Diastolic dysfunction – pitfalls of etiological diagnosis in CKD patients

George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, The 8th International Medical Congress for Students and Young Doctors, September 24-26, 2020Introduction. It is acknowledged that patients with chronic kidney disease (CKD) have an increased risk of cardiovascular morbidity. One of the most frequent consequences among the cardiac alterations is the decrease of the heart’s performance during diastole. Sometimes it is difficult to indicate the cause-effect relationship taking into account other comorbidities of these patients, which can likewise lead to diastolic dysfunction. Aim of the study. The aim of this study is to investigate the main chronic morbidities found in patients with CKD and diastolic dysfunction. Materials and methods. We performed a retrospective study on 44 patients (21 males and 23 females). Patients with the diagnosis of CKD and altered echocardiographic parameters of the diastolic function were included in the study. Heart failure with reduced ejection fraction and implantable cardiac devices were exclusion criteria. We analysed the data regarding personal features (age, gender, environmental origin, BMI) and the presence of other comorbidities. Results.The mean age of the group was 71,84 years (range from 54 to 86 years), with a distribution of 53.49% in the rural area. The patients were diagnosed with CKD stages 2-5 (18.6% stage 2; 51.16% stage 3A; 27.91% stage 3B; 2.33% stage 5) and diastolic dysfunction (88.37% had impaired relaxation, 6.98% had pseudonormal pattern and 4.65% had reversible restrictive pattern). We found arterial hypertension (AHT) as the most frequent comorbidity, with 95.35% of the patients being affected (2.33% stage 1; 44.19% stage 2; 48.84% stage 3). Hypertensive cardiopathy appeared in 72% of the total number of patients, while chronic ischemic cardiopathy was found in 60.47% of the subjects. Diabetes Mellitus type 2 was diagnosed in 46.51% of the cases. 37.21% of the patients associated obesity of different degrees and 55.81% were overweight. Conclusions. Despite the fact that CKD can lead to diastolic dysfunction, according to our results, patients often associate other comorbidities that can interfere with the pathophysiology process, such as AHT, ischemic cardiopathy, Diabetes Mellitus type 2 and obesity

On Regularity for Constrained Extremum Problems

The fundamental necessary optimality criterion of nonlinear mathematical programming is the Kuhn-Tucker stationary point optimality criterion. Both for the Kuhn-Tucker optimality criterion and for the saddle point sufficient optimality criterion there is no guarantee that the multiplier associated to the objective function is strictly positive. If the multiplier is equal to zero, then the respective condition has been achieved without the contribution of the objective function. Even if this degenerate case is mathematically correct, this fact means perhaps that there is a gap between the mathematical model and the real problem represented by it. A condition ensuring that the multiplier is strictly positive involves only the constraints it is called constraint qualification(CQ); it is called regularity condition if it involves also the objective function. This thesis deals with regularity conditions ensuring the existence of Lagrange multipliers both for finite-dimensional and infinite-dimensional problems; the approach used is that of the Image Space approach, i.e. the space where the values of the functions run. For the finite-dimensional problems a new condition for linear separation based on Caratheodory's Theorem and having a Helly like form is given. This condition makes possible a subtle treatment of the distinction between various constraint qualifications as well as an exact characterisation of the existence of a saddle point for the Lagrangian function. Comparison with calmness and metric regularity are performed. In a framework of C-differentiabiltiy, which encompasses the separate cases of classical differentiability and the subdifferentiability of convex analysis, we give a regularity condition necessary and sufficient for the existence of regular Lagrange multipliers is provided in terms of the nonintersection of two special sets in the Image Space. Comparison with calmness, metric regularity, Slater CQ, Mangasarian-Fromowitz CQ, Guignard CQ, Basic CQ, Abadie CQ together with a new CCQ condition are elucidated. Examples and graphical representations, both for sufficient and for necessary conditions, demonstrate all the implications found. For infinite-dimensional problems two approaches are analysed. First, for a classic geodesic type problem of Calculus of Variations, a selection approach is adopted in which, by means of a selection multifunction, an equivalent finite-dimensional problem is introduced. The tools of the finite-dimensional are used to obtain necessary and sufficient optimality conditions. It is shown that the classic Euler Equation is equivalent to the regular separation of two sets in the Image Space. Following the classical approach, convexity is needed in order to obtain strong duality for a general infinite-dimensional problem. The regular separation of two special sets in the infinite-dimensional Image Space is proved to be equivalent to the existence of Lagrange multipliers. Exploiting the quasirelative interior of convex sets, a new Slater type CQ is given

Proyecto de centro sobre la enseñanza de las Artes Plásticas a partir del artista Keith Haring

Treball Final de Grau en Mestre o Mestra d'Educació Primària. Codi: MP1040. Curs acadèmic: 2019/2020El DECRETO 108/2014, de 4 de julio, del Consell, por el que establece el currículo y desarrolla la ordenación general de la educación primaria en la Comunitat Valenciana, fija la asignatura de plástica, perteneciente al área de educación artística, como primordial para el desarrollo cultural. Bajo el título “Proyecto de centro sobre la enseñanza de las Artes Plásticas a partir del artista Keith Haring”, se encuentra una propuesta didáctica llena de ambición y compromiso alrededor de la enseñanza de las Artes Plásticas en Educación Primaria. Se trata de un proyecto surgido a partir de las ideas de autores como Eisner, Gardner y Maria Acaso, entre otros. Estos autores defienden una educación artística de calidad y que desarrolle la creatividad y la imaginación del alumnado, entre otras cualidades importantes dentro del desarrollo cognitivo y social. Quien dijo la frase popular “Una imagen vale más que mil palabras” no se equivocaba. Este proyecto está basado en la observación y reflexión en torno a la variedad artística que nos ha dejado el artista pop Keith Haring. Se trata de una idea que acoge al conjunto del centro educativo y pretende unificar el aprendizaje poniendo a todos los niveles bajo el mismo hilo conductor del proceso de enseñanza- aprendizaje. El objetivo principal es crear un ambiente de aprendizaje común y fomentar el respeto y la curiosidad por el arte, al mismo tiempo que se desarrollan contenidos curriculares y transversales como la educación en valores

Socio-economic disparities in science knowledge, biomedical self-efficacy, and public participation in medical decision-making

The thesis consists of three self-contained articles that empirically investigate socio-economic differences in, and interrelationships amongst, science knowledge, biomedical self-efficacy, and participation in medical decision-making. Chapter 2 investigates age-related bias in the science knowledge questions in the Wellcome Trust Monitor Survey Waves I and II. It also examines what evidence there is for three dimensions of knowledge. Chapter 3 studies the influence of Internet use and paying attention to medical stories online in reducing science knowledge and biomedical self-efficacy gaps between low and high educational groups. Wave II of the Wellcome Trust Monitor Surveys is employed in this chapter. Chapter 4 scrutinises the influence of various socio-economic factors, biomedical self-efficacy, and trust in physicians and other medical practitioners on public willingness and confidence to take part in the medical decision-making process. Chapter 4 uses Wave III of the Wellcome Trust Monitor Survey. Chapter 2 finds evidence for age-related bias in the science knowledge battery of questions; no evidence of a misinformed group of respondents was found; a group who consistently said they didn’t know instead of providing an answer that was wrong was found; a sensitivity analysis showed that using the summed score approach leads to the same substantive conclusions as a model taking into account age-related non-invariance. Chapter 3 finds evidence of education-based knowledge and efficacy gaps. It also finds some evidence that the Internet can help reduce that democratic deficit in information. Chapter 4 finds evidence that people are generally confident to participate. Those who are more self-efficacious are also more confident to participate in medical decisions. The opposite held true for those who place high trust in doctors. Women were found to be more confident than men

COORDINATES OF BANKING SERVICES QUALITY MANAGEMENT

In the field of services, quality is, in general, defined by the client and the management ensures the overfulfilment of the client’s demands and expectations. The quality of services implies two essential aspects that a manager has to take into account: the client’s satisfaction and the absence of the errors made by employees. Introducing a system of quality management has the goal of satisfying the clients and surpassing their expectations. Such a system has to be dynamic, which makes it adaptable to the clients’ needs, demands and expectations. Principles of quality management in banking institutions have to be : customer orientation, leadership, personnel involvement, procedural approach, system approach to management, continuous improvement, factual approach to decision, mutually beneficial supplier relationships.

Saharan dust transport over Romania

The paper analyses the synoptic process of Saharan dust or sand transport which might affect Romanian territory too. The main cause of Saharan dust transport on large distances is associated to an intense Mediterranean cyclone, as well as to a specific configuration of the jet stream. The rainfall occurring in these periods were called „dirty rains” or „blood rains”. The presence of the Saharan dust over Romania is quite frequent in transition seasons (especially in spring), as well as in summer, less often during winter. In cases of high intensity, the phenomenon might have significant economic consequences, especially affecting the air transport, and people’s health too. Under the circumstances of the intensification of actual climate warming, the transport of Saharan dust or sand may become more intense and more frequent. The paper is useful for all the people interested in climate changes and their consequences

Exploring the meaning behind twitter hashtags through clustering

Abstract. Social networks are generators of large amount of data produced by users, who are not limited with respect to the content of the information they exchange. The data generated can be a good indicator of trends and topic preferences among users. In our paper we focus on analyzing and representing hashtags by the corpus in which they appear. We cluster a large set of hashtags using K-means on map reduce in order to process data in a distributed manner. Our intention is to retrieve connections that might exist between different hashtags and their textual representation, and grasp their semantics through the main topics they occur with