ANN Based Inverse Dynamic Model of the 6-PGK Parallel Robot Manipulator

This paper presents an inverse dynamic model estimation based on an artificial neural network of a complete new parallel robot manipulator prototype 6- PGK with six degrees of freedom, built at Petru Maior University of Tirgu-Mures. The model estimation of the parallel robot manipulator is performed with a feedforward artificial neural network. In the control engineering domain there are control structures that need the direct or inverse model of the process for ensuring the process control at the imposed performances. Usually, the determination of the direct/inverse mathematical model is a difficult or impossible task to be achieved. In these cases different non-parametric or parametric, off-line or on-line identification methods are used. A solution that may support the on-line parametric methods is represented by the feedforward artificial neural networks. By implementing feedforward artificial neural networks as a nonlinear autoregressive model with exogenous inputs, the authors investigate the possibility of choosing the optimum parameters that characterize the neural network so that it approximates as better as possible the model of the 6-PGK prototype robot. Finally an innovative algorithm is developed for obtaining the optimal configuration parameters set of the feedforward artificial neural network. The proposed algorithm helps in setting the optimal parameters of the neural network that offer high opportunities to provide satisfactory identification of the robot model. Experimental results obtained by a structure derived from the proposed solution demonstrate a good approximation related to the studied system, which is characterized by nonlinearities and high complexity

Human Papilloma Virus (HPV) Infection and HPV Vaccination: Assessing the Level of Knowledge among Students of the University of Medicine and Pharmacy of Tirgu Mures, Romania

Introduction: Human Papilloma Virus (HPV) infection, a cause in the development of cervical cancer, remains a topic of great interest. About 80% of sexually active women are at risk of acquiring an HPV infection at some point in life, the peak incidence of infection having been identified in young women. The aim of the study was to assess medical students’ knowledge and attitudes about sexually transmitted diseases, HPV infection, HPV vaccinations, and the students’ sexual behaviour. Material and method: A transversal study was conducted by applying a questionnaire to students on the first and 6th year of school at the Faculty of Medicine of Tirgu Mures University, Romania. Results: The study resulted in 522 questionnaires fully completed. The percentages of students who have heard about HPV were 82.1% from the first year and 99.1% from the 6th year of medicine school, but the level of knowledge was different: 62% of senior students had a good or very good level of knowledge, whereas 55.1% of first year students, had little knowledge on the topic. About 75% of 6th year students would have their child vaccinated against HPV, compared with only 52.4% of first year students (p &lt;0.001). Conclusions: The level of knowledge about HPV infection among students in their first year of medicine school is rather low, significantly lower compared to year 6th year students, which suggests acquiring some basic information in this area since the first year of college or even high school.</p

A Large Ascending Aorta Thrombus in a Patient with Acute Myocardial Infarction—Case Report

We present the case of a 50-year-old male, with no cardiovascular risk factors other than smoking, that presented with acute chest pain, revealed to be an acute myocardial infarction with a large thrombus located in the ascending aorta. Such findings are rare in a patient with no other afflictions, such as atherosclerosis, aortic aneurysm, or aortic wall injury (surgical or traumatic). There is no specific pathway regarding the management of ascending aorta thrombus in such a patient; therapeutic options include surgical, interventional, or medical methods. Surgical thrombectomy was performed in this case, considering the high risk of systemic embolism and stroke and the hemodynamic stability of the patient

Same Clinical Reality of Spontaneous Rupture of the Common Iliac Artery with Pseudoaneurysm Formation&mdash;Comparison of Two Therapeutical Solutions, Endovascular Stent-Graft and Open Surgical Correction, for Two Cases and Review of the Literature

The incidence of isolated iliac artery aneurysms is approximately 2% and common iliac artery pseudoaneurysms are even rarer. A pseudoaneurysm is a localized hemorrhage as opposed to an actual aneurysm, which affects the entire vascular wall. They are typically asymptomatic and only detectable accidentally while looking for other causes. If large and symptomatic, they typically exhibit pressure symptoms as a result of the compression of the structures around them. Common symptoms include generalized stomach pain, urological problems, gastrointestinal bleeding, and neurological symptoms such as leg paralysis or sciatica-like back pain. Rarely, they may exhibit hemodynamic instability together with an aneurysm rupture, which has a high fatality rate. Due to the unique presentation, the diagnosis is typically rarely made and there is little experience with treating it. We report two cases of common iliac artery pseudoaneurysm found in two patients who had no notable medical history and who we chose to repair through the endovascular technique in the first case, an approach that has gained more ground for vascular repair worldwide, making it the current go-to method, and for the second case we chose a more traditional approach, through open surgery

CUNOŞTINŢELE ŞI ATITUDINILE MEDICILOR DE FAMILIE ŞI FARMACIŞTILOR CU PRIVIRE LA UTILIZAREA ADECVATĂ A ANTIBIOTICELOR

INTRODUCTION: The unprecedented multiplication of infection rates with antibiotic-resistant germs currently represents a complex problem that doctors face, driven by closely linked factors. The antibiotic resistance rate of microbial agents is unknown, however, it is provided by various factors such as the knowledge of microbiology of general practitioners and pharmacists, as well as patient self-medication. The purpose of this study was to investigate the way antibiotics are prescribed by general practitioners and the way they are released by pharmacists. Another aim was to update the knowledge about the appearance of multiresistant microorganisms to antibiotics. MATERIALS AND METHODS: We used a questionnaire consisting of 33 questions on the knowledge of general practitioners and pharmacists about antibiotic therapy and antibiotic resistance. RESULTS: Most general practitioners considered that antibiotic resistance was a matter of practice, while pharmacists regarded it a national problem. In the view of the respondents, the important causes of antibiotic resistance are excessive prescriptions/ release of antibiotics (68.5%), unnecessary prescription/ release of antibiotics (63.8%), inappropriate duration of the antibiotic treatment (49.1%). The most important factor for prescribing/ release of proper antibiotics is the correct diagnosis of the infection with resistant germs. Important criteria also include the restrictive use of antibiotics in targeted therapy against resistant bacteria and the correct duration of drug administration. CONCLUSIONS: The main causes affecting antibiotic resistance are determined by professionalism and the lack of an effective national program to combat antibiotic resistance, or the lack of educational programs for the population, but also due to insufficient medical knowledge in the general population, which inevitably leads to self-medication with antibiotics without a medical examination and a microbiological diagnosis.   Keywords: Antibiotics, general practitioners, pharmacists, antibiotic resistance, knowledge and attitudesINTRODUCERE: Creșterea fără precedent a ratei infecțiilor cu germeni rezistenți la antibiotice reprezintă o problemă de actualitate cu care se confruntă medicii, fiind o problemă complexă, determinată de factori str&acirc;ns interconectați. Rata rezistenței agenților microbieni la antibiotice răm&acirc;ne o necunoscută, ea fiind dată de variați factori precum cunoștințele &icirc;n materie de microbiologie ale medicilor de familie și farmaciștilor sau automedicația pacientului. SCOPUL LUCRĂRII a fost de a studia modul de prescriere a reţetelor cu antibiotice de către medicii de familie şi eliberarea acestor reţete de către farmacişti. S-a dorit actualizarea cunoştinţelor despre modul de apariţie a germenilor multirezistenţi la antibiotice. MATERIAL ȘI METODĂ: Am aplicat un chestionar format din 33 de &icirc;ntrebări legate de cunoștințele medicilor de familie și a farmaciștilor despre antibioticoterapie și antibioticorezistență. REZULTATE: Majoritatea medicilor de familie au considerat antibioticorezistența o problemă de practică medicală, pe c&acirc;nd farmaciștii o problemă națională. &Icirc;n opinia respondenților, cauzele importante ale antibioticorezistenței sunt: prescrieri/eliberări excesive de antibiotice (68.5%), prescrieri/eliberări ale antibioticelor fără să fie nevoie (63.8%), durata inadecvată a antibioterapiei (49.1%). Cel mai important factor pentru prescrierea/eliberarea corectă a antibioticelor este reprezentat de diagnosticul corect al infecțiilor cu germeni rezistenți. Utilizarea restrictivă a antibioticelor care se administrează țintit bacteriilor rezistente respectiv durata corectă a terapiei, reprezintă de asemenea,&nbsp; criterii importante. CONCLUZII: Principalele cauze care influențează antibioticorezistența sunt de natură profesională, de natură organizatorică, prin lipsa unui program național eficient de combatere a antibioticorezistenței sau lipsa unor programe educaționale pentru populație, dar și datorate unor cunoștințe medicale insuficiente a populației generale, ce duce la automedicație cu antibiotice &icirc;n lipsa unui consult medical și a unui diagnostic de certitudine microbiologic. &nbsp; Cuvinte cheie: antibiotice, medici de familie, farmaciști, antibioticorezistența, cunoștințe și atitudin

Methods and Strategies for Biomonitoring in Occupational Exposure to Plant Protection Products Containing Glyphosate

Glyphosate, and the ever growing reliance on its use in agriculture, has been a point of contention for many years. There have been debates regarding the risk and safety of using glyphosate-based herbicides as well as the effects of occupational, accidental, or systematic. Although there have been a number of studies conducted, the biomonitoring of glyphosate poses a series of challenges. Researchers attempting to determine the occupational exposure face questions regarding the most appropriate analytical techniques and sampling procedures. The present review aims to summarize and synthetize the analytical methodologies available and suitable for the purpose of glyphosate biomonitoring studies as well as discuss the advantages and disadvantages of each analytical technique, from the most modern to more well-established and older ones. The most relevant publications that have described analytical methods and published within the last 12 years were studied. Methods were compared, and the advantages and disadvantages of each methods were discussed. A total of 35 manuscripts describing analytical methods for glyphosate determination were summarized and discussed, with the most relevant one being compared. For methods that were not intended for biological samples, we discussed if they could be used for biomonitoring and approaches to adapt these methods for this purpose

The Prevalence and Treatment Costs of Non-Melanoma Skin Cancer in Cluj-Napoca Maxillofacial Center

Background and Objectives: An increasing incidence of non-melanoma skin cancer (NMSC) is noted, as well as an increasing cost of the treatment, with NMSC becoming a public health problem. We aimed to investigate the prevalence and treatment costs of surgically treated NMSC from the Oral and Maxillofacial Surgery Department of Cluj-Napoca County Hospital. Materials and Methods: We retrospectively analyzed the clinical data and the charge data of hospitalization from the informatic system of Cluj-Napoca County Hospital. All patients benefited from standard surgical excision with the reconstruction of the post-excisional defect. A statistical analysis of the costs related to the patients&rsquo; features, period and conditions of hospitalization, materials, medication, and paraclinical investigations was performed. Results: Between 2015 and 2019, 133 patients with NMSC were addressed to our department, with basal cell carcinoma (BCC) being four-fold higher than squamous cell carcinoma (SCC). Most NMSC cases were diagnosed in stage I or II, and they benefited from local reconstruction. The treatment costs progressively increased in the last five years, reaching a total cost of EUR ~13.000 in 2019. The treatment cost per episode was higher for SCC compared to BCC, while the total cost of treatment in 5 years was higher for BCC. Low income, immunosuppression, comorbidities, flap reconstruction option, long-lasting surgery, and prolonged hospitalization were associated with an increased cost of the treatment. Conclusion: The prevalence and treatment cost of surgically treated NMSC of the head and neck region increased in the last five years, with high-cost drivers being related to patients and treatment options

The Prevalence and Treatment Costs of Non-Melanoma Skin Cancer in Cluj-Napoca Maxillofacial Center

Background and Objectives: An increasing incidence of non-melanoma skin cancer (NMSC) is noted, as well as an increasing cost of the treatment, with NMSC becoming a public health problem. We aimed to investigate the prevalence and treatment costs of surgically treated NMSC from the Oral and Maxillofacial Surgery Department of Cluj-Napoca County Hospital. Materials and Methods: We retrospectively analyzed the clinical data and the charge data of hospitalization from the informatic system of Cluj-Napoca County Hospital. All patients benefited from standard surgical excision with the reconstruction of the post-excisional defect. A statistical analysis of the costs related to the patients’ features, period and conditions of hospitalization, materials, medication, and paraclinical investigations was performed. Results: Between 2015 and 2019, 133 patients with NMSC were addressed to our department, with basal cell carcinoma (BCC) being four-fold higher than squamous cell carcinoma (SCC). Most NMSC cases were diagnosed in stage I or II, and they benefited from local reconstruction. The treatment costs progressively increased in the last five years, reaching a total cost of EUR ~13.000 in 2019. The treatment cost per episode was higher for SCC compared to BCC, while the total cost of treatment in 5 years was higher for BCC. Low income, immunosuppression, comorbidities, flap reconstruction option, long-lasting surgery, and prolonged hospitalization were associated with an increased cost of the treatment. Conclusion: The prevalence and treatment cost of surgically treated NMSC of the head and neck region increased in the last five years, with high-cost drivers being related to patients and treatment options

Challenges for Management of Dilated Cardiomyopathy during COVID-19 Pandemic&mdash;A Telemedicine Application

Background and Objectives: The 2019 coronavirus pandemic (COVID-19) represented a significant challenge for the medical community. The first aim of this study was to examine the COVID-19 impact on the follow-up of patients with dilated cardiomyopathy (DCM) and to establish the advantages of multiparametric home monitoring. Also, we tried to establish the main prognostic predictors at 2-years follow-up and the value of LV diastolic filling pattern (LVDFP) in increasing mortality and morbidity. Materials and Methods: We conducted a prospective study of 142 patients with DCM assessed by in-patient visit in the pre-pandemic period and hybrid (face-to-face, online consultation and telemedicine home monitoring with a dedicated application) during the pandemic period. The statistical analysis compared the strategy used in the pre-pandemic with management during the pandemic, in terms of clinical assessment, hospitalizations/emergency room visits due to HF exacerbation and total mortality. Results: We did not observe significant changes in blood pressure (BP), heart rate (FC), weight and symptoms or an increased rate of adverse drug events between the two periods. We successfully titrated HF medications with close monitoring of HF decompensations, which were similar in number, but were mostly managed at home during the pandemic. There was also no statistically significant difference in emergency room visits due to severe decompensated HF. Mortality in the first and second year of follow-up was between 12.0 and 13%, similar in the pre-pandemic and pandemic periods, but significantly higher in patients with restrictive LVDFP. Clinical improvement or stability after 2 years was more frequent in patients with nonrestrictive LVDFP. The main prognostic predictors at 1 and 2-years follow-up were: the restrictive LVDFP, significantly dilated LV, comorbidities (DM, COPD), older age, associated severe mitral regurgitation and pulmonary hypertension. Conclusions: The pandemic restrictions determined a marked decrease of the healthcare use, but no significant change in the clinical status of DCM patients under multiparametric home monitoring. At 2-years follow-up, the presence of the restrictive LVDFP was associated with an increased risk of death and with a worse clinical status in DCM patients