Can Air Quality be Influenced in Coastal Areas by Shipping?

The problem of pollution is a topical issue at global, regional but also at the local level. Starting from this idea, the question arises whether the coastal region in the North-East of the Black Sea is affected by the emissions resulting from the combustion of marine fuels in large ship engines, which manage to set in motion floating buildings intended for the transport of goods and passengers. This paper wants to evaluate the variation of the air quality indicators in the coastal area of Romania, taking into account the contribution that the ships by their number, size and destination can have on these qualitative factors. Such an approach is needed from the perspective of the more than 500,000 inhabitants possibly affected by the effects with which this industry is accompanied. As the Black Sea active fleet is already old, as its ages year by year, the premises for the need for this study can be set up. As in other regions, drastic measures are taken in order to reduce the effects of pollution due to such economic activity, the assessment of the effects that this industry produces in inhabited areas becomes necessary. In order to carry out this study, air quality data from the database provided by the National Air Quality Monitoring Network of the Workshop on the calitateaer.ro site were evaluated

Reverse logistics and space allocation for recovery management in new urban settlements

This paper presents the authors’ vision about the planning foundation for the new residential areas from the large cities outskirts, in a sustainable development framework. One considers the great generation potential of the high and very high income population in case of the used products with remained reuse value, or new and undesired products, available in the residential places. We propose a space allocation model with a hexagonal hierarchical structure for the centralized return centers in a reverse logistics. The space allocation model for the recovery centers implementation takes into consideration: the recovery habits, environmental care and sustainable development education, “moral” compensations, centralized recovery centers facilities, walking willingness of the average inhabitant of the considered area, decision makings involvement at the local Public Authority level, and local community. One reveals the importance of the data collecting stage for the potential and availability of the exhausted products (having reuse value) in a specific area with high and very high income populationreverse logistics; centralized return centres; recovery potential; space allocation

Human Factor’s Involvement in the Consumer Protection Management

The study emphasizes the results of the excellence research dedicated to theoretical and practical basics for the human factor involvement in the consumer protection management between 2008 – 2009 at the level of National Authority for Consumer Protection, the Region Committee for Consumer Protection Sibiu, and the Brasov County Committee for Consumer Protection. The article presents several elements regarding consumer protection management and the manager’s profession in the consumer protection field. In order to reflect the human factor’s degree of involvement in the consumer protection management we carried out a survey at the level of National Authority for Consumer Protection (NACP). The findings of our study imply that consumer protection and its management represent a new step of human civilization, a better quality life style, implying the intensive use of information from various fields, involving the human factor not only as a producer, but also as a consumer, with a great economic and social impact. Under these circumstances, consumer protection management at the level of NACP and its local institutions is an important source of information and decision; this is not only as a way of data processing. Moreover, in order to be socially efficient visible it is necessary to imply operational and top management in fields of planning-decision, organization-coordination, training-leading and controlling-monitoring, all of them being in a special position of priority. All these allowed us to present some solutions for improving the activity of NACP, from the point of view of the human factor’s involvement in this institution’s management.consumer protection, human factor, consumer protection management, manager in the field of consumer protection, NACP

Education and Training Needs in the Field of Consumer Protection in the Lower Danube Region

The issues of consumer rights and consumer welfare are increasingly important, especially in the current economic climate in which the ability to make informed choices represents a real advantage in consumers’ daily life. In order to make their purchases with confidence, both in their country and abroad, consumers need easy access to precise information and to professional advice. Taking into account the fact that education and training are a strategic factor for a sustainable development through contribution to human capital development, within the Romania–Bulgaria Cross-Border Cooperation Program 2007–2013, the Academy of Economic Studies in Bucharest, Romania and the D. Tsenov Academy of Economics in Svisthov, Bulgaria decided to collaborate in the field “Cooperation on human resources development – joint development of skills and knowledge”, through the development of cross-border liaisons and exchanges between the two universities. Our objective is to bring up new methods of training in the field of consumer protection in order to train and to supply the labour market with specialized experts in this field in charge with various issues regarding consumers in enterprises, in organizations in charge with elaborating consumer protection policies and in organizations in charge with market supervision and control and also in consumers’ associations. We consider that in this way we meet both consumers’ and employers’ needs because economic agents need professionals in the field as well, in order to advise them in their quest to protect the rights and interests of consumers. Also, Meglena Kuneva, the European Commissioner for Consumer Protection, noted that studies conducted at European level revealed that there is a high level of interest for recruiting qualified experts in the field of consumer protection shown by large companies, national governments, small and medium enterprises and consumers’ associations. In order to evaluate the requirement for education and training in the field of consumer protection in the Lower Danube Region, we decided to collect and study the necessary information, both at EU level as well as those specific to the counties bordering the Danube, information which sustain the need for the establishment of a new form of expert training in this field. As a result, the paper brings up aspects regarding the need for training experts in the field of consumer protection, referring to the Romanian counties bordering the Danube and neighbouring Bulgaria. Also, this report presents the findings of a research project whose aim is to evaluate the availability of prerequisites for seeking educational products in the field of consumer protection in Bulgaria. The institutional framework of the process in Bulgaria has been analyzed and the results of a survey among the representatives of the four parties involved in it – government authorities, NGOs, consumers and suppliers – have been presented. The research presents their point of view regarding the extent to which the process of consumer protection in Bulgaria is developed, what are the major obstacles it faces, what means of improvement are there, to what extent the more active offer of educational products would facilitate the process and based on this, what would the role played by the institutions of higher education be, what types of educational products would best be realized on the market in a short-term and medium term aspect. The motivation for such research is related both to the strive to improve the status of the consumer rights protection in Bulgaria and the intention of Tsenov Academy of Economics in Svishtov, Bulgaria and the Academy of Economic Studies in Bucharest to collaborate towards intensifying the cross-border co-operation and facilitate the human resource development in the region by jointly offering educational products.consumer protection, educational needs, educational products, training

Sensor Fusion for Location Estimation Technologies

Location estimation performance is not always satisfactory and improving it can be expensive. The performance of location estimation technology can be increased by refining the existing location estimation technologies. A better way of increasing performance is to use multiple technologies and combine the available data provided by them in order to obtain better results. Also, maintaining one's location privacy while using location estimation technology is a challenge. How can this problem be solved? In order to make it easier to perform sensor fusion on the available data and to speed up development, a flexible framework centered around a component-based architecture was designed. In order to test the performance of location estimation using the proposed sensor fusion framework, the framework and all the necessary components were implemented and tested. In order to solve the location estimation privacy issues, a comprehensive design that considers all aspects of the problem, from the physical aspects of using radio transmissions to communicating and using location data, is proposed. The experimental results of testing the location estimation sensor fusion framework show that by using sensor fusion, the availability of location estimation is always increased and the accuracy is always increased on average. The experimental results also allow the profiling of the sensor fusion framework's time and energy consumption. In the case of time consumption, there is a 0.32% - 17.06% - 5.05% - 77.58% split between results overhead, engine overhead, component communication time and component execution time on an average. The more measurements are gathered by the data gathering components, the more the component execution time increases relative to all the other execution times because component execution time is the only one that increases while the others remain constant

Great saphenous vein stripping without distal incision: a retrospective observational case-controlled study

Catedra de chirurgie generală și semiologie, Universitatea de Stat de Medicină și Farmacie „Nicolae Testemiţanu”, Chișinău, Republica MoldovaRezumat Introducere. Recent a fost implementată o metodă nouă de tratament chirurgical al varicelor prin stripping safenian scurt fără incizie distală. Scopul studiului a fost evaluarea rezultatelor pe termen scurt ale stripping-ului venei safene, cu testarea prezumției superiorității rezultatelor medicale și ale celor raportate de către pacienți după stripping safenian fără incizie distală față de metoda convențională. Materiale și metode. Din baza de date au fost preluate două loturi de pacienți cu varice ale membrelor inferioare – 10 bolnavi operați prin stripping scurt al venei safene mari fără incizie distală (Lotul „InvisiGrip”) și 10 pacienți operați prin tehnica convențională (Lotul „Standard”). Subiecții din lotul martor au fost atribuiți prin metoda de matching individual pentru a se potrivi în funcție de vârstă, gen și clasa clinică a insuficienței venoase cu cei din lotul de studiu. Succesul tehnic al intervenției, durata operației, severitatea durerii postoperatorii și necesitatea în analgezice, extinderea echimozei la nivelul coapsei, precum și satisfacția pacientului de rezultatul tratamentului au fost analizate și comparate între loturi. Teste statistice aplicate: testul t pentru eșantioane perechi, testul perechilor potrivite al lui Wilcoxon, testul exact Fisher. Datele sunt prezentate ca valori medii cu deviații standard, mediane cu abaterea intercuartilică sau în procente. Rezultate. Succesul tehnic primar al stripping-ului fără incizie distală a fost de 90% față de 70% în cazul strippingului convențional (p>0,05). Pacienții din Lotul „InvisiGrip” au raportat o durere semnificativ mai redusă conform scălii analogice vizuale – 20,6±3,3 mm versus 26,3±6,9 mm la pacienții după stripping convențional (p<0,05). Valoarea medie a satisfacției pacienților la o lună după tratament a fost 97,7±2,0 mm în Lotul “InvisiGrip”, fiind semnificativ mai înaltă decât în Lotul “Standard” – 92,3±6,8 mm (p<0,05). Concluzii. Stripping-ul venei safene fără incizie distală reprezintă o procedură eficace, iar rata succesului tehnic primar al acestei metode, cel puțin, nu este inferioară strippingului convențional. Rezultatele raportate de către pacienți cu referință la durerea postoperatorie și gradul de satisfacție de tratament sunt semnificativ mai bune după stripping-ul safenian efectuat fără incizie distală.Abstract Introduction. Recently the new method of short saphenous stripping without distal incision was implemented in varicose vein surgery. The aim of study was to evaluate the short-term outcomes of saphenous stripping by testing the hypothesis of superiority of medical and patient-reported outcomes after stripping without distal incision compared to conventional technique. Materials and methods. Two groups of patients with varicose veins of the lower limbs were retrieved from database – 10 patients who underwent saphenous stripping without distal incision (Group „InvisiGrip”) and 10 patients operated on by means of conventional technique (Group „Standard”). Controls were individually matched according to their age, sex and clinical class of venous insufficiency. The technical success of intervention, duration of surgery, postoperative pain severity and analgesic requirement, extension of thigh ecchymosis and patient satisfaction survey results were analyzed and compared between groups. Applied statistics: paired two-tiled t-test, Wilcoxon matched-pairs signed rank test, Fisher’s exact test. Data are presented as means with standard deviation, medians with interquartile range or as percentages. Results. The primary technical success of stripping without distal incision was 90% compared to 70% after conventional stripping (p>0.05). Patients from Group „InvisiGrip” reported significantly less pain according to the visual analogue scale – 20.6±3.3 mm vs 26.3±6.9 mm in patients after conventional stripping (p<0.05). The mean value of patient satisfaction at one month after treatment was 97.7±2.0 mm in Group „InvisiGrip” and was significantly higher than in Group „Standard” – 92.3±6.8 mm (p<0.05). Conclusions. Saphenous stripping without a distal incision is an effective procedure and primary technical success rate of this technique is at least not inferior to the conventional stripping. Patient reported outcomes regarding postoperative pain and level of patient satisfaction are significantly better in patients after saphenous stripping without a distal incision

The correlation between laparoscopic anti-reflux surgery outcomes and the efficacy of preoperative acidsuppressive medication

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Actualmente, fundoplicația laparoscopică (FL) reprezintă „standardul de aur” în tratamentul chirurgical al bolii de reflux gastroesofagian (BRGE). Totuși, majoritatea pacienților operați au un istoric de medicație acidosupresiva cu inhibitori ai pompei de protoni (IPP) preoperator, eficiența acesteia variind mult. Scopul lucrării a fost analiza corelației dintre rezultatele FL și eficiența medicației acidosupresive preoperatorii. Material și metode. Au fost incluși 152 pacienți, ce au suportat FL în perioada anilor 2012-2019. Toți pacienții au primit tratament antisecretor cu IPP, ulterior fiind selectați pentru FL. Succesul operației și calitatea vieții pacienților au fost evaluate utilizând chestionarul GERD-HRQL (Velanovich) și scala Visick. Rezultate. După eficiența terapiei cu IPP, „responderi compleți” – au constituit 44 (28,9 %), „responderi parțiali” - 94 (61,9%) și „non-responderii” - 14 (9,2%). Vârsta bolnavilor a variat între 19 și 76 ani (media – 52 ani); 97 (63,8%) au fost femei și 55 (36,2%) – bărbați. Rezultate excelente și bune (Visick I și II, scor Velanovich stabil mic) s-au determinat în 141 cazuri (92.7%); fără schimbări (Visick III, scor Velanovich elevat) – 9 cazuri (6%); agravarea simptomaticii (Visick IV) – 2 cazuri (1.3%). În același timp, rezultate mai bune s-au observat la „responderi compleți”, față de „responderi parțiali” și „non-responderi” (regresia simptomelor 100% vs 92.5% vs 71.4%, p<0.05). Concluzii. Chirurgia laparoscopică anti-reflux este o metodă eficientă de tratament la toți pacienții cu BRGE. Totuși, eficacitatea terapiei acidosupresive a constituit un factor predictiv pozitiv pentru rezultatul FL. Astfel, în cazul lipsei răspunsului la terapia cu IPP, este necesară documentarea prezenței reale a BRGE și/sau corelației simptom-reflux, pentru a avea rezultate bune postoperatorii.Background. Currently, laparoscopic fundoplication (LF) is the „gold standard” in the surgical treatment of gastroesophageal reflux disease (GERD). However, most operated patients have a history of acid-suppressive medication with proton pump inhibitors (PPIs) preoperatively, which varies in effectiveness. The aim was to analyze the correlation between LF outcomes and the efficacy of preoperative acid-suppressive medication. Material and methods. The 152 patients who underwent LF between 2012-2019 were included. All patients received PPIs therapy and were subsequently selected for LF. The success of the operation and the patients’ quality of life were evaluated using the GERD-HRQL (Velanovich) questionnaire and the Visick scale. Results. Based on the efficacy of PPI therapy, „complete responders” accounted for 44 (28.9%), „partial responders” for 94 (61.9%) and „non-responders” for 14 (9.2%). The age of the patients ranged from 19 and 76 years (mean age: 52 years); 97 (63.8%) were females and 55 (36.2%) – males. Excellent and good results (Visick I and II, low stable Velanovich score) were observed in 141 cases (92.7%); no change (Visick III, elevated Velanovich score) in 9 cases (6%); and worsening of symptoms (Visick IV) in 2 cases (1.3%). At the same time, better outcomes were observed in „complete responders” compared to „partial responders” and „non-responders” (symptoms regression 100% vs 92.5% vs 71.4%, p<0.05). Conclusions. Laparoscopic anti-reflux surgery is an effective treatment method for all patients with GERD. However, the effectiveness of acid-suppressive therapy was a positive predictive factor for LF outcome. Therefore, in case of unresponsiveness to PPI therapy, it is necessary to document the presence of GERD and/or the symptom-reflux correlation, in order to achieve favorable postoperative results

Differential approach in figurate erythemas: clinical case

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Eritemul inelar centrifug (EIC) este un fenomen cronic, reactiv al pielii, caracterizat prin plăci eritematoase inelare, arciforme, policiclice, cu extindere centrifugala. EIC este adesea asociat cu infecții fungice, bacteriene, administrare de medicamente, afecțiuni autoimune sau endocrine, neoplazii. Scopul lucrării. evidențierea importanței diagnosticului diferențial al maladiilor manifestate prin leziuni eritematoase figurate, prin prisma unui caz clinic. Material și metode. Datele anamnestice, clinice și paraclinice au fost prelevate din fișa medicală. Pacientul a fost investigat prin biopsie cutanată. A fost studiată literatura privind cazurile similare. Rezultate. Pacienta internată în staționar cu acuzele: leziuni cutanate diseminate la nivelul membrelor superioare și inferioare, fără senzații subiective. Din anamneză, leziunile au apărut primar cu 8 ani în urmă, în timpul sarcinii, pe membrele superioare și inferioare. Testul la Ac către Borrelia burgdoferi IgM si IgG - negativ. La examenul microscopic cu KOH a fost exclusă infecția fungică. Medicul de familie a indicat Desloratadină oral cu efect terapeutic pozitiv. Peste 6 ani, leziunile au reapărut. Test calitativ IgM la boala Lyme - pozitiv. La biopsia cutanată - modificări patologice caracteristice pentru EIC: infiltrat limfocitar perivascular dens; spongioză și hiperkeratoză cu parakeratoză. Concluzie. Diagnosticul diferențial al EIC poate fi dificil, simptomele si semnele sale pot fi similare cu cele ale altor afecțiuni cutanate, cum ar fi eritemul migrator, TBC, tinea corporis, erythema marginatum, sifilis, erythema gyratum repens.Background. Erythema annulare centrifugum (EIC)- a chronic, reactive skin phenomenon, characterized by annular, arciform, polycyclic, erythematous plaques that expand centrifugally. EIC is often associated with fungal, bacterial infections, drug administration, autoimmune or endocrine disorders, neoplasms. The objective of the study. To highlight the importance of the differential diagnosis of diseases manifested by figurative erythematous lesions, through a clinical case. Material and methods. History, clinical and paraclinical data were taken retrospectively from the medical record. The patient was investigated by skin biopsy. Literature on similar cases was studied. Results. Patients complains widespread skin lesions on the upper and lower limbs, without subjective sensations. From the anamnesis, the lesions first appeared 8 years ago, during pregnancy, in the upper and lower limbs. Borrelia burgdoferi IgM and IgG antibody test - negative. Fungal infection was excluded by microscopic examination. The therapist indicated oral Desloratadine with a positive therapeutic effect. After 6 years, the lesions reappeared. Qualitative IgM test for Lyme disease - positive. The infectionist prescribed antibiotic-therapy for Lyme disease. The skin biopsy revealed characteristic pathological changes for EIC: dense perivascular lymphocytic infiltrate; spongiosis and hyperkeratosis with parakeratosis. Conclusion. The differential diagnosis of EIC can be difficult because its symptoms and signs can be similar to those of other skin conditions, such as erythema migrans, TB, tinea corporis, erythema marginatum, syphilis, and erythema gyratum repens

Colecistita acută calculoasă la adult: protocol clinic naţional PCN-293

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Instituţia Medico-Sanitară Publică Spitalul Clinic Municipal nr. 1Acest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii, Muncii și Protecției Sociale al Republicii Moldova (MSMșiPS RM), constituit din specialiştii Catedrei Chirurgie Generală şi Semiologie a USMF „Nicolae Testemiţanu” şi ai Spitalului Clinic Municipal nr.1 din Chişinău. Protocolul clinic naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind colecistita calculoasă acută la adulţi şi va servi drept bază pentru elaborarea protocoalelor clinice instituţionale. La recomandarea MS RM, pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în Protocolul Clinic Naţional