MEDICAL LIBRARIES IN THE REPUBLIC OF MOLDOVA IN THE CURRENT CONDITIONS: NEW CHALLENGES, NEW RISKS, NEW OPPORTUNITIES

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. În lucrare vor fi scoase în evidență provocările la care sunt supuse astăzi bibliotecile, acestea fiind generate de tendințele de dezvoltare ale domeniului, de extinderea rapidă a tehnologiilor informaționale, de criza sanitară instituită la nivel național etc. În același timp, schimbările la care sunt supuse bibliotecile oferă acestora noi oportunități de a-și diversifica activitatea, de a implementa noi servicii, de a fi accesibile de oriunde și oricând. Scopul. Identificarea provocărilor și a riscurilor la care sunt supuse bibliotecile medicale din RM și căutarea soluțiilor pentru a face față acestor provocări. Materiale și metode. A fost analizat Formularul statistic „Cercetare statistică anuală nr. 6-c. Activitatea bibliotecilor”. S-a realizat intervievarea specialiștilor din biblioteci. Au fost efectuate vizite de documentare în teritoriu. Rezultate. Rezultatele cercetării au demonstrat o situație bună doar la BȘM - cea mai mare bibliotecă medicală din țară, care oferă o gamă largă de servicii moderne pentru întreaga comunitate medicală. O situație relativ bună urmărim în bibliotecile colegiilor de medicină, care fac efort pentru a se conforma noilor cerințe. Acestea, prin accesarea paginii web a BȘM, asigură utilizatorilor săi acces la resursele informaționale pentru asigurarea procesului de studiu și cercetare, dezvoltă colecții de documente electronice, creează baze de date cu acces local. Concluzii. Bibliotecile medicale din rețea dispun de potențial pentru a face față provocărilor actuale, acestea, însă, necesită o susținere din partea fondatorilor pentru a fi dotate cu echipamente moderne.Introduction. Today, libraries are subject of challenges, generated by the development trends of the field of librarianship, by the rapid expansion of information technologies, by the health crisis instituted at the national level, etc. At the same time, this changes offer them new opportunities to diversify their activity, to implement new services, to be accessible from anywhere and anytime. Purpose. To identify the challenges and risks to which the medical libraries of the RM are subjected and to find solutions to resist these challenges. Materials and methods. Analysis of the statistical form „Annual statistical survey no. 6-c „Library activity” and develop performance indicators for the last 10 years (Chapter Electronic Resources and Library Services). Interviewing librarians. Documentary visits in the territory. Results. The research results showed a good situation only at the Scientific Medical Library (SML) — the largest medical library in Moldova, which offers a wide range of modern services for the entire medical community. Relatively good is the situation in the libraries of medical colleges, which make an effort to comply with the new requirements. By accessing the website of the SML, they provide its users the access to information resources to ensure the study and research process; they develop collections of electronic documents, and create databases with local access. Conclusions. Medical libraries in the republic have potential to meet current challenges, but they need the support of the founding institutions to be equipped with modern equipment

The statistics of the trajectory in a certain billiard in a flat two-torus

We consider a billiard in the punctured torus obtained by removing a small disk from the two-dimensional flat torus, with trajectory starting from the center of the puncture. In this case the phase space is given by the range of the velocity only. We prove that the probability measures on $[0,\infty)$ associated with the first exit time are weakly convergent when the size of the puncture tends to zero and explicitly compute the density of the limit.Comment: 21 pages, 6 figure

Bibliotecile medicale din Republica Moldova în condițiile actuale: noi provocări, noi riscuri, noi oportunități

Introduction. Today, libraries are subject of challenges, generated by the development trends of the field of librarianship, by the rapid expansion of information technologies, by the health crisis instituted at the national level, etc. At the same time, this changes offer them new opportunities to diversify their activity, to implement new services, to be accessible from anywhere and anytime. Purpose. To identify the challenges and risks to which the medical libraries of the RM are subjected and to find solutions to resist these challenges. Materials and methods. Analysis of the statistical form „Annual statistical survey no. 6-c „Library activity” and develop performance indicators for the last 10 years (Chapter Electronic Resources and Library Services). Interviewing librarians. Documentary visits in the territory. Results. The research results showed a good situation only at the Scientific Medical Library (SML) — the largest medical library in Moldova, which offers a wide range of modern services for the entire medical community. Relatively good is the situation in the libraries of medical colleges, which make an effort to comply with the new requirements. By accessing the website of the SML, they provide its users the access to information resources to ensure the study and research process; they develop collections of electronic documents, and create databases with local access. Conclusions. Medical libraries in the republic have potential to meet current challenges, but they need the support of the founding institutions to be equipped with modern equipment.Introducere. În lucrare vor fi scoase în evidență provocările la care sunt supuse astăzi bibliotecile, acestea fiind generate de tendințele de dezvoltare ale domeniului, de extinderea rapidă a tehnologiilor informaționale, de criza sanitară instituită la nivel național etc. În același timp, schimbările la care sunt supuse bibliotecile oferă acestora noi oportunități de a-și diversifica activitatea, de a implementa noi servicii, de a fi accesibile de oriunde și oricând. Scopul. Identificarea provocărilor și a riscurilor la care sunt supuse bibliotecile medicale din RM și căutarea soluțiilor pentru a face față acestor provocări. Materiale și metode. A fost analizat Formularul statistic „Cercetare statistică anuală nr. 6-c. Activitatea bibliotecilor”. S-a realizat intervievarea specialiștilor din biblioteci. Au fost efectuate vizite de documentare în teritoriu. Rezultate. Rezultatele cercetării au demonstrat o situație bună doar la BȘM - cea mai mare bibliotecă medicală din țară, care oferă o gamă largă de servicii moderne pentru întreaga comunitate medicală. O situație relativ bună urmărim în bibliotecile colegiilor de medicină, care fac efort pentru a se conforma noilor cerințe. Acestea, prin accesarea paginii web a BȘM, asigură utilizatorilor săi acces la resursele informaționale pentru asigurarea procesului de studiu și cercetare, dezvoltă colecții de documente electronice, creează baze de date cu acces local. Concluzii. Bibliotecile medicale din rețea dispun de potențial pentru a face față provocărilor actuale, acestea, însă, necesită o susținere din partea fondatorilor pentru a fi dotate cu echipamente moderne

On the distribution of the free path length of the linear flow in a honeycomb

Let $\ell \geq 2$ be an integer. For each \eps >0 remove from $\R^2$ the union of discs of radius \eps centered at the integer lattice points $(m,n$, with m\nequiv n\mod{\ell}. Consider a point-like particle moving linearly at unit speed, with velocity $\omega$, along a trajectory starting at the origin, and its free path length \tau_{\ell,\eps} (\omega)\in [0,\infty]. We prove the weak convergence of the probability measures associated with the random variables \eps \tau_{\ell,\eps} as \eps \to 0^+ and explicitly compute the limiting distribution. For $\ell=3$ this leads to an asymptotic formula for the length of the trajectory of a billiard in a regular hexagon, starting at the center, with circular pockets of radius \eps\to 0^+ removed from the corners. For $\ell=2$ this corresponds to the trajectory of a billiard in a unit square with circular pockets removed from the corners and trajectory starting at the center of the square. The limiting probability measures on $[0,\infty)$ have a tail at infinity, which contrasts with the case of a square with pockets and trajectory starting from one of the corners, where the limiting probability measure has compact support.Comment: 20 pages, 9 figure

Red Blood Cell as an Elastic Probe: Interaction with Drugs and Toxins

In this thesis we investigate the interaction between drugs and toxins with membranes using red blood cells (RBCs) as morphoelastic probes. Using fluctuation spectroscopy, we were able to probe the RBC mechanical response to a simulated diabetic environment and to investigate the effect of metformin, one of the most widely used medicines to treat diabetes. Healthy RBCs were incubated in high levels of glucose or glucose and metformin and their mechanical properties were tested upon the exposure to oxidation with hydrogen peroxide (H2O2). My results show that the response to oxidation and glycation is different for different donors, with some donors more susceptible to oxidation than others. I have also found that glycated cells are more susceptible to oxidation with H2O2 than control and metformin treated RBCs. Metformin treated RBCs show a response to oxidation similar to control cells which suggests that metformin may have some antihyperglycaemic and antioxidant effects which could preserve the RBCs membrane elasticity within the normal limits, counteracting the adverse effects of oxidative stress. The interaction between the RBC membrane and two of the Clostridium perfingens toxins, $alpha$ -toxin and NetB, is next studied in this thesis. Using fluctuation and absorbance spectroscopy, changes in the RBCs morphology caused by the toxins can be monitored allowing us to describe the course of the toxin membrane interaction. I conclude that the two toxins studied in this thesis have two different mechanisms of action. Both toxins produce a decrease in the cell radius but through two different mechanisms. NetB causes a decrease in the cell radius by forming large pores in the red cell membrane allowing for quick lysis and the exchange of material across the membrane. Whereas $alpha$-toxin causes a decrease in the cell radius by hydrolysing specific lipids in the cell membrane without necessarily causing the formation of membrane pores. These differences in the interactions between the two toxins and the red cell membrane have distinct fingerprints in the evolution of the cell shape and membrane thermal fluctuation dynamics. Fluctuation and absorbance spectroscopy were also used to investigate the effect of nitroglycerine (GTN) on the RBC morphology and mechanical properties. This study was prompted by a recent report in the literature that related decreases in the viscosity of whole blood to changes in the membrane surface charge. My results show that changes in the electrophoretic mobility of GTN-treated RBCs strongly depend on the incubation time. Cells incubated in GTN for 5 minutes decreased their mobility by about 20% whereas cells incubated for 20 minutes increased their mobility by about the same amount. Further investigations on the RBC morphology showed that GTN causes changes in the RBC shape. The matching times scales between those experiments and the electrophoretic experiments made me conclude that RBCs shape may play a role in the electrophoretic mobility of the RBCs treated with GTN. The main results obtained in this thesis demonstrate the viability of the idea of using RBCs as morphoelastic probes, which can provide detailed information about the interaction of solutes of interest and the plasma membrane. At the end of this thesis I propose use of RBCs in such a capacity to monitor the progression of disease by comparing the cell elastic state to clinical markers of disease

HER-2/neu, Topoisomerase-II-α, Östrogen- und Progesteronrezeptor

Die Diagnose Brustkrebs betrifft jährlich etwa 55.150 Frauen in Deutschland. Das Mammakarzinom stellt somit die häufigste Krebsneuerkrankung und Krebstodesursache der Frau dar. Die Wahl der geeigneten Therapie wird für das metastasierte Mammakarzinom anhand des pathologisch untersuchten Gewebes des Primärtumors getroffen. Die Untersuchung der biologischen Marker von Fernund lokoregionären Lymphknotenmetastasen wird routinemäßig nicht durchgeführt. Dies beruht auf der Annahme, dass sich der histopathologische Charakter des Tumors in den Metastasen widerspiegelt, und sich selbst bei Metastasierung nach einigen Jahren nicht verändert. Die vorliegende Arbeit untersucht die Konkordanz des Expressionsverhaltens von HER-2/neu, Topoisomerase-II-α und den Hormonrezeptoren Östrogen- und Progesteronrezeptor in Geweben von Primärtumor und Lymphknotenmetastase von 121 Patientinnen mit mindestens einer ipsilateralen axillären Lymphknotenmetastase. Zusätzlich wird das Amplifikationsverhalten von HER-2/neu und Topoisomerase-II-α in den HER-2/neu überexprimierten Fällen mittels Fluoreszenz in situ Hybridisierung und Chromogener in situ Hybridisierung analysiert. Die Tumorexzisionen sowie die Lymphknotendissektionen erfolgten im Rotkreuzklinikum – Frauenklinik – München, unter der Leitung von Prof. Dr. W. Eiermann in der Zeit zwischen Dezember 1999 und April 2002. Die immunhistochemischen Untersuchungen zeigen Ergebnisse von hoher Konkordanz (97,4% für Östrogenrezeptor, 96,6% für Progesteronrezeptor, 96,6% für HER-2/neu und 96,5% für Topoisomerase-II-α) zwischen Primärtumor und Lymphknotenmetastase. Die Fluoreszenz und Chromogene in situ Hybridisierung(FISH und CISH) zeigen sowohl für HER-2/neu als auch für Topoisomerase-II-α eine absolute (100%) Konkordanz zwischen Primärtumor und Lymphknoten. Bezüglich des HER-2/neu sind die Ergebnisse von FISH und CISH untereinander zu 100% konkordant. Im Gegensatz dazu detektiert CISH deutlich mehr Topoisomerase-II-α-amplifizierte Fälle als FISH (13 vs. 3). Eine Routine-Untersuchung der metastatischen Lymphknoten auf HER-2/neu ist trotz der hohen konkordanten Ergebnisse sinnvoll. Dies betrifft zwar nur einen geringen prozentualen Anteil im vorliegenden Kollektiv (2,6%), pro Jahr sind dies allerdings ca. 1400 Patientinnen in Deutschland. Weitere 1500 Patientinnen könnten von einer Hormonrezeptorbestimmung der Lymphknoten profitieren. Um eine Beurteilung des Stellenwertes der Topoisomerase-II-α zu ermöglichen,sollte deren Auswertung durch weitere Studien verbessert und standardisiert werden. Erst dann kann das Ziel der gerichteten und limitierten Anwendung von Anthrazyklinen zur Vermeidung unnötiger Nebenwirkungen angestrebt und verwirklicht werden