Diagnostic Analysis of Professional Vocation Education of Romania

The education represents a priority to all the governments from the European countries, even though the structure of the educational system differs from one country to another. Taking this in consideration, the importance of the educational and formation systems must be reconsidered, in order for them to adapt to the always changing needs of the society and of the citizens: providing the specific aptitudes and competences required for the knowledge society, the necessary quality of the educational and formative systems, sustaining the principles of equity and inclusion and the European dimension in education and formation. The diagnostic analysis of the vocational professional education of Romania should have, as a starting point, the underlining of the positive (hard points) and dysfunctional aspects (weak points), so as to globally formulate strategies and intervention methods that should improve its performances, taking in consideration the disturbing factors from the specific environment of the educational activity, because the efficacy of the vocational-professional education and the evaluation of the quality of professional formation offer should have as a target the developing of transparency and system quality, also to raise the mobility on the working market.Vocation education; Analysis of education

From Tumor Immunosuppression to Eradication: Targeting Homing and Activity of Immune Effector Cells to Tumors

Unraveling the mechanisms used by the immune system to fight cancer development is one of the most ambitious undertakings in immunology. Detailed knowledge regarding the mechanisms of induction of tolerance and immunosuppression within the tumor microenvironment will contribute to the development of highly effective tumor eradication strategies. Research within the last few decades has shed more light on the matter. This paper aims to give an overview on the current knowledge of the main tolerance and immunosuppression mechanisms elicited within the tumor microenvironment, with the focus on development of effective immunotherapeutic strategies to improve homing and activity of immune effector cells to tumors

Die Lieder der Bewegung "Eiserne Garde" im Rumänien der Zwischenkriegszeit

Die rumänische radikal-nationalistische Bewegung „Eiserne Garde“, bzw. „Legion des Erzengels Michael“, die sich den faschistischen Bewegungen der europäischen Zwischenkriegszeit unterordnen lässt, spielt eine sehr wichtige Rolle in der neueren Geschichte Rumäniens. In ihrem Glauben, der einer Ideologie nur bedingt gleich zu setzen ist, vereinigen sich sowohl Elemente der rumänisch-orthodoxen Tradition, als auch revolutionär-moderne Auffassungen, die zu der Schaffung eines „neuen Menschen“ führen sollen. Die Legionäre glaubten, für dieses Ideal sterben zu müssen und waren auch dazu bereit. Der Führer der Bewegung, Corneliu Zelea Codreanu, war für sie die Verkörperung dieses Ideals, ein Übermensch, der alle orthodox-traditionellen Werte des rumänischen Volkes in sich einbinden konnte. Der Kontrast zwischen Glaube und Wirklichkeit trat aber bald ans Licht, als die Legionäre im Dienste ihres „heiligen“ Zieles, zu unorthodoxen Maßnahmen, wie Mord, griffen. Was die „Legion“ aber zu einer eigenartigen sozialen und politischen Bewegung Rumäniens macht, ist die Art der Legionäre, politische Propaganda zu treiben. Sie nahmen Abstand von politischen Programmen und demagogischen Reden und setzten ihre physische Kraft ein, indem Studenten, Arbeiter, Schüler, Ärzte, Anwälte, usw., den Bauern bei der Ernte halfen, Kirchen, Dämme und Häuser reparierten und Gemüsegärten bebauten. Sie imponierten den Menschen aber nicht nur durch ihre Hilfsbereitschaft und ihren aktiven Einsatz, sondern auch durch ihre strenge Disziplin. Die „Legionäre“ marschierten singend von Dorf zu Dorf in ihren Uniformen und beeindruckten die Massen. Als sehr wichtigen Teil des legionären Lebens erscheint somit das Lied. Zahlreiche legionäre Lieder zu allen Bereichen des legionären Glaubens hatten die Funktion, die Disziplin zu erhalten, den Glauben zu äußern und die Seele zu entlasten. Kein Ereignis im Rahmen der „Legion“, ob positiv oder negativ, blieb unbesungen, sodass die Lieder zum Spiegel der Entwicklung der „Legion“ seit dem Anfang und bis zu ihrem Ende wurden

Novel strategies for enhancing the efficacy of therapeutic immunization against cancer

In dit proefschrift zijn strategieën beschreven die de effectiviteit van immunotherapie met het SFVeE6,7 kanker vaccin verder verhogen. We laten zien dat lokale tumorbestraling de migratie van tumor-specifieke T cellen naar de tumor verhoogt. Echter ook het aantal immuun-suppressieve cellen, MDSCs, in de tumor neemt toe door deze behandeling. Netto wordt evenwel het antitumor effect versterkt door de combinatie van lokale bestraling met SFVeE6,7 immunisatie. Vervolgens laten we zien dat de behandeling met de tyrosine-kinase remmer sunitib selectief het aantal immuun-suppressieve MDSC’s in de tumor verlaagt en daarmee ook de effectiviteit van SFVeE6,7 verhoogt. Op basis van deze resultaten hebben we een nieuwe behandeling ontworpen en onderzocht die het immuunsysteem sterk activeert, immuuncellen doet migreren en accumuleren in de tumor, en tot slot de immuun suppressieve immuuncellen sterk doet afnemen. Deze combinatie leidt tot een sterk verhoogde verhouding van anti-tumor effectorcellen en immuun-suppressieve cellen in de tumor resulterend in een complete blokkering van tumorgroei. Naast deze functionele studies wordt er in dit proefschrift een geheel nieuwe methode beschreven om de infiltratie van geactiveerde T cellen te visualiseren met behulp van PET

Therapy-Induced Changes in CXCR4 Expression in Tumor Xenografts Can Be Monitored Noninvasively with N-[C-11]Methyl-AMD3465 PET

Purpose Chemokine CXCL12 and its receptor CXCR4 are constitutively overexpressed in human cancers. The CXCL12-CXCR4 signaling axis plays an important role in tumor progression and metastasis, but also in treatment-induced recruitment of CXCR4-expressing cytotoxic immune cells. Here, we aimed to demonstrate the feasibility of N-[C-11]methyl-AMD3465 positron emission tomography (PET) to monitor changes in CXCR4 density in tumors after single-fraction local radiotherapy or in combination with immunization. Procedure TC-1 cells expressing human papillomavirus antigens E6 and E7 were inoculated into the C57BL/6 mice subcutaneously. Two weeks after tumor cell inoculation, mice were irradiated with a single-fraction 14-Gy dose of X-ray. One group of irradiated mice was immunized with an alpha-viral vector vaccine, SFVeE6,7, and another group received daily injections of the CXCR4 antagonist AMD3100 (3 mg/kg -intraperitoneal (i.p.)). Seven days after irradiation, all animals underwent N-[C-11]methyl-AMD3465 PET. Results PET imaging showed N-[C-11]methyl-AMD3465 uptake in the tumor of single-fraction irradiated mice was nearly 2.5-fold higher than in sham-irradiated tumors (1.07 +/- 0.31 %ID/g vs. 0.42 +/- 0.05 % ID/g, p <0.01). The tumor uptake was further increased by 4-fold (1.73 +/- 0.17 % ID/g vs 0.42 +/- 0.05 % ID/g, p <0.01) in mice treated with single-fraction radiotherapy in combination with SFVeE6,7 immunization. Administration of AMD3100 caused a 4.5-fold reduction in the tracer uptake in the tumor of irradiated animals (0.24 +/- 0.1 % ID/g, p <0.001), suggesting that tracer uptake is indeed due to CXCR4-mediated chemotaxis. Conclusion This study demonstrates the feasibility of N-[C-11]methyl-AMD3465 PET imaging to monitor treatment-induced changes in the density of CXCR4 receptors in tumors and justifies further evaluation of CXCR4 as a potential imaging biomarker for evaluation of anti-tumor therapies

Miniinvazivitate în chirurgia abdominală

Sfârșitul secolului XX, consfințește un nou concept medical, și anume, miniinvazivitatea, demolând blocajele conceptuale, “chirurg mare-incizie mare”, miniinvazivitatea iși face loc și în chirurgie, sprijinită de un “boom” tehnologic într-o specialitate veche dar nou denumită imagistică medicală: ECHO, CT, RMN, Colangio-RMN, PET-CT, Angiografie. De fapt, acest secol XX lărgește considerabil și explicit orizontul chirurgical. Alături de chirurgia tradițională și desprinsă din ea apar două noi orientări: miniinvazititatea și chirugia de transplant, ambele făcand parte din palmaresul românesc, de pe ambele maluri ale Prutului, datorită unor poli de influență și promovare. Chirurgia de transplant, complexă, dificilă, de excepție, ce presupune echipe multiple, spitale multiple, orașe multiple, țări multiple, costisitoare, energofagă, este posibilă prin „chivernisirea” banului public și în conțiile chirurgiei de zi cu zi. Compensator, această reducere a costurilor este generată de apariția miniinvazivitătii chirurgicale. Mininvazivitatea chirurgicală este un nou concept, departe de a fi unul centimetric, eventual milimetric, și este un concept larg, anatomic, anatomo-patologic, fiziologic, fizio-patologic, topografic, cosmetic, psiho-sociologic, tactic, tehnico-tehnologic, dimensional, financiar, umanist și în primul rând de protecție a pacientului. Obiectul miniinvazivității poate fi definit drept “evitarea sacrificiilor inutile, mai ales a celor parietale, consumatoare plastic, imunitar, temporal, în final energetic având drept consecință diminuarea până aproape la dispariție a complicațiilor căilor de abord și o vindecare mult accelerata”. Efectele pozitive tardive sau imediate sunt: - Vindecare spitalicească rapidă (până la “one day surgery” ) sau alte variante cu costuri directe mici și recuperarea post-spitalicească (convalescență) mult redusă (costuri indirecte mici); - Dispariția cicatricilor mari și a patologiei lor (etalare,cheloid, granuloma de fir); - Dispariția patologiei de plagă extinsă ( serom, hematom, supurație, eviscerație, eventrație); - Dispariția patologiei de secțiune musculară, nervoasă și vasculară extinsă; - Cicatrici inaparente (incizii subcicatriceale - liniile de tensiune tegumantară ale lui Langer); - Consumuri energetice și plastice minime, cee ce presupune accelerarea procesului de vindec-re și aplicarea mai rapidă a terapiei oncologice (dacă e necesar); - Consumuri terapeutice minimale (pierderi sangvine minime/nule, antialgice și antibiotice mult reduse cantitativ și calitativ); - Menajarea psihicului bolnavului prin reluarea mobilițății precoce, absența plăgilor largi, dureroase, cicatrici inaparente, absența firelor extractibile de sutură, părăsirea rapidă a spitalu-lui, elemente ce transferă bolnavul din zona omului suferind în zona omului sanatos

Strategies to Target Tumor Immunosuppression

The tumor microenvironment is currently in the spotlight of cancer immunology research as a key factor impacting tumor development and progression. While antigen-specific immune responses play a crucial role in tumor rejection, the tumor hampers these immune responses by creating an immunosuppressive microenvironment. Recently, major progress has been achieved in the field of cancer immunotherapy, and several groundbreaking clinical trials demonstrated the potency of such therapeutic interventions in patients. Yet, the responses greatly vary among individuals. This calls for the rational design of more efficacious cancer immunotherapeutic interventions that take into consideration the “immune signature” of the tumor. Multimodality treatment regimens that aim to enhance intratumoral homing and activation of antigen-specific immune effector cells, while simultaneously targeting tumor immunosuppression, are pivotal for potent antitumor immunity

Animal bite and rabies post-exposure prophylaxis reporting in Central Zone, Alberta, Canada

Description of the Problem and Objectives: Rabies risk assessment and follow up in Central Zone, Alberta, Canada can be time consuming and, given that Environmental Public Health (EPH) receives an average of 615 animal exposure reports every year, this program is resource-intensive. Evaluation of this program requires accurate information, and it was believed that the EPH database that reports animal exposures was incomplete. The aim of this project was to improve the quality and efficiency of the animal bite and rabies post exposure prophylaxis (PEP) reporting process in Central Zone, Alberta, Canada by investigating the sources of the present errors in the current EPH database, facilitating discussion on how to mitigate those errors for future reporting processes, and identifying indicators for the EPH program to evaluate the efficiency of the animal bite response process. This project was carried out in two stages. Method(s) Used: The first stage aimed to understand why the EPH database was incomplete. The Communicable Disease Control (CDC) database was used as a “gold standard” for all cases who had been offered PEP from January 2011 through May 30, 2015. The EPH database and Animal Exposure Investigation Report files were searched for these cases, and reports missing from the EPH database were identified. Errors in the reporting process were listed and categorized using a fishbone analysis diagram. The second stage was data analysis and query development. First, any CDC PEP referrals missing from the EPH database were entered into the EPH database to create a single source with a complete list of the cases of interest. Descriptive statistics were generated for parameters of interest for all of the PEP referrals and for a domestic animal subset using Microsoft Excel and pivot tables. Results: There were 198 PEP referrals in the CDC database for the time period in question of which, only 141 were recorded by the EPH database. It was identified that 30% of the PEP referrals were missing from the EPH database of which, 14% were due to in-zone exposures and 15% were due to out of zone exposures. The fishbone analysis diagram showed that the most prevalent category of error that led to an incomplete EPH database was data entry such as illegible handwriting on the original form. The evaluation process in stage two showed that 60% of the PEP referrals were due to provoked animal exposures. In 84% of the victims who were offered PEP, the mechanism of exposure was a bite, 47% of which were bites to the hand. It was also found that approximately 40% of the PEP referrals were due to domestic animal exposures of which, 71% were to domestic dogs. Furthermore, 60% of the domestic animal exposures for which PEP was offered was due to a provoked exposure, 70% of which were from domestic dogs. It was further identified that only 12% of the domestic animals involved in an incident roamed unsupervised, but approximately 60% of the domestic animals involved in an incident were not available for quarantine. Discussion: The fishbone analysis demonstrates that there are many errors that contribute to the current incomplete EPH database, most notably, data entry. Data evaluation identified that PEP recommendations include many apparently low risk exposures, based on the summary statistics, however the incomplete and inconsistent nature of many of the reports does not permit a robust conclusion. This is public health relevant because although rabies infection leads to fatal encephalitis once clinical symptoms manifest, rabies PEP may not be cost-effective in a low rabies risk country. These results were discussed with the Central Zone public health team responsible for animal bite risk assessment and follow up, who identified that more work is required to understand how practitioners decide how to code different exposures, and how this would inform the interpretation of the summary statistics from this project. They plan to organize an EPH committee who will oversee improvement in the collection, storage and use of animal bite data; as well as to ensure that resources are utilized effectively