An Optimization Model for the Temporary Locations of Mobile Charging Stations

A possible solution with which to alleviate the range anxiety of electric vehicle (EV) drivers could be a mobile charging station which moves in different places to charge EVs, having a charging time of even half an hour. A problem that arises is the impossibility of charging in any location due to heavy traffic or limited space constraints. This paper proposes a new operational mode for the mobile charging station through temporarily stationing it at different places for certain amounts of time. A mathematical model, in the form of an optimization problem, is built by modeling the mobile charging station as a queuing process, the goal of the problem being to place a minimum number of temporary service centers (which may have one or more mobile charging stations) to minimize operating costs and the charger capacity of the mobile charging station so that the service offered is efficient. The temporary locations obtained are in areas with no or few fixed charging stations, making the mobile station infrastructure complementary to the fixed charging station infrastructure. The temporary location operational mode, compared to current moving operational mode, is more efficient, having a small miss ratio, short mean response time and short mean queuing time

Researches regarding weed control in winter wheat in the context of climate changes

The aim of the researches carried out in Tămădăul Mare village from Călăraşi county, during 2015-2018 was the weeds control in winter wheat crop. The segetal flora that infests wheat crops in Romania is varied both in species and especially as a species-related relationship, being subject to permanent changes, especially in the context of climatic changes. The changes occurred in the structure of the segetal flora represent the qualitative and quantitative expression of the influence of the soil seed stock dynamics, of the changes in the plant cultivation technology and of the weed control management, of the climatic variations and, last but not least, of the influences related to the economic and social factors. These changes involve and justify permanent monitoring of weed structure and dynamics in a certain territory in order to establish the most effective and rational methods of control, having the effect of reducing the yield losses. In wheat cultivated fields, aspects related to: the dynamics of the degree of weed infestation, the identification of the problematic weeds, the criteria for choosing the most effective herbicides and the optimal moments of application were studied. The best results in weed control of autumn wheat crops were obtained by integrating agrotechnical, phytotechnical and chemical measures, conclusion resulting also from this study

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

Embolizarea endovasculară a anevrismelor cerebrale: Studiu. Serie de cazuri

Background. Nontraumatic subarahnoid hemorrhage (SAH) of aneurysmal etiology is a neurosurgical emergency. Aneurysm rupture accounts for 80% of nontraumatic SAH and has a high rate of complications and death. Endovascular coiling embolization of the aneurysm is a basic method for aneurysm exclusion. Objective of the study. The objective of this study is to share the results of a series of cases that underwent aneurysm coiling for aneurysmal SAH. Material and Methods. The study represents a series of patients who underwent aneurysm coiling for the treatment of SAH. Before intervention the patients were assessed based on mFisher, Hunt-Hess and WFNS scales. Coiling embolization was performed under general anesthesia. Outcome criteria were assessed at 3 and 6 months. Results. All the patients were initially evaluated with an angiographic study (CT angio or angiography) for planning the intervention. The patients were operated under general anesthesia. Coiling and baloon-assisted coiling were procedures used in the majority of cases. One case were complicated by intraprocedural rupture of the aneurysm and later the patient passed away. All other cases were successfully and the patients were discharged in a mRS score below 3. Conclusion. Considering minimal invasiveness of endovascular coiling of an brain aneurysm for a patient than neurosurgical clipping, we conclude that implementation of this technique will improve the quality of patient care and improve clinical results. Introducere. Hemoragia subarahnoidiană (HSA) anevrismală este o urgență neurochirurgicală. Anevrismele erupte sunt responsabile de 80% din HAS nontraumatică. Embolizarea endovasculară este o metodă de bază pentru a exclude anevrismul din circulație. Scopul lucrării. Scopul lucrării este prezentarea rezultatelor unei serii de cazuri de embolizare endovasculară a anevrismelor cerebrale. Material și Metode. Studiul reprezintă o serie de cazuri de embolizare endovasculara a anevrismelor cerebrale. Preoperator, pacienții au fost evaluați conform scalelor uzuale: Hunt-Hess, WFNS, mFisher. Procedurile au fost efectuate în anestezie generală. Evaluarea pacienților a avut loc la 3 și 6 luni, postoperator. Rezultate. Preoperator, pacienții au fost evaluați printr-o metodă angiografică (CT angio sau angiografie clasică) în vederea planificării intervenției chirurgicale. Toate procedurile au avut loc în anestezie generală. Embolizarea și embolizarea balon-asistată au fost tehnicile folosite cel mai des. Un caz s-a complicat cu o erupție repetată intraoperatorie a anevrismului și ulterior, decesul pacientului. Restul cazurilor s-au finisat cu succes, pacienții fiind externați într-un scor Rankin mai mic ca 3. Concluzii. Având în vedere caracterul minimal invaziv al procedurii de embolizare, comparativ cu clipping-ul, implimentarea pe larg a acestei metode de tratament va ameliora outcome-ul și calitatea vieții pacienților cu anevrisme cerebrale

Local hypothermia therapy using a Peltier elements cooling device severe traumatic brain injury patients

SUMPh „Nicolae Testemitanu” Department of Neurosurgery, INN „Diomid Gherman”, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction 1. Severe traumatic brain injury (TBI) is one of the causes contributed to the major source of death and severe disability worldwide. Patients suffering from severe traumatic brain injury usually will end up with disability, as they most often are associated with extensive irreversible damages to the brain. This makes the management of severe TBI to be challenging and very often associate with disappointing outcomes. 2. Hypothermic neuroprotection has been demonstrated in many preclinical models of injury. 3. The humoral and cellular neuroinflammatory response to TBI has been shown to be temperature dependent. 4. Hypothermia has effects on many secondary injury mechanisms including (1) cerebral metabolism, (2) excitotoxicity, (3) oxidative stress, (4) blood– brain barrier (BBB) permeability, (5) gene expression, (6) neurotrophin levels and function, (7) neuroinflammation, (8) cerebral swelling, and (9) axonal injury. Purpose The study aims to use a Peltier effect device in severe TBI patients as a method of local hypothermia, because therapeutic hypothermia showed promising results in reducing secondary tissue injury and intracranial pressure after TBI. Material and methods Thermoelectric coolers (TECs) based on the Peltier effect are preferred in hypothermia because they have small thickness, low weight, lack of moving mechanisms, high precision, and safe operation. Peltier cooling elements allow elaboration of a small mobile device, complementary to ICP monitoring that can be operated in emergency medical services, as well as neurointensive care units, in this way reducing the risk of secondary tissue injury after TBI. Results As mentioned earlier, targeting Brain temperature (BT) is now possible— making regional or selective hypothermia of the patient’s head an alternative method to achieving hypothermia after TBI, which may have fewer side effects than systemic hypothermia. Preliminary studies suggest that custom cooling devices of the brain were effective at achieving a BT 34°C within a 2–6 h time frame. Conclusions There is a possibility to implement this device for local hypothermia in the clinical settings, for this purpose a RCT is being designed to test the efficacy of the device, and ICP monitoing because there is an ongoing debate about local hypothermia efficacy in TBI in clinical trials compared to laboratory ones

Hipotermia locală cu dispozitiv pe bază de elemente Peltier ca terapie la pacienții cu traumatism cranio-cerebral sever

Background. Severe traumatic brain injury (TBI) is one of the causes contributing death and disability worldwide. Patients suffering from severe TBI usually will end up with disability, as they are associated with extensive damages to the brain. This makes the management of severe TBI to be challenging, Objective of the study. The study aims to use a Peltier effect device in severe TBI patients as a method of local hypothermia, because therapeutic hypothermia showed promising results in reducing secondary tissue injury and intracranial pressure after TBI. Material and Methods. Thermoelectric coolers (TECs) based on the Peltier effect are preferred for hypothermia because they have small size, low weight, lack of moving parts, high precision and safe operation. For the purpose of the study a therapeutic hypothermia device was assembled, software for the device was designed, as well a graphical user interface (GUI). The TEC helmet was assebled and tested. Results. Computer simulations and mathematical calculations were made prior to assembly, the dimensions and location of the Peltier elements in the helmet were adjusted to the simulation results, with elements dimensions 40x40 mm, and placement on temporal, parietal and occipital regions and divided in two sides controlled by 2 separate microcontrollers to allow cooling of a more specific region of the head. Previous studies suggest that local cooling devices of the brain were effective at achieving a brain temperature 34°C within a 2–6 h time frame while available systems were not adequate to achieve this desired goal, so further research into local cooling systems is needed. Conclusion. There is a possibility to implement this device for local hypothermia in the clinical settings, for this purpose a RCT is being designed to test the efficacy of the device, because there is an ongoing debate about local hypothermia efficacy in TBI in clinical trials compared to laboratory ones. Introducere. Traumatismul cranio-cerebral grav (TCC) este una din cauzele principale ale decesului și le dizabilității la nivel mondial. Pacienții ce au suportat TCC grav, de obicei vor rămâne cu dizabilități din cauza injuriei cerebrale. Din această cauză managementul TCC sever este dificil. Scopul lucrării. Studiul are scopul de a utiliza un dispozitiv pe bază de elemente Peltier ca metodă de hipotermie locală în TCC grav, deoarece hipotermia are un efect pozitiv în reducerea injuriei cerebrale secundare și a tensiunii intracraniene dupa TCC. Material și Metode. Dispozitivele termoelectrice (DTE) pe baza efectului Peltier sunt preferabile în hipotermie, deoarece sunt de dimensiune, masă mică, absența părților mobile, precizie înaltă, operare sigură. Pentru studiu un dispozitiv a fost asamblat, software-ul și interfața grafică proiectate pentru grafică. Precum și casca cu elemente DTE a fost asamblată si testată. Rezultate. Înainte de asamblarea dispozitivului au fost efectuate simulări computerizate și calcule matematice, ulterior dimensiunea și localizarea elementelor Peltier au fost ajustate în conformitate cu rezultatele simulărlior, dimensiunile elementelor fiind 40x40 mm și localizare în regiunile temporală, parietală și occipitală, de asemenea dispozitivul constă funcțional din 2 jumătăți controlate de 2 microcontrolere ce permite o precizie mai înaltă de lucru. Studiile precedente au demostrat că dispozitivele de hipotermie locală sunt eficiente în răcirea țesutului cerebral până la 34oC, însă sistemele disponibile la moment nu pot realiza scopul dat și sunt necesare studii suplimentare. Concluzii. Cu implementarea dispozitivului pentru hipotermie locală în condiții clinice, un studiu randomizat este în elaborare pentru testarea eficienței dispozitivlului, din cauză că există o dezbatere continuă asupra eficienței hipotermiei locale în TCC în studiile clinice comparativ cu cele de laborator

Internal carotid artery stenting for secondary prevention of stroke: case series study

Background: Internal carotid artery atherosclerosis accounts for an estimate of 15 – 25% of ischemic strokes. Carotid revascularization techniques have proven useful in reducing the incidence of ischemic stroke. Nowadays, carotid artery stenting is a basic treatment for carotid stenosis. Material and methods: The study represents a series of 60 consecutive symptomatic patients who underwent carotid stenting for critical carotid stenosis between August 2019 and April 2021. All the procedures were performed in Institute of Neurology and Neurosurgery. Main outcomes like morbidity and mortality rates at 30 days post procedure; repeated ischemic stroke in the territory of stented artery; and common complications were registered. Results: All the patients were initially evaluated with an angiographic study (CT angio or angiography) for planning the intervention. The patients were operated under conscious sedation and with distal embolic protection. The design of the stents was chosen according to the vascular anatomy of carotid bifurcation. In our case series of patients, we did not register major complications during, or in first 30 days after the procedure. One patient had a hyperperfusion syndrome, which was resolved with careful arterial tension monitoring. Conclusions: Carotid stenting is a safe and efficient procedure, with low periprocedural complications and good outcomes in correctly selected patients. Due to its minimal invasiveness, in the future it may become first choice procedure in the treatment of carotid artery stenosis

Endovascular options in treatment of cerebral aneurysms

Introducere. Tratamentul anevrismelor cerebrale cunoaște o continuă dezvoltare. Începând cu prima operație de clipare anevrismală și ulterior embolizare anevrismală, tehnicile de tratament s-au îmbunătățit continuu pentru a oferi pacientului o metodă eficientă și sigură de tratament. Scopul lucrării. Scopul lucrării este prezentarea opțiunilor endovasculare de embolizare a anevrismelor cerebrale și implementarea acestora în Institutul de Neurologie și Neurochirurgie, Chișinău, Moldova. Material si Metode. Studiul reprezintă o serie de cazuri de embolizare endovasculară a anevrismelor cerebrale. Preoperator pacienții au fost evaluați conform scalelor uzuale: Hunt-Hess, WFNS, mFisher. Procedurile au fost efectuate în anestezie generală. Evaluarea pacienților a avut loc la 3 și 6 luni postoperator. Rezultate. Preoperator pacienții au fost evaluați printr-o metodă angiografică(CT angio sau angiografie clasică) în vederea planificării intervenției chirurgicale. Toate procedurile au avut loc în anestezie generală a pacientului. Embolizarea, embolizarea balon-asistată, embolizarea stent-asistată și instalarea de flowdiverter au fost tehnicile folosite cel mai des. Cazurile rare de complicații intraoperatorii sunt descrise minuțios în lucrare. Restul cazurilor s-au finisat cu succes, pacienții fiind externați într-un scor Rankin mai mic ca 2. Concluzii. Având în vedere caracterul minimal invaziv al procedurii de embolizare, comparativ cu clipping-ul, implementarea pe larg a acestei metode de tratament va îmbunătăți outcome- ul și calitatea vieții pacienților cu anevrisme cerebrale.Introduction. The treatment of cerebral aneurysms knows a continuous development. Starting with the first aneurysmal clipping surgery and later, aneurysmal embolization, the treatment techniques have been continuously improved to offer the patient an efficient and safe method of treatment. Objective. The objective of this study is to present endovascular options of treatment of cerebral aneurysms performed in Institute of Neurology and Neurosurgery, Chisinau, Moldova. Methods. The study represents a series of patients who underwent aneurysm coiling for the treatment of SAH. Before intervention, the patients were assessed based on mFisher, Hunt-Hess and WFNS scales. Coiling embolization was performed under general anesthesia. Outcome criteria were assessed at 3 and 6 months. Results. All the patients were initially evaluated with an angiographic study (CT angio or angiography) for planning the intervention. The patients were operated under general anesthesia. Coiling, baloon-assisted coiling, stent-assisted coiling, and flow-diverter placement were procedures used in the majority of cases. Rare cases of intraprocedural complications are discussed. All other cases were successfully and the patients were discharged in a mRS score below 3. Conclusions. Considering minimal invasiveness of endovascular coiling of a brain aneurysm for a patient than neurosurgical clipping, we conclude that implementation of this technique will improve the quality of patient care and improve clinical results

MIDDLE MENINGEAL ARTERY EMBOLIZATION AS A TREATMENT OPTION FOR CHRONIC SUBDURAL HEMATOMAS. CASE SERIES AND LITERATURE REVIEW

Universitatea de Stat de Medicină şi Farmacie „Nicolae Testemiţanu”, Chişinău, Republica MoldovaIntroducere. Hematomul subdural cronic (HSDc) este o entitate comună care afectează de obicei persoanele în vârstă. Incidența HSDc este de până la 13/100,000 și crește la 127/100,000 la persoane cu vârstnice. Embolizarea arterei meningeale medii (MMA) drept tratament promițător pentru HSDc. Embolizarea MMA blochează fluxul de sânge către capsulă și induce resorbția hematomului. În mod convențional, cazurile sunt tratate prin evacuare chirurgicală. Scopul lucrării. În această lucrare, trecem în revistă literatura existentă privind embolizarea MMA și discutăm patofiziologia de bază a HSDc. Material și metode. Au fost incluși pacienți consecutivi căror a fost efectuată embolizarea MMA pentru HSDc (tratament primar sau recidivă după intervenția chirurgicală) în cadrul centrului nostru. Detaliile clinice și urmărirea au fost colectate prospectiv. NIHSS și mRS au fost, de asemenea, monitorizate. Tratamentul chirurgical în cazurile de HSDc cu efect de masă semnificativă (de obicei > 10 mm grosime a colecției de sânge sau > 5 mm deplasare a structurilor medii) este indicat și se efectuează în mod obișnuit prin tratament chirurgical. Cu toate acestea, între 9 și 30% din cazuri vor prezenta reacumularea hematomului. Rezultate. Un total de 10 pacienți au suferit intervenții uni și bilaterale de tratament primar și secundar. La prezentare, 23,9% dintre pacienți erau în tratament antiagregant sau anticoagulant. Grosimea medie a cSDH de admitere a fost de 14 mm. Toate embolizările au fost efectuate sub anestezie generală și au fost finalizate cu succes. În toate cazurile s-au folosit embolie lichide. La ultima urmărire, grosimea mediană a cSDH a fost de 4 mm (71%). Concluzii. Conform literaturii și studiilor anterioare, embolizarea MMA este o procedură sigură și eficientă pentru tratamentul cSDH, în special în cazurile de recidivă și pacienții vârstnici care urmează tratament anticoagulant sau antiagregant.Background. Chronic subdural hematoma (cSDH) is a common pathology that typically affects the elderly. The incidence of HSDc is up to 13/100,000 and increases to 127/100,000 in elderly people. Middle meningeal artery (MMA) embolization has emerged as a promising treatment for cSDH. MMA embolization blocks the blood flow to the capsule and induces hematoma resolution. Conventionally, cases are treated by surgical evacuation. Aim. In this paper, we review the existing literature on MMA embolization and discuss the underlying pathophysiology of cSDH. Materials and methods. Consecutive patients who underwent MMA embolization for cSDH (primary treatment or recurrence after conventional surgery) at our center were included. Clinical details and follow-up were collected prospectively. NIHSS and mRS were also clinical outcomes. Surgical treatment in cases of cHSD with significant mass effect (usually > 10 mm thickness of the blood collection or > 5 mm displacement of the medial structures) is indicated and is usually performed by surgical treatment. However, between 9.4 and 30% of cases will show hematoma reaccumulation. Results. A total of 10 patients underwent uni- and bilateral interventions primary treatment and secondary. At presentation, 23.9% of patients were on antiplatelet or anticoagulation therapy. Median admission cSDH thickness was 14 mm. All embolizations were performed under general anesthesia, and were successfully completed. In all cases, liquid embolics were used. On last follow-up, median cSDH thickness was 4 mm (71%). Conclusions. According to literature and prior studies, MMA embolization is a safe and efficient procedure for cSDH treatment, especially in recurrence cases and elderly patients who are on anticoagulant or antiaggregant therapy

Endovascular coiling embolization of cerebral aneurysms: a case series study

State University of Medicine and Pharmacy ”Nicolae Testemitanu”, Institute of Neurology and Neurosurgery ”Diomid Gherman”, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction Cerebral aneurysm rupture accounts for 80% of nontraumatic SAH and has a high rate of complications and death. Endovascular coiling embolization of the aneurysm is a basic method for aneurysm exclusion from circulation to prevent a repeated rupture. Purpose The main purpose of this presentation is to share the results of a series of cases that underwent aneurysm coiling for aneurysmal SAH. Material and methods The study represents a series of patients who underwent aneurysm coiling for the treatment of SAH. Before intervention the patients were assessed based on different scales. Outcome criteria were assessed at 3 and 6 months. Results All the patients were initially evaluated with an angiographic study (CT angio or angiography) for planning the intervention. Coiling and baloon-assisted coiling were procedures used in the majority of cases. The majority of cases were successfully and the patients were discharged in a mRS score below 3. Conclusions Considering minimal invasiveness of endovascular coiling of an brain aneurysm for a patient, than neurosurgical clipping, we conclude that implementation of this technique will improve the quality of patient care and improve clinical results