Liver transplantation in Romania

Institultul Clinic Fundeni-Clinica Chirurgie Generală și Transplant Hepatic “Dan Setlacec”, Al XI-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova și cea de-a XXXIII-a Reuniune a Chirurgilor din Moldova „Iacomi-Răzeșu” 27-30 septembrie 2011Analiza retrospectivă a 300 de transplanturi hepatice efectuate în Centrul de Chirurgie Generală și Transplant Hepatic “Dan Setlacec “.Retrospective analysis of 300 liver transplantation performed in General Surgery Center and Liver Transplantation “Dan Setlacec”

Numerical and experimental transition results evaluation for a morphing wing and aileron system

A new wing-tip concept with morphing upper surface and interchangeable conventional and morphing ailerons was designed, manufactured, bench and wind tunnel tested. The development of this wing tip model was performed in the frame of an international CRIAQ project, and the purpose was to demonstrate the wing upper surface and aileron morphing capabilities in improving the wing tip aerodynamic performances. During numerical optimization with ‘in-house’ genetic algorithm software, and during wind tunnel experimental tests, it was demonstrated that the air flow laminarity over the wing skin was promoted, and the laminar flow was extended with up to 9% of the chord. Drag coefficient reduction of up to 9% was obtained when the morphing aileron was introduced

Epidemiology of fractures in Armenia: development of a country-specific FRAX model and comparison to its surrogate

Summary: Fracture probabilities derived from the surrogate FRAX model for Armenia were compared to those from the model based on regional estimates of the incidence of hip fracture. Disparities between the surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal. Objective: Armenia has relied on a surrogate FRAX model based on the fracture epidemiology of Romania. This paper describes the epidemiology of fragility fractures in Armenia used to create an Armenia-specific FRAX model with an aim of comparing this new model with the surrogate model. Methods: We carried out a population-based study in two regions of Armenia (Ararat and Vayots Dzor representing approximately 11% of the country’s population). We aimed to identify all low-energy fractures: retrospectively from hospital registers in 2011–2012 and prospectively in 2013 with the inclusion of primary care sources. Results: The differences in incidence between the surveys with and without data from primary care suggested that 44% of patients sustaining a hip fracture did not receive specialized medical care. A similar proportion of forearm and humeral fractures did not come to hospital attention (48 and 49%, respectively). Only 57.7% of patients sustaining a hip fracture were hospitalized. In 2013, hip fracture incidence at the age of 50 years or more was 201/100,000 for women and 136/100,000 for men, and age- and sex-specific rates were incorporated into the new “authentic” FRAX model for Armenia. Compared to the surrogate model, the authentic model gave lower 10-year fracture probabilities in men and women aged less than 70 years but substantially higher above this age. Notwithstanding, there were very close correlations in fracture probabilities between the surrogate and authentic models ( >  0.99) so that the revisions had little impact on the rank order of risk. Conclusion: A substantial proportion of major osteoporotic fractures in Armenia do not come to hospital attention. The disparities between surrogate and authentic FRAX models indicate the importance of developing country-specific FRAX models. Despite large differences between models, differences in the rank order of fracture probabilities were minimal

FRAX- vs. T-score-based intervention thresholds for osteoporosis

Many current guidelines for the assessment of osteoporosis, including those in Kuwait, initiate fracture risk assessment in men and women using BMD T-score thresholds. We compared the Kuwaiti guidelines with FRAX-based age-dependent intervention thresholds equivalent to that in women with a prior fragility fracture. FRAX-based intervention thresholds identified women at higher fracture probability than fixed T-score thresholds, particularly in the elderly. PURPOSE: A FRAX® model been recently calibrated for Kuwait, but guidance is needed on how to utilise fracture probabilities in the assessment and treatment of patients. METHODS: We compared age-specific fracture probabilities, equivalent to women with no clinical risk factors and a prior fragility fracture (without BMD), with the age-specific fracture probabilities associated with femoral neck T-scores of -2.5 and -1.5 SD, in line with current guidelines in Kuwait. Upper and lower assessment thresholds for BMD testing were additionally explored using FRAX. RESULTS: When a BMD T-score of -2.5 SD was used as an intervention threshold, FRAX probabilities of a major osteoporotic fracture in women aged 50 years were approximately twofold higher than those in women of the same age but with an average BMD. The increase in risk associated with the BMD threshold decreased progressively with age such that, at the age of 83 years or more, a T-score of -2.5 SD was associated with a lower probability of fracture than that of the age-matched general population with no clinical risk factors. The same phenomenon was observed from the age of 66 years at a T-score of -1.5 SD. A FRAX-based intervention threshold, defined as the 10-year probability of a major osteoporotic fracture in a woman of average BMI with a previous fracture, rose with age from 4.3% at the age of 50 years to 23%, at the age of 90 years, and identified women at increased risk at all ages. Qualitatively comparable findings were observed in the case of hip fracture probability and in men. CONCLUSION: Intervention thresholds based on BMD alone do not optimally target women at higher fracture risk than those on age-matched individuals without clinical risk factors, particularly in the elderly. In contrast, intervention thresholds based on fracture probabilities equivalent to a 'fracture threshold' consistently target women at higher fracture risk, irrespective of age

Numerical optimization of the UAS-S4 Éhecatl airfoil using a morphing wing approach

In this paper, we describe the new methodology and the results obtained for multiple flight conditions optimization of the airfoil of the S4 unmanned aerial system, using a morphing wing approach. The goal of reducing the airfoil drag coefficient over a broad range of speeds and angles of attack has been achieved using an in-house optimization tool based on the relatively new Artificial Bee Colony algorithm, coupled with the Broyden-Fletcher-Goldfarb-Shanno algorithm to provide a final refinement of the solution. The obtained results were validated with an advanced, multi-objective, commercially available optimizing tool. The aerodynamic calculations were performed using a 2D linear panel method, coupled with an incompressible boundary layer model and a transition estimation criterion, to provide accurate estimations of the airfoil drag coefficient. For very small displacements of the airfoil surface, less than 2.5 mm, drag reductions of up to 14% have been achieved for a wide range of different flight conditions