Improving public sector performance: the power of implementing corporate governance

The concept of corporate governance of public entities is evolving. Corporate governance in public institutions, as a method of management and control, requires clear rules and principles of integrity, transparency and accountability, well-defined risk management and control mechanisms, elements that are essential for achieving public entities’ goal, which means meeting public needs. Corporate governance is a process through which management monitors and maintains a corporation’s compliance with laws and regulations. Is it necessary to use corporate governance in public entities? Can it reduce expenditure or budget deficits, ensuring an efficient use of public funds? Can it eliminate corruption and improve the performance of public entities? The purpose of this study is to carry out an academic analysis of the evolution of the corporate governance in public entities and to highlight its effectiveness, through principles that encourage better decision-making and resource efficiency. The applied methodology involves focusing on the in-depth study of the subject using the analytical method. Moreover, the study draws comparisons of different models on the aspects researched, using comparative analysis. In conclusion, good corporate governance is essential for any organization to ensure the sustainability of its resources and operations, with a direct effect on the entity’s performance

Challenging diagnoses of tetraploidy/diploidy and trisomy 12: utility of first-tier prenatal testing methods

Introduction: Chromosome mosaicism and low-grade mosaicism present a challenge for diagnosis in the era of SNP array and NGS. Tetraploidy is a rare numerical chromosomal abnormality characterized by the presence of four copies of each chromosome. The prevalence of tetraploidy/diploidy mosaicism cases is extremely rare in the human population. Accurate estimates of the frequency of this chromosomal anomaly are lacking due to its classification as an extremely rare and difficult-to-detect condition.Methods: In this report, we describe two cases involving challenging diagnoses of tetraploidy/diploidy and trisomy 12. We utilized advanced genetic testing techniques, including SNP array, to examine the chromosomal abnormalities in these cases. We compared the results from SNP array to conventional G band karyotyping to assess the utility of first-tier prenatal testing methods.Results:Our analysis revealed two cases of tetraploidy/diploidy and trisomy 12 with atypical presentations. SNP array analysis provided higher resolution and more precise information about the chromosomal anomalies in these cases compared to conventional G band karyotyping. Additionally, the prevalence of tetraploidy/diploidy mosaicism was confirmed to be extremely rare in the population.Discussion: Low-level mosaicism is difficult to diagnose, and in many cases, it has traditionally been identified through techniques such as G band karyotype or FISH. Microarray has become an invaluable diagnostic tool for detecting chromosomal abnormalities, offering high-resolution insights. However, it may not always be able to detect rare occurrences of tetraploidy or tetraploidy/diploidy mosaicism. As a result, it is recommended to perform a G band karyotype analysis after obtaining a negative microarray result before considering other diagnostic methods with a potentially higher yield of diagnosis. For the detection of low-level mosaicism, combined diagnostic methods should be considered. The diagnosis of mosaicism is a multistep process that can be time-consuming, often requiring the application of more than one diagnostic technique. This approach is crucial for accurate diagnosis and comprehensive patient care. Further research is warranted to better understand the underlying mechanisms of these rare chromosomal anomalies and to develop more effective diagnostic strategies for challenging cases

Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTIC‐HF: baseline characteristics and comparison with contemporary clinical trials

Aims: The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTIC‐HF) trial. Here we describe the baseline characteristics of participants in GALACTIC‐HF and how these compare with other contemporary trials. Methods and Results: Adults with established HFrEF, New York Heart Association functional class (NYHA) ≥ II, EF ≤35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokinetic‐guided dosing: 25, 37.5 or 50 mg bid). 8256 patients [male (79%), non‐white (22%), mean age 65 years] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NT‐proBNP 1971 pg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTIC‐HF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressure < 100 mmHg (n = 1127), estimated glomerular filtration rate < 30 mL/min/1.73 m2 (n = 528), and treated with sacubitril‐valsartan at baseline (n = 1594). Conclusions: GALACTIC‐HF enrolled a well‐treated, high‐risk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

CONSUMER’S ATTITUDE CONCERNING ORGANIC FOODS

Despite the fact that Romanians have increasingly healthier habits and the consumption of organic foods is growing year after year by 20%-30%, this consumption represents less than 1% of the aggregate sales in Romanian retail, compared to the Western Europe, where the share exceeds 5%. Also, national consumption of certified organic products represents only 2% of the total foods consumed. In order to be able to change the existing situation it is necessary to determine, firstly, the consumer’s attitudes on organic products. Since the attitudes are the result of learning, they can be changed. In the light of the organic consumers’ possible attitudes, this aspect has two connotations. One can be favorable, in changing the view of a greater number of consumers in favor of more products, promotional messages, etc., environmentally oriented. The other may be unfavorable, if the companies are not careful and do not maintain constant and convincing efforts to protect health and the environment. In this context, we aim to add more insight on consumers’ behavior regarding organic foods

Hydrocarbons soil pollution in Romania: issue and solutions

In Romania, according to the National Strategy and National Action Plan for Contaminated Sites Management in Romania, there are more than 215 potentially contaminated sites. According to the same report on the management of contaminated sites in 2013, starting more than 150 years ago, the oil industry in Romania is considered extremely important for economic development. Contaminated sites related to petroleum industry are ranging from small (extraction fields) to large and complex (refinery or storage facilities large - distribution of petroleum products). This paper will present the most used remediation methods at nationally level for petroleum contaminated sites. Moreover they will be presented and feasible alternatives that could be applied in Romania. The three methods presented here can be classified as a biological method (bioremediation), a thermal method (thermal desorbtion) and a physico-chemical method (electrochemical method). If the first two methods are already used at real scale at national level, the third method was studied during the development of an european project

ETHNOMARKETING - A NEW PARADIGM THAT REFLECTS MARKETING’S CONCERN FOR THE CULTURAL DIMENSION OF THE MARKET

Culture has often been regarded as one of the main determinants of consumer behavior and of the symbolism acquired by certain products. It is well known that states are composed of many subcultures and that cultural diversity is an ever-present topic. Culture has invaded the entire current range of business, its presence is seen everywhere, and marketing makes no exception. In this context and considering culture as an important factor that conducts and guides the entrepreneurial success, the following paper reveals some important concepts, characteristics and principles of ethnomarketing for a better exploitation of market opportunities, especially on its consumer behavior dimension

Hydrocarbons soil pollution in Romania: issues and solutions

In Romania, according to the National Strategy and National Action Plan for Contaminated Sites Management in Romania, there are more than 215 potentially contaminated sites. According to the same report on the management of contaminated sites in 2013, starting more than 150 years ago, the oil industry in Romania is considered extremely important for economic development. Contaminated sites related to petroleum industry are ranging from small (extraction fields) to large and complex (refinery or storage facilities large - distribution of petroleum products). This paper will present the most used remediation methods at nationally level for petroleum contaminated sites. Moreover they will be presented and feasible alternatives that could be applied in Romania. The three methods presented here can be classified as a biological method (bioremediation), a thermal method (thermal desorbtion) and a physicochemical method (electrochemical method). If the first two methods are already used at real scale at national level, the third method was studiedduring the development of an european project

Functionalized Β-Cyclodextrin for Smart Drug Delivery Application

In recent years, an emphasis has been established on advanced cancer drug delivery, in order to improve the efficiency of the cancer therapy [1]. Cyclodextrin (CD) is a cyclic oligosaccharide formed by 6, 7, or 8 glucose units by α-1,4 glycosidic bonds, which are called α, β, γ-cyclodextrin, respectively [2]. Due to its hollow truncated morphology with a hydrophobic inside and hydrophilic outside, CD has been studied in numerous drug delivery systems [3–5]. In the present study, the modification of β-CD with 3-(Aminopropyl)triethoxysilane (APTES) was investigated. For this study we used: β-Cyclodextrin (β-CD) purchased from Fluka, 3-(Aminopropyl) triethoxysilane (APTES) from Sigma Aldrich, NaOH from Roth, dimethylforamide (DMF) from Acros Organics, and acetone from Chimreactiv. Firstly, NaOH, APTES, and DMF were solubilized by magnetic stirring for 1 h at 40 °C. After solubilization, β-CD was added and allowed to react for 2 h, at 40 °C, under magnetic stirring. The functionalized β-CD was precipitated in acetone, and in the end washed and filtered. The sample was dried at room temperature and investigated by NMR. The 1H NMR was employed to further demonstrate the molecular structure of β-CD. The obtained NMR spectrum of β-CD shows the presence of characteristic proton peaks. The chemical structure of functionalized β-CD was studied, in order to look for possible biomedical applications, such as smart drug delivery systems

Preparation and Characterization of Chitosan/LDH Composite Membranes for Drug Delivery Application

In this study, composite membranes based on chitosan (CS), layered double hydroxide (LDH), and diclofenac were prepared via dispersing of LDH and diclofenac (DCF) in the chitosan matrix for gradual delivery of diclofenac sodium. The effect of using LDH in composites was compared to chitosan loaded with diclofenac membrane. LDH was added in order to develop a system with a long release of diclofenac sodium, which is used in inflammatory conditions as an anti-inflammatory drug. The prepared composite membranes were characterized by Fourier Transform Infrared Spectroscopy (FT-IR), Scanning Electron Microscope Analysis (SEM), X-ray Photoelectron Spectroscopy (XPS), Thermogravimetric Analysis (TGA) and UV–Vis Spectroscopy. The results of the FTIR and XPS analyses confirmed the obtaining of the composite membrane and the efficient incorporation of diclofenac. It was observed that the addition of LDH can increase the thermal stability of the composite membrane and favors the gradual release of diclofenac, highlighted by UV–Vis spectra that showed a gradual release in the first 48 h. In conclusion, the composite membrane based on CS-LDH can be used in potential drug delivery application