The Quality of Educational Services in Higher Education – Assurance, Management or Excellence?

The present paper has as its target to present the regulations characterizing the quality of educational services in higher education, with a view to identifying the system which is the most efficient and revealing for their real quality. This approach also takes into account the central role that key intellectual and cultural responsibilities play in the development of modern society, as well as the moral impact of higher education on society as a whole. The authors reach the conclusion that, in order to have real quality in higher education, it is important to introduce a quality management system and to constantly improve it, using as feedback the satisfaction of clients and other interested parties, with the intention of attaining performance and excellence.excellence, performance, quality management, quality assurance, quality indicators

Halophilic microorganisms from Romanian saline environments as a source of extracellular enzymes with potential in agricultural economy

Halophilic microorganisms, either bacteria or archaea, flourish in media with salinity levels varying from negligible until to saturation in NaCl and thus are considered extremophiles. Such kinds of media as salt lakes, salted soils, salt deposits or salt mines are widely distributed over the entire Romanian landscape. Several strains of halophilic bacteria and archaea have been isolated from such environments and characterized either by polyphasic taxonomy approach or by their ability to produce extracellular enzymes with putative potential for use in several domains like industry, agriculture and biotechnology. Even if sodium chloride is widely used in Romanian agriculture fields, little is known about salt microbiota, and its effect on the agricultural processes. This paper approaches the wide spectrum of extracellular hydrolytic enzymes with putative use in agriculture for treatment of polluted soils or recovery of salted soils. The strains isolated from inside of salt crystal are divided in two groups, one consisting of six strains belonging to Halorubrum, Haloarcula and Halobacterium genera and characterized by the absence of detectable extracellular enzymatic activity for the tested substrates and the other group consisting of four strains, all belonging to Halorubrum genus and characterized by the presence of amylolytic activity and the absence of other activities. The starch degrading enzymes appear to have a wide distribution both among the strains associated with salt lakes and among those isolated from rock salt

Intestinal dysbiosis – a new treatment target in the prevention of colorectal cancer

The gastrointestinal microbiome contains at least 100 trillion microorganisms (bacteria, viruses, fungi), whose distribution varies from the mouth to the rectum spatially and temporally throughout one\u27s lifetime. The microbiome benefits from advancing research due to its major role in human health. Studies indicate that its functions are immunity, metabolic processes and mucosal barrier. The disturbances of these functions, dysbiosis, influence physiology, lead to diabetes, inflammatory bowel disease, obesity and colon tumorigenesis. The third most common form of cancer, colorectal cancer, is the result of many factors and genes, and although the link between dysbiosis and this type of cancer is poorly characterized, it has been shown that some bacterial species and their metabolites have a critical role in developing colorectal cancer. Also, gut microbiota plays a role in the inflammatory response and immune process perturbations during the progression of colorectal cancer. Some new technologies, such as metagenome sequencing, facilitated the progress by analyzing the metabolic and genetic profile of microbiota, revealing details about the bacterial composition, host interactions, and taxonomic alterations. This review summarizes the studies regarding the link between gut microbiota and colorectal cancer, targeting new therapeutic strategies

Right ventricle to pulmonary artery coupling after transcatheter aortic valve implantation—Determinant factors and prognostic impact

IntroductionRight ventricular (RV) dysfunction and pulmonary hypertension (PH) have been previously associated with unfavorable outcomes in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve implantation (TAVI), but little is known about the effect of right ventricle (RV) to pulmonary artery (PA) coupling. Our study aimed to evaluate the determinant factors and the prognostic value of RV-PA coupling in patients undergoing TAVI.MethodsOne hundred sixty consecutive patients with severe AS were prospectively enrolled, between September 2018 and May 2020. They underwent a comprehensive echocardiogram before and 30 days after TAVI, including speckle tracking echocardiography (STE) for myocardial deformation analysis of the left ventricle (LV), left atrium (LA), and RV function. Complete data on myocardial deformation was available in 132 patients (76.6 ± 7.5 years, 52.5% men) who formed the final study population. The ratio of RV free wall longitudinal strain (RV-FWLS) to PA systolic pressure (PASP) was used as an estimate of RV-PA coupling. Patients were analyzed according to baseline RV-FWLS/PASP cut-off point, determined through time-dependent ROC curve analysis, as follows: normal RV-PA coupling group (RV-FWLS/PASP ≥0.63, n = 65) and impaired RV-PA coupling group (RV-FWLS/PASP < 0.63, n = 67).ResultsA significant improvement of RV-PA coupling was observed early after TAVI (0.75 ± 0.3 vs. 0.64 ± 0.3 before TAVI, p < 0.001), mainly due to PASP decrease (p < 0.001). LA global longitudinal strain (LA-GLS) is an independent predictor of RV-PA coupling impairment before and after TAVI (OR = 0.837, p < 0.001, OR = 0.848, p < 0.001, respectively), while RV diameter is an independent predictor of persistent RV-PA coupling impairment after TAVI (OR = 1.174, p = 0.002). Impaired RV-PA coupling was associated with a worse survival rate (66.3% vs. 94.9%, p-value < 0.001) and emerged as an independent predictor of mortality (HR = 5.97, CI = 1.44–24.8, p = 0.014) and of the composite endpoint of death and rehospitalization (HR = 4.14, CI = 1.37–12.5, p = 0.012).ConclusionOur results confirm that relief of aortic valve obstruction has beneficial effects on the baseline RV-PA coupling, and they occur early after TAVI. Despite significant improvement in LV, LA, and RV function after TAVI, RV-PA coupling remains impaired in some patients, it is mainly related to persistent pulmonary hypertension and is associated with adverse outcomes

Features and Management Team Project

For a project, whatever its characteristics, to be effective should be based on a team. Although designed as a team, especially team projects implemented and monitored easily become reality. Regarding the management team should be good first identifying problems that arise during the project, to be able to choose whether they can be solved by one person or group. Manager must be a personality complex because in addition to knowledge, abilities, skills, abilities and skills, the manager should develop and attitudes, values and desirable behaviors in the team.project team, manager, leadership, company

Optimal Cardiac Resynchronization Therapy with Conduction System Pacing Guided by Electro-Anatomical Mapping: A Case Report

Introduction: Biventricular pacing has been the gold standard for cardiac resynchronization therapy in patients with left bundle branch block and severely reduced left ventricular ejection fraction for decades. However, in the past few years, this role has been challenged by the promising results of conduction system pacing in these patients, which has proven non-inferior and, at times, superior to biventricular pacing regarding left ventricular function outcomes. One of the most important limitations of both procedures is the long fluoroscopy times. Case description: We present the case of a 60-year-old patient with non-ischemic dilated cardiomyopathy and left bundle branch block in whom conduction system pacing was chosen as the first option for resynchronization therapy. A 3D electro-anatomical mapping system was used to guide the lead to the His bundle region, where correction was observed at high amplitudes, and afterward to the optimal septal penetration site. After reaching the left endocardium, left bundle branch pacing achieved a narrow, paced QRS complex with low fluoroscopy exposure. The three-month follow-up showed a significant improvement in clinical status and left ventricular function. Conclusion: Since conduction system pacing requires a great deal of precision, targeting specific, narrow structures inside the heart, 3D mapping is a valuable tool that increases the chances of success, especially in patients with complex anatomies, such as those with indications for cardiac resynchronization therapy