the entire cohort, the median PSA level was 1.0 ng/mL and the median %f/tPSA was 25%. According to the age categories the PSA level and %f/tPSA medians within the entire cohort were, respectively, 0.7, 0.9, 1.3, 1.8 ng/mL and 28.0, 26.0, 24.0 and 25.0%. Of the 2323 men, 438 (18.9%) had a PSA level of >2.5 ng/mL and 1172 (50.5%) had a %f/tPSA of < or = 25%. When either a PSA level of >2.5 ng/mL or a %f/tPSA of < or = 25% were considered, 1235 (53.2%) had one or two abnormal values. Finally, if either a PSA level of >2.5 ng/mL or %f/tPSA of < or = 15% was used, 617 (26.6%) were considered abnormal. CONCLUSION: Half of men with no clinical evidence of prostate cancer should have PSA levels of <1.0 ng/mL and a %f/tPSA of >25%. A PSA level threshold of 2.5 ng/mL would require a biopsy in 20% of men and a %f/tPSA threshold of < or = 25% in half of the men. Alternatively, a %f/tPSA threshold of < or = 15% would decrease the probability to 15%.