The Importance of E-Learning and GSM Alarm System in the Medical Engineering

The present social context is disturbed by questions, diversity, complexity, and the time and space parameters. Thus it is justifying the change of institution activity at news requirements which oblige and which sometimes are contradictory. That is why a special importance presents the adaptation capacity of entities to continuum improvement of their offers. Thus, the aim of this paper is to present new aspects which can increase the medical services quality. Much more, the paper represents an interdisciplinary approach because it presents the importance of integration of technical aspects with the learning system founded by technology, Internet and electronic materials, all integrated of medical engineering

The Resistance of European Beech (Fagus sylvatica) From the Eastern Natural Limit of Species to Climate Change

In this study, different approaches were used to investigate the vulnerability of beech forests, located at the eastern limit of their natural range, to climate change. To accomplish this, six 2500 m2 plots were sampled in four European beech forest genetic resources, located in Romania at different altitudinal levels, varying from 230 to 580 m in the Bacău hills and between 650 and 1300 m in the Curvature Carpathian (Braşov region). The analysis of trees phenotypic traits, their radial growth, and the regeneration, did not indicate a vulnerability of the sampled stands to the fluctuations of the environmental factors from the 1950-2014 period. The growth indices of all three populations of Bacău hills are negatively correlated with both June air temperature of current year and September of the previous year. The precipitation amount of September previous year positively influenced the growth indices. The radial growth of plots in Braşov region is slightly linked to the climate. The temperature during the growing season represents a limiting factor for stands that are located outside of the optimal altitudinal species distribution (600-1200 m, in Romania), especially at low altitudes. Our results indicated that a rise of the temperature accompanied by a possible reduction of the precipitations (as is predicted for the coming years) could increase the sensibility of beech forests at lower altitude

Diallel crossing in Pinus cembra: IV. age trends in genetic parameters and genetic gain for growth and branching traits

<span style="font-family: Arial,Helvetica,sans-serif; font-size: small;">This paper reports results from a complete 10 x 10 diallel carried out in a natural population of Swiss stone pine (Pinus cembra L.) from the southern Carpathian Mountains. At age six, after nursery testing, the material was field planted on one site, using a completely randomized block design with 100 families, four replicates and 15 tree row-plots per replication, spaced 2.5 x 2.5m. Total and annual height growth, root collar diameter, number of branches per whorl and survival were assessed at successive ages between ages eight and 14 after seed. In addition, several traits that were assessed during the nursery test were used in correlation and some other analyses. Plot means of the measured traits were analyzed using the general least-squares method by means of the computer DIALL programme prepared by Schaffer and Usanis (1969). Across the field testing periods, significant (p&lt;0.05) and highly significant (p&lt;0.01; p&lt;0.001) differences occurred in total height growth and root collar diameter for general and specific combining ability as well for maternalinteraction effects. These results suggest that the traits are controlled by nuclear (additive and non-additive) and by nuclear x extra-nuclear gene interactions. In an ascendant trend, the additive variance, as a percent of the total genetic variance, ranged from 35% at age eight to 66% at age 14 for total height growth, while that for root collar diameter trend varied less between 16% and 34%. In a descendant trend, the dominance ratios s2SCA/ s2GCA for total height growth ranged from 0.9 at age eight to 0.3 at age 14, suggesting that the additive variance should be used in the breeding programme. Parents with significant general combining effects for all but one trait were found. For total height growth, the narrow-sense family mean heritability estimates varied in an ascendant trend between 0.45 and 0.65 while the narrow- sense individual tree heritability varied irregularly from year to year between 0.31 and 0.37. By selecting the best 20 families and the best 20% of individuals within families, a genetic gain in total height growth of 9.7% and 10.9%, respectively, could be achieved at age 14. The improvement of growth and branching by using both family and individual selections could be applied. The very high age-age and trait-trait genetic correlations suggest that both early and indirect selection could be applied effectively.</span

Chloroplast DNA Diversity of Oak Species in Eastern Romania

The chloroplast DNA of 34 sessile oak (Quercus petraea) and 27 pedunculate oak (Q. robur) populations covering the entire natural distribution of the two oak species in Eastern Romania was investigated using four large regions of the chloroplast genome by PCR and RFLP technique. A total of seven chloroplast DNA haplotypes sensu lato have been observed by analysing 305 mature trees. However, due to the high resolution of the electrophoresis method a total of 22 chloroplast variants could have been detected, with new mutations and fragment combinations in two of the amplified regions: psbC/trnD and trnT/trnF. All of the haplotypes belong to the phylogenetic lineages A and E, which originate from the Balkan Peninsula. Most of genetic diversity is distributed among populations (GST=0.779). The chloroplast DNA haplotypes are shared by the two oak species. Different dispersal abilities may explain the higher value of genetic differentiation among populations in sessile oak than in pedunculate oak

Relationship between Novel Elastography Techniques and Renal Fibrosis&mdash;Preliminary Experience in Patients with Chronic Glomerulonephritis

Introduction: A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Supersonic Mach 30 is a promising method for assessing the renal tissue&rsquo;s stiffness and viscosity. We investigated whether this elastography technique could reveal renal tissue fibrosis in patients with chronic glomerulonephritis. Materials and methods: Two-dimensional-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) assessments were performed in 40 patients with chronic glomerulopathies before being referred for a renal biopsy. For each kidney, the mean values of five stiffness and viscosity measures were compared with the demographic, biological, and histopathological parameters of the patients. Results: In total, 26 men and 14 women with a mean age of 52.35 &plusmn; 15.54 years, a mean estimated glomerular filtration rate (eGFR) of 53.8 &plusmn; 35.49 mL/min/1.73m2, and a mean proteinuria of 6.39 &plusmn; 7.42 g/24 h were included after providing their informed consent. Out of 40 kidney biopsies, 2 were uninterpretable with inappropriate material and were divided into four subgroups based on their fibrosis percentage. Even though these elastography techniques were unable to differentiate between separate fibrosis stages, when predicting between the fibrosis and no-fibrosis group, we found a cut-off value of &lt;20.77 kPa with the area under the curve (AUC) of 0.860, a p &lt; 0.001 with 88.89% sensitivity, and a 75% specificity for the 2D SWE PLUS measures and a cut-off value of &lt;2.8 Pa.s with an AUC of 0.792, a p &lt; 0.001 with 94% sensitivity, and a 60% specificity for the Vi PLUS measures. We also found a cut-off value of &lt;19.75kPa for the 2D SWE PLUS measures (with an AUC of 0.789, p = 0.0001 with 100% sensitivity, and a 74.29% specificity) and a cut-off value of &lt;1.28 Pa.s for the Vi PLUS measures (with an AUC 0.829, p = 0.0019 with 60% sensitivity, and a 94.29% specificity) differentiating between patients with over 40% fibrosis and those with under 40%. We also discovered a positive correlation between the glomerular filtration rate (eGFR) and 2D-SWE PLUS values (r = 0.7065, p &lt; 0.0001) and Vi PLUS values (r = 0.3637, p &lt; 0.0211). C reactive protein (CRP) correlates with the Vi PLUS measures (r = -0.3695, p = 0.0189) but not with the 2D SWE PLUS measures (r = &minus;0.2431, p = 0.1306). Conclusion: Our findings indicate that this novel elastography method can distinguish between individuals with different stages of renal fibrosis, correlate with the renal function and inflammation, and are easy to use and reproducible, but further research is needed for them to be employed routinely in clinical practice

Relationship between Novel Elastography Techniques and Renal Fibrosis—Preliminary Experience in Patients with Chronic Glomerulonephritis

Introduction: A renal biopsy represents the gold standard in the diagnosis, prognosis, and management of patients with glomerulonephritis. So far, non-invasive elastographic techniques have not confirmed their utility in replacing a biopsy; however, the new and improved software from Hologic Supersonic Mach 30 is a promising method for assessing the renal tissue’s stiffness and viscosity. We investigated whether this elastography technique could reveal renal tissue fibrosis in patients with chronic glomerulonephritis. Materials and methods: Two-dimensional-shear wave elastography (SWE) PLUS and viscosity plane-wave ultrasound (Vi PLUS) assessments were performed in 40 patients with chronic glomerulopathies before being referred for a renal biopsy. For each kidney, the mean values of five stiffness and viscosity measures were compared with the demographic, biological, and histopathological parameters of the patients. Results: In total, 26 men and 14 women with a mean age of 52.35 ± 15.54 years, a mean estimated glomerular filtration rate (eGFR) of 53.8 ± 35.49 mL/min/1.73m2, and a mean proteinuria of 6.39 ± 7.42 g/24 h were included after providing their informed consent. Out of 40 kidney biopsies, 2 were uninterpretable with inappropriate material and were divided into four subgroups based on their fibrosis percentage. Even though these elastography techniques were unable to differentiate between separate fibrosis stages, when predicting between the fibrosis and no-fibrosis group, we found a cut-off value of p p p = 0.0001 with 100% sensitivity, and a 74.29% specificity) and a cut-off value of p = 0.0019 with 60% sensitivity, and a 94.29% specificity) differentiating between patients with over 40% fibrosis and those with under 40%. We also discovered a positive correlation between the glomerular filtration rate (eGFR) and 2D-SWE PLUS values (r = 0.7065, p r = 0.3637, p p = 0.0189) but not with the 2D SWE PLUS measures (r = −0.2431, p = 0.1306). Conclusion: Our findings indicate that this novel elastography method can distinguish between individuals with different stages of renal fibrosis, correlate with the renal function and inflammation, and are easy to use and reproducible, but further research is needed for them to be employed routinely in clinical practice

Proximal tubule dysfunction is associated with podocyte damage biomarkers nephrin and vascular endothelial growth factor in type 2 diabetes mellitus patients: a cross-sectional study.

There is an ongoing debate as to whether early diabetic nephropathy in Type 2 diabetes mellitus may be attributed to the glomerulus or to the proximal tubule. Urinary excretion of nephrin and vascular endothelial growth factor may increase even in the normoalbuminuria stage. In the course of diabetic nephropathy, the proximal tubule may be involved in the uptake of urinary nephrin and vascular endothelial growth factor.Two groups of consecutive Type 2 diabetes mellitus outpatients (38 normo-, 32 microalbuminuric) and 21 healthy subjects were enrolled in a cross-sectional study and evaluated concerning the relation of proximal tubule dysfunction with the podocyte biomarkers excretion, assessed by ELISA methods. The impact of advanced glycation end-products on this relation was also queried.Urinary alpha1-microglobulin and kidney injury molecule-1 correlated with urinary albumin:creatinine ratio (R2 = 0.269; p < 0.001; R2 = 0.125; p < 0.001), nephrinuria (R2 = 0.529; p<0.001; R2 = 0.203; p < 0.001), urinary vascular endothelial growth factor (R2 = 0.709; p < 0.001; R2 = 0.360; p < 0.001), urinary advanced glycation end-products (R2 = 0.578; p < 0.001; R2 = 0.405; p < 0.001), serum cystatin C (R2 = 0.130; p < 0.001; R2 = 0.128; p<0.001), and glomerular filtration rate (R2 = 0.167; p < 0.001; R2 = 0.166; p < 0.001); nephrinuria and urinary vascular endothelial growth factor correlated with urinary albumin:creatinine ratio (R2 = 0.498; p < 0.001; R2 = 0.227; p<0.001), urinary advanced glycation end-products (R2 = 0.251; p < 0.001; R2 = 0.308; p < 0.001), serum cystatin C (R2 = 0.157; p < 0.001; R2 = 0.226; p < 0.001), and glomerular filtration rate (R2 = 0.087; p = 0.007; R2 = 0.218; p < 0.001).In Type 2 diabetes mellitus there is an association of proximal tubule dysfunction with podocyte damage biomarkers, even in the normoalbuminuria stage. This observation suggests a potential role of the proximal tubule in urinary nephrin and urinary vascular endothelial growth factor processing in early diabetic nephropathy, a fact which could be related to advanced glycation end-products intervention. Podocyte damage and proximal tubule dysfunction biomarkers could be validated as a practical approach to the diagnosis of early diabetic nephropathy by further studies on larger cohorts

Genetic effects of air pollution on forest tree species of the Carpathian Mountains

The effects of air pollution on the genetic structure of Norway spruce, European silver fir and European beech were studied at four polluted sites in Slovakia, Romania and Czech Republic. In order to reduce potential effects of site heterogeneity on the health condition, pair-wise sampling of pollution-tolerant and sensitive trees was applied. Genotypes of sampled trees were determined at 21 isozyme gene loci of spruce, 18 loci of fir and 15 loci of beech. In comparison with Norway spruce, fewer genetic differences were revealed in beech and almost no differentiation between pollution-tolerant and sensitive trees was observed in fir. In adult stands of Norway spruce, sensitive trees exhibited higher genetic multiplicity and diversity. The decline of pollution-sensitive trees may result thus in a gradual genetic depletion of pollution-exposed populations of Norway spruce through the loss of less frequent alleles with potential adaptive significance to altered stressing regimes in the future. Comparison of the subsets of sensitive and tolerant Norway spruce individuals as determined by presence or absence of discolorations ( spruce yellowing ) revealed different heterozygosity at 3 out of 11 polymorphic loci. © 2003 Elsevier Ltd. All rights reserved

Non-Invasive Evaluation of Kidney Elasticity and Viscosity in a Healthy Cohort

Introduction: There is currently a lack of published data on kidney elasticity and viscosity. Non-invasive techniques, such as two-dimensional shear-wave elastography (2D-SWE PLUS) and viscosity plane-wave ultrasound (Vi PLUS), have surfaced as new detection methods, which, thanks to efficient processing software, are expected to improve renal stiffness and viscosity measurements. This study aims to be the first one to assess the normal range values in normal renal function subjects and to investigate the factors that impact them. Methods: We conducted a cross-sectional study employing 50 participants (29 women and 21 men) with a mean age of 42.22 &plusmn; 13.17, a mean estimated glomerular filtration rate (eGFR) of 97.12 &plusmn; 11 mL/min/1.73 m2, a mean kidney length of 10.16 &plusmn; 0.66 cm, and a mean body mass index (BMI) of 24.24 &plusmn; 3.98. With a C6-1X convex transducer and the Ultra-FastTM software available on the Hologic Aixplorer Mach 30 ultrasound system, we acquired five measurements of renal cortical stiffness and viscosity (achieved from five distinct images in the middle part of the subcapsular cortex) from each kidney. The ten measurements&rsquo; median values correlated with the participant&rsquo;s demographical, biological, and clinical parameters. Results: The mean kidney elasticity was 31.88 &plusmn; 2.89 kiloPascal (kPa), and the mean viscosity was 2.44 &plusmn; 0.57 Pascal.second (Pa.s) for a mean measurement depth 4.58 &plusmn; 1.02 cm. Renal stiffness seemed to be influenced by age (r = &minus;0.7047, p &lt; 0.0001), the measurement depth (r = &minus;0.3776, p = 0.0075), and eGFR (r = 0.6101, p &lt; 0.0001) but not by BMI (r = &minus;0.2150, p = 0.1338), while viscosity appeared to be impacted by age (r = &minus;0.4251, p = 0.0021), eGFR (r = 0.4057, p = 0.0038), the measurement depth (r = &minus;0.4642, p = 0.0008), and BMI (r = &minus;0.3676, p = 0.0086). The results of the one-way ANOVA used to test the differences in the variables among the three age sub-groups are statistically significant for both 2D-SWE PLUS (p &lt; 0.001) and Vi PLUS (p = 0.015). The method found good intra-operator reproducibility for the 2D-SWE PLUS measurements, with an ICC of 0.8365 and a 95% CI of 0.7512 to 0.8990, and for the Vi PLUS measurements, with an ICC of 0.9 and a 95% CI of 0.8515 to 0.9397. Conclusions: Renal stiffness and viscosity screening may become an efficacious, low-cost way to gather supplemental diagnostic data from patients with chronic kidney disease (CKD). The findings demonstrate that these non-invasive methods are highly feasible and not influenced by gender and that their values correlate with renal function and decrease with age progression. Nevertheless, more research is required to ascertain their place in clinical practice

Genetic signatures of divergent selection in European beech ( Fagus sylvatica L.) are associated with the variation in temperature and precipitation across its distribution range

High genetic variation and extensive gene flow may help forest trees with adapting to ongoing climate change, yet the genetic bases underlying their adaptive potential remain largely unknown. We investigated range-wide patterns of potentially adaptive genetic variation in 64 populations of European beech (Fagus sylvatica L.) using 270 SNPs from 139 candidate genes involved either in phenology or in stress responses. We inferred neutral genetic structure and processes (drift and gene flow) and performed differentiation outlier analyses and gene-environment association (GEA) analyses to detect signatures of divergent selection. Beech range-wide genetic structure was consistent with the species’ previously identified postglacial expansion scenario and recolonization routes. Populations showed high diversity and low differentiation along the major expansion routes. A total of 52 loci were found to be putatively under selection and 15 of them turned up in multiple GEA analyses. Temperature and precipitation related variables were equally represented in significant genotype-climate associations. Signatures of divergent selection were detected in the same proportion for stress response and phenology-related genes. The range-wide adaptive genetic structure of beech appears highly integrated, suggesting a balanced contribution of phenology and stress-related genes to local adaptation, and of temperature and precipitation regimes to genetic clines. Our results imply a best-case scenario for the maintenance of high genetic diversity during range shifts in beech (and putatively other forest trees) with a combination of gene flow maintaining within-population neutral diversity and selection maintaining between-population adaptive differentiation.Scénarios pour la dynamique de la biodiversité des forêts européennes sous changement global identifier les points de basculement micro-evolutif