Robocar and Urban Space Evolution:

How can we create more human-centered, resilient, and sustainable cities in the tech age? Can we make use of technology and the opportunities presented rather than resisting its fast-paced evolution? What are the biggest and most likely spatial changes that autonomous vehicles will bring in cities? How can this change in mobility contribute to a better urban environment? To what extent do the spatial opportunities created by automated mobility respond to current urban issues and what is the role of urban design and spatial planning in this debate? Autonomous cars—Robocars—will dramatically change urban environments and the practice of urbanism, potentially making cities less dependent on and less dominated by cars. Driverless and mainly guided by digital infrastructure, Robocars can open up new opportunities for urban development. If guided by sustainable development goals, the automation of mobility can lead to urban evolution—a shared paradigm shift in mobility and urban design. However, if Robocars are introduced as profit-driven products rather than tools to improve cities, they can cause sprawl, undermine public transport and reduce active mobility, ultimately affecting people’s health and wellbeing. Consequently, it is necessary to explore how the Robocars’ technological capabilities can provide solutions to pressing urban issues, such as growth, climate change, environmental quality, social inequality and the energy transition. On September 13, 2018, the Section of Urban Design at the Faculty of Architecture and the Built Environment, TU Delft, organised a public debate with international and Dutch experts to discuss the spatial changes that autonomous cars may bring about in cities. Subsequently, this publication gathers illustrated contributions by the key speakers at the symposium, which present ideas and further reflection points on Robocars’ relation to the urban environment. The three thematic sessions of the symposium were video recorded and are available online at robocarevolution.com. The symposium and the publication aim to raise awareness about the importance of the topic for the field of urban design and other disciplines dealing with various aspects of urban sustainability. To date, the topic of autonomous cars has mainly been addressed by car industries, technology companies and transportation planning groups. The current discourse is predominantly driven by business and marketing goals, potentially leading to cities shaped around technology. In this context, the symposium and the publication are a step forward to engaging various experts in a debate around Robocars and urban design. They propose a complementary approach to the current tech discourse on automated mobility by emphasising the importance of an urban design and spatial planning perspective, thus exploring Robocars as a spatial project. Automated vehicles can bring a mobility revolution: traffic systems and infrastructure can be reinvented, public and private transport modes can blend, and the logic of mobility in cities can be reformed, as time spent in the car will no longer be lost. Such changes create spatial opportunities and can help cities respond better to sustainable development goals; for instance, the space made available if Robocars could park themselves can be redesigned and, instead of parked cars, streets can accommodate more green space and larger sidewalks, revaluing streets as public spaces. The goal of the Robocar and Urban Space Evolution symposium and publication is to start a more inclusive debate about Robocars and their impact on the urban environment and to explore the potential of this new technology beyond market-oriented goals. The experts involved came from multiple disciplines, including spatial planning, urban design, architecture, ecology, psychology, environmental engineering and transportation planning. They discussed why and how we need to engage with the topic, given that mobility automation will dramatically shape the urban environment in different contexts and societies in the coming decades. The publication includes contributions by Rients Dijkstra and Anca Ioana Ionescu, Dominic Stead, Víctor Muñoz Sanz, David Hamers, Salvador Rueda, Nico Larco, Emilia Bruck and Mathias Mitteregger

Jetrena osteodistrofija: globalni pre(po)gled problema

Hepatic osteodystrophy is a common and frequently untreated complication, manifested as osteoporosis or osteopenia, encountered in the evolution of chronic liver diseases. Th is article provides a narrative review of hepatic osteodystrophy. Th e aim is to revise the prevalence, pathophysiology, diagnosis and management of hepatic osteodystrophy. We searched medical literature via PubMed, Google Scholar, Wiley, Science Direct, and Springer Link using respective keywords to obtain data on low bone mineral density connected to chronic liver diseases. Many studies have reported an increased prevalence of osteoporosis/osteopenia in patients with chronic liver diseases. Th e pathogenesis is multifactorial, involving genetic factors, vitamin defi ciencies, proinfl ammatory cytokines, hypogonadism, hyperbilirubinemia, antiviral therapy, corticosteroid drugs, and lifestyle factors. Th e management of patients should include individualized assessment for fracture risk factors and bone mineral density. Vitamin D and calcium supplementation should be recommended in all patients with chronic liver diseases and osteoporosis. Bisphosphonates are the most effi cient drugs used in the treatment of hepatic osteodystrophy. In the future, it is necessary to defi ne better the management and specifi c treatment of hepatic osteodystrophy for prevention of fragility fractures and to improve the patient quality of life.Jetrena osteodistrofi ja je česta i nerijetko neliječena komplikacija koja se manifestira kao osteoporoza ili osteopenija, a susreće se u bolesnika s kroničnim bolestima jetre. Ovaj narativni pregled jetrene osteodistrofi je preispituje učestalost, patofiziologiju, dijagnostiku i liječenje jetrene osteodistrofi je. Proveli smo pretragu medicinske literature u bazama podataka PubMed, Google Scholar, Wiley, Science Direct i Springer Link pomoću prikladnih ključnih riječi kako bismo dobili podatke o niskoj mineralnoj gustoći kosti povezanoj s kroničnim bolestima jetre. Mnoga istraživanja izvještavaju o povećanoj učestalosti osteoporoze/osteopenije u bolesnika s kroničnim jetrenim bolestima. Patogeneza je multifaktorijalna i uključuje genetske čimbenike, pomanjkanje raznih vitamina, proupalne citokine, hipogonadizam, hiperbilirubinemiju, protuvirusnu terapiju, kortikosteroidne lijekove te čimbenike povezane s načinom života. Liječenje ovih bolesnika treba obuhvatiti individualiziranu procjenu čimbenika rizika za prijelome te mineralnu gustoću kosti. Svim bolesnicima s kroničnim bolestima jetre i osteoporozom treba preporučiti uzimanje dodataka vitamina C i kalcija. Bisfosfonati su najučinkovitiji lijekovi za liječenje jetrene osteodistrofi je. Potrebno je bolje defi nirati zbrinjavanje i specifi čno liječenje jetrene osteodistrofi je kako bi se sprije čili prijelomi zbog krhkih kosti te poboljšala kvaliteta života ovih bolesnika

Translation of the Fugl-Meyer assessment into Romanian: Transcultural and semantic-linguistic adaptations and clinical validation

PurposeThe Fugl-Meyer Assessment (FMA) scale, which is widely used and highly recommended, is an appropriate tool for evaluating poststroke sensorimotor and other possible somatic deficits. It is also well-suited for capturing a dynamic rehabilitation process. The aim of this study was to first translate the entire sensorimotor FMA scale into Romanian using the transcultural and semantic-linguistic adaptations of its official afferent protocols and to then validate it using the preliminary clinical evaluation of inter- and intra-rater reliability and relevant concurrent validity.MethodsThrough three main steps, we completed a standardized procedure for translating FMA's official afferent evaluation protocols into Romanian and their transcultural and semantic-linguistic adaptation for both the upper and lower extremities. For relevant clinical validation, we evaluated 10 patients after a stroke two times: on days 1 and 2. All patients were evaluated simultaneously by two kinesi-physiotherapists (generically referred to as KFT1 and KFT2) over the course of 2 consecutive days, taking turns in the roles of an examiner and observer, and vice versa (inter-rater). Two scores were therefore obtained and compared for the same patient, i.e., being afferent to an inter-rater assay by comparing the assessment outcomes obtained by the two kinesi-physiotherapists, in between, and respectively, to the intra-rater assay: based on the evaluations of the same kinesi-physiotherapist, in two consecutive days, using a rank-based method (Svensson) for statistical analysis. We also compared our final Romanian version of FMA's official protocols for concurrent validity (Spearman's rank correlation statistical method) to both of the widely available assessment instruments: the Barthel Index (BI) and the modified Rankin scale (mRS).ResultsSvensson's method confirmed overall good inter- and intra-rater results for the main parts of the final Romanian version of FMA's evaluation protocols, regarding the percentage of agreement (≥80% on average) and for disagreement: relative position [RP; values outside the interval of (−0.1, 0.1) in only two measurements out of the 56 comparisons we did], relative concentration [RC; values outside the interval of (−0.1, 0.1) in only nine measurements out of the same 56 comparisons done], and relative rank variation [RV; all values within an interval of (0, 0.1) in only five measurements out of the 56 comparisons done]. High correlation values were obtained between the final Romanian version of FMA's evaluation protocols and the BI (ρ = 0.9167; p = 0.0002) for FMA–upper extremity (FMA-UE) total A-D (motor function) with ρ = 0.6319 and for FMA-lower extremity (FMA-LE) total E-F (motor function) with p = 0.0499, and close to the limit, with the mRS (ρ = −0.5937; p = 0.0704) for FMA-UE total A-D (motor function) and (ρ = −0.6615; p = 0.0372) for FMA-LE total E-F (motor function).ConclusionsThe final Romanian version of FMA's official evaluation protocols showed good preliminary reliability and validity, which could be thus recommended for use and expected to help improve the standardization of this assessment scale for patients after a stroke in Romania. Furthermore, this endeavor could be added to similar international translation and cross-cultural adaptations, thereby facilitating a more appropriate comparison of the evaluation and outcomes in the management of stroke worldwide

ASTMUL ÎN FIBROZA CHISTICĂ

Fibroza chistică (FC) este cea mai comună afecţiune autozomal recesivă la populaţia caucaziană. Boala pulmonară se caracterizează prin afectarea clearance-ului mucociliar cu obstrucţia căilor aeriene, infecţie şi infl amaţie cronică. Wheezingul este un simptom comun în FC, dar în unele cazuri este determinat de prezenţa con comitentă a astmului. Nu există un consens în cum defi nim astmul în fi broza chistică, dar diagnosticul se bazează în principal pe istoricul personal şi familial de atopie al pacientului

ASTHMA IN CYSTIC FIBROSIS

Cystic fi brosis (CF) is the most common autosomal recessive disease in Caucasians. Lung disease is characterized by impaired mucocilliary clearance with airway obstruction and chronic pulmonary infection and infl ammation. Wheeze is a common symptom in CF, but in some cases the wheeze is due to the presence of concomitant asthma. There is no consensus on how to defi ne CF asthma, but the diagnosis is predominantly based on the patient’s strong family and personal history of atopy

The Impact of SARS-CoV-2 Pandemic on the New Cases of T1DM in Children. A Single-Centre Cohort Study

Type 1 diabetes mellitus (T1DM) represents one of the most frequent chronic illnesses affecting children. The early diagnosis of this disease is crucial, as it plays a key role in preventing the development of a life-threatening acute complication: diabetic ketoacidosis. The etiopathogenetic role of viral infections has long been suggested and emerging data are pointing towards a complex bidirectional relationship between diabetes and COVID-19. The aim of this study is to assess the impact of the COVID-19 pandemic on the incidence and severity of new T1DM cases in children in Romania. We analyzed the differences between a group of 312 patients diagnosed with T1DM in the period 2003–2019 and a group of 147 children diagnosed during the pandemic. The data were investigated using statistical analysis of a series of relevant variables. The total number of newly diagnosed T1DM increased by 30.08% in the period March 2020–February 2021 compared to the previous years. The patients in the pandemic group had a higher mean age at the onset of T1DM, were less frequently living in an urban area, and presented a higher mean value of HbA1c. Diabetic ketoacidosis at the onset of T1DM was 67.40% more frequent, and a higher percentage of these patients presented with a severe form. The duration of T1DM symptoms did not differ significantly between the two groups. A number of 8 patients associated SARS-CoV-2 infection at the time of T1DM diagnosis

Hepatic Osteodystrophy: A Global (Re)View of the Problem

Hepatic osteodystrophy is a common and frequently untreated complication, manifested as osteoporosis or osteopenia, encountered in the evolution of chronic liver diseases. Th is article provides a narrative review of hepatic osteodystrophy. Th e aim is to revise the prevalence, pathophysiology, diagnosis and management of hepatic osteodystrophy. We searched medical literature via PubMed, Google Scholar, Wiley, Science Direct, and Springer Link using respective keywords to obtain data on low bone mineral density connected to chronic liver diseases. Many studies have reported an increased prevalence of osteoporosis/osteopenia in patients with chronic liver diseases. Th e pathogenesis is multifactorial, involving genetic factors, vitamin defi ciencies, proinfl ammatory cytokines, hypogonadism, hyperbilirubinemia, antiviral therapy, corticosteroid drugs, and lifestyle factors. Th e management of patients should include individualized assessment for fracture risk factors and bone mineral density. Vitamin D and calcium supplementation should be recommended in all patients with chronic liver diseases and osteoporosis. Bisphosphonates are the most effi cient drugs used in the treatment of hepatic osteodystrophy. In the future, it is necessary to defi ne better the management and specifi c treatment of hepatic osteodystrophy for prevention of fragility fractures and to improve the patient quality of life

A Multifaced Aspect of <i>Clostridium difficile</i> Infection in Pediatric Patients with Inflammatory Bowel Disease: Case Series and Literature Review

Children with inflammatory bowel disease (IBD) have an increased susceptibility to Clostridium difficile infection (CDI), with a rising incidence over time. Differentiating between CDI and IBD exacerbation is challenging due to overlapping symptoms. In our cohort of 55 pediatric IBD patients, 6 were diagnosed with CDI. Upon conducting a thorough patient evaluation and subsequent data analysis, an exhaustive review of the existing literature was undertaken. CDI is more prevalent in ulcerative colitis (UC) than Crohn’s disease (CD) patients, as seen in our patients and in the existing literature. The management of a pediatric patient with IBD is itself a challenge for a clinician because of the chronic, possibly relapsing course, and substantial long-term morbidity. When CDI is added, it becomes even more demanding, since CDI leads to more severe disease in children with IBD. A multidisciplinary approach and intensive treatment for possible sepsis, anemia, hypoalbuminemia, and hydro-electrolytic and acid-base imbalances are frequently mandatory in patients with CDI and IBD, which leads to a significant health care burden in hospitalized children with IBD. After the infection is treated with antibiotic therapy, important considerations regarding the future treatment for the underlying IBD are also necessary; in most cases, a treatment escalation is required, as also seen in our study group

Determination of Coenzyme Q10 Content in Food By-Products and Waste by High-Performance Liquid Chromatography Coupled with Diode Array Detection

Coenzyme Q10 (CoQ10) is a vitamin-like compound found naturally in plant- and animal-derived materials. This study aimed to determine the level of CoQ10 in some food by-products (oil press cakes) and waste (fish meat and chicken hearts) to recover this compound for further use as a dietary supplement. The analytical method involved ultrasonic extraction using 2-propanol, followed by high-performance liquid chromatography with diode array detection (HPLC-DAD). The HPLC-DAD method was validated in terms of linearity and measuring range, limits of detection (LOD) and quantification (LOQ), trueness, and precision. As a result, the calibration curve of CoQ10 was linear over the concentration range of 1–200 µg/mL, with an LOD of 22 µg/mL and an LOQ of 0.65 µg/mL. The CoQ10 content varied from not detected in the hempseed press cake and the fish meat to 84.80 µg/g in the pumpkin press cake and 383.25 µg/g in the lyophilized chicken hearts; very good recovery rates and relative standard deviations (RSDs) were obtained for the pumpkin press cake (100.9–116.0% with RSDs between 0.05–0.2%) and the chicken hearts (99.3–106.9% CH with RSDs between 0.5–0.7%), showing the analytical method’s trueness and precision and thus its accuracy. In conclusion, a simple and reliable method for determining CoQ10 levels has been developed here