bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging roles of adhesion G protein-coupled receptors
Authors: Rosa Matthew , Noel Timothy , Harris Matthew , Ladds Graham
Published: July 2021

Adhesion G protein-coupled receptors (aGPCRs) form a sub-group within the GPCR superfamily. Their distinctive structure contains an abnormally large N-terminal, extracellular region with a GPCR autoproteolysis-inducing (GAIN) domain. In most aGPCRs, the GAIN domain constitutively cleaves the receptor into two fragments. This process is often required for aGPCR signalling. Over the last two decades, much research has focussed on aGPCR-ligand interactions, in an attempt to deorphanize the family. Most ligands have been found to bind to regions N-terminal to the GAIN domain. These receptors may bind a variety of ligands, ranging across membrane-bound proteins and extracellular matrix components. Recent advancements have revealed a conserved method of aGPCR activation involving a tethered ligand within the GAIN domain. Evidence for this comes from increased activity in receptor mutants exposing the tethered ligand. As a result, G protein-coupling partners of aGPCRs have been more extensively characterised, making use of their tethered ligand to create constitutively active mutants. This has led to demonstrations of aGPCR function in, for example, neurodevelopment and tumour growth. However, questions remain around the ligands that may bind many aGPCRs, how this binding is translated into changes in the GAIN domain, and the exact mechanism of aGPCR activation following GAIN domain conformational changes. This review aims to examine the current knowledge around aGPCR activation, including ligand binding sites, the mechanism of GAIN domain-mediated receptor activation and how aGPCR transmembrane domains may relate to activation. Other aspects of aGPCR signalling will be touched upon, such as downstream effectors and physiological roles.
Finite control‐set model predictive direct speed control of a PMSM drive based on the Taylor series model
Authors: Wang Huimin , Zhang Senkai , Liu Wei , Geng Qiang , Zhou Zhanqing
Published: July 2021

In the traditional finite control‐set model predictive direct speed control (FCS‐MPDSC), the coupling items in the current equation have been ignored because of predictive complexity, leading to imperfect prediction accuracy and control performance. Meanwhile, the current error and speed error are both included in the weighted sum cost function. The two types of errors lead to the difficulty of weight coefficients' distribution, which can only rely on subjective experiences. Thus, an FCS‐MPDSC strategy based on the 2nd‐Taylor‐series model with quadratic cost function is proposed. The dynamic performance has been greatly improved because the input variables of the Taylor series model are unified as the basic voltage vector with the same control period. And the static error is also reduced as the weight coefficient matrix of the quadratic cost function is solved offline. On this basis, the verification experiments are carried out. The results show that a better dynamic and static performance is achieved at the same time by the proposed strategy.
Statistical multivariate monitoring of rolling bearings working under varying operational conditions
Authors: Wang Baoxiang , Pan Hongxia
Published: July 2021

In recent years, statistical data‐driven approaches have been developed for health monitoring of rolling bearings working under variable operational conditions. Due to the reliance on reference models, most of them encounter with the model mismatch problem. A novel statistical multivariate health monitoring framework is proposed in this article to determine the initial degradation of rolling bearings. On the one hand, multivariate statistical parameters are extracted from original vibration signals to indicate bearing's degradation trajectories from different perspectives, a dynamic autoencoder neural network is extended with a matrix augmentation trick for discovering both dynamic and nonlinear latent representation in the high‐dimensional features. On the other hand, an eccentricity index is introduced for measuring information variations in the latent representation, such that bearing health development can be revealed timely. Then, an adaptive threshold is exploited for online monitoring of bearing damage. The effectiveness of the proposed work is substantiated using real vibration signals acquired from two different bearing degradation test rigs. The monitoring performance of the proposed work is evaluated in terms of false alarm rate (FAR). Experimental results confirm that the proposed work can identify early bearing damage under variable working conditions, by circumventing the model mismatch problem. It is found to be more superior than existing techniques.
Normal incidence sound insulation provided by Sonic Crystal Acoustic Screens made from rigid scatterers – assessment of different simulation methods
Authors: Peiró-Torres M.P. , Ferri M. , Godinho Luis M. , Amado-Mendes Paulo , Jose Vea Folch Francisco , Redondo Javier
Published: July 2021

Sonic crystal acoustic screens have been in progressive research and development in the last two decades as a technical solution for mitigating traffic noise. Their behaviour is quite different from that observed in classical barriers, with the latter being based on physically blocking the direct sound propagation path (only allowing diffracted noise to reach sensible receivers), and sonic crystals providing attenuation efficiency based on the creation of “band-gaps” at specific frequency ranges, due to the Bragg’s interference phenomenon. The distinct physical mechanisms of these two types of noise barriers complicates the use of classical simplified or even numerical models developed for traditional barriers to simulate and predict the attenuation performance of a sonic crystal, and alternative methods become thus required. In the acoustics scientific literature, several authors have proposed estimation and simulation methods based on different numerical tools to predict the sound insulation provided by these new noise abatement solutions. This paper presents a comparative evaluation of some of these methods, with emphasis on the assessment of their accuracy versus memory usage in order to determine which one is the most suitable for optimization methodologies in the design of new devices with improved acoustic performance.
Evaluation of the safety parameters for a permitted explosive type emulsion
Authors: Jitea Ilie-Ciprian , Rus Daniela Carmen , Rădeanu Cristian , Vasilescu Dragoş Gabriel
Published: July 2021

When preparing a permitted explosive recipe an energy or an explosive heat is considered, which should ensure the detonability of the system and at the same time a power that satisfies the purpose for which it will be used, under the conditions of firedamp hazardous mines. The safety parameters for the explosive charges used in the firedamp hazardous mines are decisive, in order to ensure the safety and health requirements at work together with the efficient performance of the blasting operation. The permitted explosive type emulsion is recommended to be used in underground mines, open pit mines as a special methane explosive and can be used where a coal dust and/or methane explosion hazard exists can be loaded into dry and wet blasting holes and it can be used for mechanical loading. The permitted explosive type emulsion is a Detonator-sensitive explosives that can be reliably initiated in an unconfined state by a No. 8 strength detonator it have safety handling characteristics because of the relatively low sensitivity to friction, shock and impact. Technological changes due to the change of suppliers of certified explosives for civil use for underground use in the firedamp hazardous mines, involve reassessing the safety and efficiency of the loads made with these products, which have not been tested and evaluated for the conditions from the Jiu Valley mines.
The influence of economic factors in the management of health and safety specific to SMEs
Authors: Caldarescu Gabriela , Tanasievici George Daniel , Bejinariu Costica , Bernevig Mihai-Adrian
Published: July 2021

The first of the general objectives of the National Strategy in the field of health and safety at work for the period 2018 - 2020 in Romania was “a better implementation of the choice of occupational safety and health legislation, especially in micro-enterprises and SMEs”.In this context, this paper presents the main vulnerabilities of management in SMEs, where the occupational safety and health component has a formal role being strongly influenced by economic factors. The first part presents a statistical situation of the verification campaigns, carried out in the last 3 years by Labor Inspection, on how SMEs have implemented health and safety legislation in their activities, subsequently, an analysis is made of the economic factors that have limited the development of health and safety management. Finally, a cost-benefit analysis is presented on the economic consequences that occur in the event of an accident and / or illness that demonstrates the theory that economic factors influence the management of health and safety and health specific to SMEs both before and after an event occurs.
The importance of seismic protection of strategic objectives, in the area of influence of useful rock quarries, in which blasting works are carried out
Authors: Garaliu-Buşoi Bogdan , Kovacs Attila , Gheorghiosu Edward , Rădeanu Cristian , Miclea Olga
Published: July 2021

In this scientific article was studied the main methods for assessing the seismic effect generated during the blasting operations with explosives, from quarries on essential infrastructure elements, in the analyzed situation - railway tunnel and supporting pillars of the railway superstructure in the adjacent area of the quarry, regarding the most appropriate technique for estimating and assessing the seismic effect through the specificity of the evaluated parameter.

In order to be able to carry out an activity with as little impact as possible on the environment, the economic operator carrying out career blasting works must apply technical measures to ensure the protection of civil / industrial objectives in the area close to carrying out these works.

The establishment of measures leading to the maintenance of the stability and integrity of the objectives, as well as to the protection of the environment, is based on an artificial earthquake assessment process, which highlights the possible effects on the adjacent area.

The evaluation of the seismic effect can be done by monitoring some parameters that characterize the seismic waves produced by quarry blasting such as: frequency of oscillations, amplitude of movement, soil particles oscillations velocity, acceleration of oscillations, duration of their manifestation.
Determination of the rock mass resistance index (GSI) based on image processing
Authors: Popescu Sorin , Tomuş Ovidiu-Bogdan
Published: July 2021

More and more often, and on an increasingly large scale, the geological resistance index (GSI) system is used for the design and practice of the mining process. The GSI, is a unique system for classifying the mass of rocks, linked to the parameters of rock strength and mass distortion, based on the generalized criteria of Hoek-Brown and MohrCoulomb. The GSI can be estimated using standard and in situ tables by direct surface observations in underground or surface mining. The GSI value provides a numerical representation of the overall Geotechnical quality of the rock mass. The method for determining GSI using photographic images of the in situ rock mass, with image processing technology, fractal theory and artificial neuronal network (ANN), is already known and successfully applied in several projects.
The use of modern technologies in the surveying field
Authors: Dragomir Lucian Octavian , Herbei Roxana Claudia , Herbei Mihai Valentin
Published: July 2021

In order to achieve or complete the 1: 1.000 scale situation plan and the digital terrain model for the Timişoara - Sibiu highway section, and given the difficult access conditions in the project area, it was decided to use photogrammetric techniques for extraction of spatial information needed for mapping. In order to achieve the mapping requirements at a scale of 1: 1.000, the following activities were performed: Realization of the geodetic support network; Realization of the aerial photography project; Making pre-marking points in areas without clear details or other location possibilities; Simultaneous aerial photography of sub-blocks at different flight heights to ensure a 12 cm pixel and simultaneous laser scanning with LiDAR system; Identification of marking and pre-marking points on the subblock frames; Performing GPS measurements to determine the coordinates of landmarks and photogrammetric pre-marking; LIDAR data processing using permanent GPS stations to obtain coordinates in the ETRS89 system and transform them into the STEREO70 system and Black Sea reference plan 75; Calibration of LIDAR data; Filtering LIDAR data; Realization of aerotriangulation on subblocks or bands; Stereo restitution of planimetric and altimetric details for 1: 1.000 scale (3D mode); Transforming 3D plans into 2D plans; Editing and elaborating topographic plans.
Comparative measurements between the results achieved with reference method and the optical method for determination of PM10 dusts in ambient air
Authors: Kovacs Marius , Călămar Angelica-Nicoleta , Toth Lorand , Simion Sorin , Simion Alexandru
Published: July 2021

The current paper aims to determine the actuality of the optical method of measuring PM10 dusts powders compared to the reference method (gravimetric method). According to the Integrated National Plan in the field of Energy and Climate Change 2021-2030, Romania must implement a program to reduce impact on atmosphere, including air quality monitoring, thus leading to an increase in the number of monitoring points and an increase in the number of samples required for monitoring.

Currently, PM10 dust monitoring stations use the gravimetric method, consisting in absorbing a known volume of air on filters and weighing the dust deposited on them. As the use of this method requires a minimum of 3 days, it is necessary to apply an alternative measuring method, with short response time, namely the optical method.

Parallel experimentation of the two measuring devices that use different principles was performed in several series of measurements at an economic agent that has the obligation to monitor dust at premises borders. Results obtained from comparison of the two devices can support future researchers in order to find limitations of the optical method of measuring PM10 dusts and to validate the method, in order to use it routinely.
The quality of the environment in the Rosia of Jiu quarry as a result of the use of Caterpillar 323D L and 323D LN excavators
Authors: Marc Bogdan Ioan , Stanimiresu Soica Alexandra , Radu Sorin Mihai
Published: July 2021

This paper studies how the activity of hydraulic excavators found in the Rosia quarry of Jiu affects the environment. For this study we chose the Caterpillar 323D L and 323 D LN hydraulic excavators. The study took place over a period of 30 days. These days we have collected data on the noise level and the level of PM 10 particles in the quarry. Caterpillar equipment not only helps to build a better world, but also helps to preserve the environment, which is so fragile today. The evolution of excavators has led to a more efficient way of working both in terms of production, costs and effects on the environment. Their efficient way of working has led to an increase in production and a decrease in the level of pollution in the Rosia Quarry area.
Identification of pollution sources in closed mining sites with an Impact on the quality of surface water in the Brad area
Authors: Dunca Emilia-Cornelia , Rusu Tiberiu , Iancu Dorin
Published: July 2021

Pollution caused by closed mining activities is particularly difficult to treat because it dates back a very long time. Water contamination results from large-scale disturbance of the land on which the underground exploitation of the useful mineral substance took place. Discharges from underground mines can be treated as diffuse point sources; water quality is due to reactions that occur in an area that can cover tens of square kilometres. The main sources are groundwater, which increases after the pumping is stopped, and tailings stored in dumps and tailings ponds. When the mine closes, the pumps are stopped and the groundwater level rises until it reaches the surface or discharges into the aquifers above. Although discharges from wells and galleries are often the most visible sources, surface activities such as mineral processing, tailings and waste disposal are also a significant source of pollution. The river is located on the Barza gold-silver ore mining operation took place. The runoff waters present in this perimeter can transport contaminated sediments, where the tailings dumps are washed away by precipitation. The paper aims to identify the sources of surface water pollution in the Barza closed mining site that influences the quality of surface water.
Management of affected areas by the pollution of the slag and ash deposits of CET Mintia
Authors: Tataru Andreea Cristina , Stanci Aurora , Tataru Dorin
Published: July 2021

The technological processes from the combustion of certain materials in boilers results in significant amounts of slag and ash waste. Such industries that produce waste as slag and ash as a result of the process obtain electricity in the thermoelectric power plants. The biggest environmental problems caused by the thermoelectric power plants are air pollution and landscaping. In order to reduce the pollution caused by the slag and ash deposits, they should be ecologized upon completion of the slag and ash deposition process. An environmental management system aims at finding the most effective solutions for complying with environmental protection requirements. In this case, more economic solutions are needed to comply with the legislation. In this paper we will present a method of greening the slag and ash deposits of the thermoelectric power plants Mintia and the related costs.
Impact of hydrocarbons transport through pipes on placement areas
Authors: Panaitescu Casen , Stoicescu Maria
Published: July 2021

Contaminants from the geological environment have induced effects specific to each category of compounds. Complex geological and geochemical studies were based on the geological drilling with depths up to 10 m. The area studied in this paper was the area of Prahova County. The paper aims to present some of the results obtained from analysis performed at soil affected by oil contamination and hydrocarbons products transported through pipelines. The maximum depth from which samples were taken was 10 m. This paper shows the need to investigate each area in terms of pollution.
Considerations regarding the inspection of equipment designed for use in potentially explosive atmospheres
Authors: Moldovan Lucian , Magyari Mihai , Rad Marcel , Moldovan Clementina , Zsido Sorin
Published: July 2021

The special characteristics providing protection to explosion for equipment design for use in potentially explosive atmospheres must be preserved during their entire period of use. Thus, the equipment designed for use in potentially explosive atmosphere shall be subjected to specific inspections in order to verify that the characteristics on which explosion protection is based were not depreciated in time. The purpose of the paper is to underline the importance of inspections in case of equipment intended to be used in potentially explosive atmospheres and to provide specific recommendations in this matter.
Factors of achieving and ensuring energy security in the context of national and EuroAtlantic security
Authors: Fîţă Nicolae Daniel , Grigorie Emilia
Published: July 2021

Energy security, alongside with industrial, food, societal, environmental and sustainable development, information, cyber, economic, defense and national order security, etc., is part of the concept of national security of a state. The level of security of a state is the ability of that state to aggregate resources internally and gain or maintain access to external economic resources. Energy security means being ensured in terms of raw material sources, control of transportation and distribution routes and alternatives. Sufficient and available raw material resources are an urgent prerequisite for achieving energy security. Any longer interruption of energy supply has a negative effect on the economic growth, the political stability and the welfare of the citizens of a state. The following elements of energy security instability can endanger a state’s energy security: risks (physical, economic, geopolitical, geostrategic, social, environmental protection, etc.); threats (terrorist action, political, industrial, economic and national instability, armed conflicts, piracy, etc.); dangers (lack of energy supply and/or raw materials, the finite nature of energy resources, use of energy as a pressure instrument or energy weapon, use of energy revenues to support undemocratic regimes, high energy costs for developing countries and global climate change) and vulnerabilities (natural and/or anthropogenic hazards). For the purpose to ensure the stability of national and EuroAtlantic security, the following factors are proposed by authors to achieve and ensure energy security: 25 proposed way to achieving energy security; 8 proposed way to ensuring energy security, and 9 proposed scenarios to quantification energy security almost complete. The final conclusion is: the energy security of a state is in fact the national security of that state.
Conducting power flow analysis and simulations for a delivery electric system with important consumers
Authors: Dumitrescu Mariana
Published: July 2021

The goals of the paper are to conduct the simulation and to analyze the power flow in a real complex industrial system. Professional Edsa digital simulation for the case study has the purpose to determine and to control/correct the operational state of the power system. The steps of the analysis are: AC Object Oriented Load Flow, AC Advanced Power Flow with integrated Motor Torque, AC Load Flow Error Checker, AC Motor Starting Load Flow Method, Standard Motor Torque and Performance.
Conducting safety analysis and simulations for protection of a delivery electric system with essential power consumers
Authors: Dumitrescu Mariana
Published: July 2021

The paper presents a real power delivery system with essential consumers safety analysis. The two levels voltage networks 6kV and 0,4kV are modeled with the help of Edsa software and short-circuit simulation is conducted in order to obtain the computed values of the currents to all the network buses. The results are used to implement a technical solution for an important safety improvement of the analysed system.
An implementation of a fault-tolerant database system using the actor model
Authors: Schuszter Ioan Cristian , Cioca Marius
Published: July 2021

Fault-tolerant systems are an important discussion subject in our world of interconnected devices. One of the major failure points of every distributed infrastructure is the database. A data migration or an overload of one of the servers could lead to a cascade of failures and service downtime for the users. NoSQL databases sacrifice some of the consistency provided by traditional SQL databases while privileging availability and partition tolerance. This paper presents the design and implementation of a distributed in-memory database that is based on the actor model. The benefits of the actor model and development using functional languages are detailed, and suitable performance metrics are presented. A case study is also performed, showcasing the system’s capacity to quickly recover from the loss of one of its machines and maintain functionality.
Automatic identification of hallucinogenic amphetamines based on their ATR-FTIR spectra processed with Convolutional Neural Networks
Authors: Negoita Catalin , Praisler Mirela , Darie Iulia-Florentina
Published: July 2021

New psychoactive drugs that are leading to severe intoxications are constantly seized on the European black market. Recent studies indicate that most of these new substances are synthetic cannabinoids and hallucinogenic amphetamines. In this study, we are presenting the results obtained with an expert system that was built to identify automatically the class identity of these types of drugs of abuse, based on their Attenuated Total Reflection-Fourier Transform Infrared (ATR-FTIR) spectra processed with Convolutional Neural Networks (CNNs). CNNs have been applied with great success in recent years in various computer applications, such as image classification, but little work has been done in using this kind of deep learning models for spectral data classification. The aim of this study was to improve the detection accuracy (classification performance) that we have already obtained with other statistical mathematics and artificial intelligence techniques. The performances of the CNN system are discussed in comparison with those of the later models.
Pose and motion capture technologies
Authors: Panaite Arun Fabian , Rosca Sebastian , Sibişanu Remus
Published: July 2021

The multitude of sensors, transducers and data acquisition systems used in the ever-increasing domains of today’s industry, were designed and created on a purpose-based agenda. Most of these technologies were rarely used for different purposes then the ones they were meant for. This research, explores the possibility of using those technologies for the purpose of motion capture. The results of the motion capture data acquisition can further be used for other purposes, itself. Because the motion capture data isn’t calculated, but only captured, the compression algorithms may result in mathematical formulas of motion, which can be the same formulas of calculating the motion synthetically. The same way the parameters and formulas are being calculated for a robot’s movement, motion can be captured, and the key position parameters can be selected, and implemented on the movement, while not only making the movement more natural, but saves time during the programming process.
Pension rights of Valea Jiului mining companies’ clerks through the privately administered pension house
Authors: Dobre-Baron Oana
Published: July 2021

Since their founding at the end of the XIXth century, the mining companies that have extracted coal in the Jiu Valley have tried to guarantee, though a private system of social security, pension rights for all of its employees, workers as well as clerks. This private system of social security would perpetuate itself, in the case of clerks working for Valea Jiului mining companies, though the interwar years up to the instauration of the Communist regime, when another pension scheme was established for those employees in the workforce. In this study we will seek to uncover the way in which these mining companies’ clerks’ Pension Houses were constituted and functioned after the First World War. They would operate on the basis of their own rules/statutes, would be under the leadership of a Committee chosen among the members of the Pension House, but also under the supervision of the Administrative Council of the mining company. Due to the levies placed upon their members, subsidies given by the mining companies, and other income, the Pension Houses managed throughout the entire period in question to guarantee honorable pensions for their members, and also for their widows and descendants.
Implementation and impact of Industry 4.0 and Quality 4.0 in the banking sector
Authors: Pogăciaş Celina , Dovleac Raluca
Published: July 2021

The digitalization of banking services refers not only to the application of new technologies, but also involves a completely different approach and way of thinking for all actors involved. Given the dominance of the technological environment and unprecedented customer expectations, banks in Romania have concluded that the practices of quality management can be implemented for banking activities, inspired by the actions of international banks that have entered the national market. Knowing and anticipating customer needs and expectations as they evolve, by focusing on achieving and maintaining a maximum degree of satisfaction to retain customers is a primary objective for all banks. It is strategically relevant that the impact of Industry 4.0 on the transformation of the banking sector does not jeopardize security, which fuels the need for a balance between competition, innovation, security and customer satisfaction. In addition to the accelerated digitalization processes in the banking sector, the human factor will continue to play a key role in the future, as the focus will remain on the bank’s customer, security and trust. The aim of the paper is to explore the possibilities of implementing Quality 4.0 and Industry 4.0 in banking systems and their impact by studying the literature.
The elderly and quality in social services: standards, indicators, procedures and tools
Authors: Corman Sorina
Published: July 2021

The paper presents an inventory of standards, indicators, procedures and tools that ensure the assessment and monitoring of quality in elderly-oriented social services and proposes a synthetic analysis of the concept of “elderly people” as reflected in documents specific to the field of social assistance. Data analysis follows the classic stages of content analysis: inventory of standards, indicators, procedures and tools; standardization of the information contained in the aforementioned quality standards, classification into units of analysis, establishment of the main categories of analysis, coding and final analysis of the data. The information obtained was broken down into three categories: senior citizens in specific roles, the elderly in the relational system, this age group in the dynamics of integration. Each category resulting from the analysis provides a specific picture of the life dimensions of institutionalized seniors. The main conclusion is that the intervention of social workers in a quality management system can be correlated with these resulting dimensions, and one can start from these indicators when it comes to the elaboration of intervention techniques and tools.
Biomecanical changes of the temporomandibular joint in restoration with implant supported overdentures. Functional analysis
Authors: Dahm Tataru Cristina Adriana
Published: July 2021

Temporo-mandibular joint disorders represent an issue of particular importance for the health and proper functioning of the dentomaxillary systhem. Research conducted in this paper aims to analyse biomechanics and temporomandibular joint among patients who, one the one side have implants placed over a history of joint disease, emphasising developments along post-interventio. On the oder side, patients without a history of joint pathology were recieving implant prosthesis. The study includes a total of 138 subjects (N=138), age between 18 and 64 years, with lateral edentulous that have been applied to dental implants and made overdenture. All patients are clinically healthy. The research methods comprise systematic observation and clinical trial, applied to two groups: one of study and one of control. Biomechanical principles can not guarantee the avoidance in the case of biopathological response to overload (respectively outer-implant bone resorption). These will not lead to the prognostic for all types of prosthetic overstructures with implant support, because the individual variations of bone resistance can not be apropriatly measured. The present paper is an applied research which is designed to solve short term problems, in order to contribute to the development of an interdisciplinary scientific field.
Pharmacognostic Evaluation of Ten Species of Medicinal Importance of Cecropia: Current Knowledge and Therapeutic Perspectives
Authors: Rivera-Mondragón Andrés , Ortíz Orlando O. , Gupta Mahabir P. , Caballero-George Catherina
Published: July 2021

This work covers a systematic review of literature about the genus Cecropia from 1978 to 2020, emphasizing the analysis of 10 of the most relevant species and their associated biological activities. Cecropia is a neotropical genus, which comprises about 61 native species in the American continent where it is known to be part of the traditional medicine of numerous countries. Secondary metabolites described for this genus showed an elevated structural and functional diversity, where polyphenols have been the most abundant. Based on this diversity, Cecropia phytochemicals represent an important source of potential therapeutic agents yet to be exploited. This review also highlights the effectiveness of combining chemometrics and ultra-performance liquid chromatography-tandem mass spectrometry as a novel approach to successfully single out Cecropia species phytochemicals. While the medicinal use of Cecropia species is officially recognized in National Pharmacopoeias and Formularies of several Latin American countries, it is important to recognize that these phytomedicines are complex mixtures requiring a thorough understanding of their chemical composition and their correlation with biological activities to guarantee their quality, safety, and efficacy.
Prevalence of Primary Aldosteronism Across the Stages of Hypertension
Based on a New Combined Overnight Test
Authors: Voulgaris Nick , Tyfoxylou Ernestini , Vlachou Sophia , Kyriazi Evagelia , Gravvanis Chris , Kapsali Chara , Markou Athina , Papanastasiou Labrini , Gryparis Alexandros , Kassi Eva , Chrousos George , Kaltsas Gregory , Piaditis George
Published: July 2021

Primary aldosteronism (PA) is the most common endocrine cause of arterial
hypertension. Despite the increasing incidence of hypertension worldwide, the
true prevalence of PA in hypertension was only recently recognized. The
objective of the work was to estimate the prevalence of PA in patients at
different stages of hypertension based on a newly developed screening-diagnostic
overnight test. This is a prospective study with hypertensive patients
(n=265) at stage I (n=100), II (n=88), and III
(n=77) of hypertension. A group of 103 patients with essential
hypertension without PA was used as controls. PA diagnosis was based on a
combined screening-diagnostic overnight test, the
Dexamethasone-Captopril-Valsartan Test (DCVT) that evaluates aldosterone
secretion after pharmaceutical blockade of angiotensin-II and
adrenocorticotropic hormone. DCVT was performed in all participants
independently of the basal aldosterone to renin ratio (ARR). The calculated
upper normal limits for post-DCVT aldosterone levels [3 ng/dl (85
pmol/l)] and post-DCVT ARR [0.32
ng/dl/μU/ml (9 pmol/IU)] from controls,
were applied together to establish PA diagnosis. Using these criteria PA was
confirmed in 80 of 265 (30%) hypertensives. The prevalence of PA was:
21% (21/100) in stage I, 33% (29/88) in stage
II, and 39% (30/77) in stage III. Serum K+
levels were negatively correlated and urinary K+ was
positively correlated in PA patients with post-DCVT ARR
(r=–0.349, p <0.01, and r=0.27, p <0.05
respectively). In conclusion, DCVT revealed that PA is a highly prevalent cause
of hypertension. DCVT could be employed as a diagnostic tool in all subjects
with arterial hypertension of unknown cause.
Age Moderates the Impact of TRAbs on Thyroid Hormones and Hepatic
Function in Patients with Graves’ Disease
Authors: Guo Kai , Ling Hongwei , Zhou Xiaoyan , Ying Changjiang
Published: July 2021

Thyrotropin receptor antibodies (TRAbs) play a significant role in the course of
hepatic dysfunction (HDF) in patients with Graves’ disease (GD).
However, few studies have considered the factors that influence the
relationships among TRAbs, thyroid hormone levels, and hepatic function in
subjects with newly diagnosed GD. Here we investigated the associations of TRAbs
with thyroid hormones and hepatic function and assessed potential factors that
can influence these associations among patients with GD. A total of 368 patients
newly diagnosed with GD were collected in this cross-sectional study. Patients
who had received antithyroid drugs, radioactive iodine, or surgery were
excluded. Levels of TRAbs and thyroid hormones and hepatic function were
recorded. Linear and binary logistic regression analysis models were applied to
investigate associations among these variables after adjusting for confounding
characteristics. There was a significant difference in TRAbs indices between the
HDF and normal hepatic function groups (p <0.05). After adjusting for
confounders, the relationship between TRAbs and thyroid hormones was nonlinear,
showing a curve with an initial positive slope and a subsequent flattening (p
<0.05). Higher TRAbs were associated with HDF [odds ratio (OR) 1.036,
95% confidence interval (CI) 1.018–1.053 per 1-IU/l
increase]. These associations were modified by age, but not by gender, smoking
status, Graves’ orbitopathy, thyroid-peroxidase antibody levels, or
thyroglobulin antibody levels. In younger patients, increasing TRAbs were
correlated with higher thyroid hormones and HDF (OR 1.034, 95% CI
1.017–1.052) per1-IU/l increase). In older patients, TRAbs were
not correlated with thyroid hormones or HDF (OR 1.024, 95% CI
0.993–1.056) per 1-IU/l increase. Age can affect the impact of
TRAbs on thyroid hormone levels and hepatic function in GD. TRAb measurement can
have good predictive value in younger patients.
Treatment Strategies for Dopamine Agonist-Resistant and Aggressive Prolactinomas: A Comprehensive Analysis of the Literature
Authors: Sari Ramazan , Altinoz Meric A. , Ozlu Eylem Burcu Kahraman , Sav Aydin , Danyeli Ayca Ersen , Baskan Ozdil , Er Ozlem , Elmaci Ilhan
Published: July 2021

Despite most of the prolactinomas can be treated with endocrine therapy and/or surgery, a significant percentage of these tumors can be resistant to endocrine treatments and/or recur with prominent invasion into the surrounding anatomical structures. Hence, clinical, pathological, and molecular definitions of aggressive prolactinomas are important to guide for classical and novel treatment modalities. In this review, we aimed to define molecular endocrinological features of dopamine agonist-resistant and aggressive prolactinomas for designing future multimodality treatments. Besides surgery, temozolomide chemotherapy and radiotherapy, peptide receptor radionuclide therapy, estrogen pathway modulators, progesterone antagonists or agonists, mTOR/akt inhibitors, pasireotide, gefitinib/lapatinib, everolimus, and metformin are tested in preclinical models, anecdotal cases, and in small case series. Moreover, chorionic gonadotropin, gonadotropin releasing hormone, TGFβ and PRDM2 may seem like possible future targets for managing aggressive prolactinomas. Lastly, we discussed our management of a unique prolactinoma case by asking which tumors’ proliferative index (Ki67) increased from 5–6% to 26% in two subsequent surgeries performed in a 2-year period, exerted massive invasive growth, and secreted huge levels of prolactin leading up to levels of 1 605 671 ng/dl in blood.
Supracricoid Partial Laryngectomy: Oncological and Functional Outcomes
Authors: Mesolella Massimo , Iorio Brigida , Buono Sarah , Cimmino Mariano , Motta Gaetano
Published: July 2021

Introduction In the present study, we have reviewed the outcomes of patients with supracricoid partial laryngectomy (SCPL) in our institution. Our results show that SCPL is a well-tolerated procedure with generally good functional outcomes for patients with advanced laryngeal cancer.

Objective We analyzed the oncological and functional results of a cohort of 35 patients who had undergone SCPL, and we highlighted the complications, identified the overall and disease-free survivals, demonstrating that the reconstructive laryngectomy guarantees the oncological safety and reproducibility of the oncological results, preserving the laryngeal functions and promoting an improvement in the patient's quality of life, favoring communication and interpersonal relationships.

Methods Between 2010 and 2018, 35 patients underwent SCPL for primary and recurrent laryngeal squamous cell carcinomas, and they were divided into two subgroups: in 16 cases, the cricohyoidoepiglottopexy according to the Mayer-Piquet technique was performed, while the remaining 19 cases were submitted to the cricohyoidopexy according to the Labayle technique. In addition to evaluating the oncological results of patients undergoing reconstructive laryngectomy, the present study also aimed to evaluate the functionality of the residual larynx and the quality of life.

Results The overall and disease-free survivals were of 83% and 76.3% respectively. All patients were able to swallow. The nasogastric tube was removed after a mean period of 21.8 days (range: 14 to 28 days). The mean decannulation time was of 23.4 days after surgery (range: 15 to 36 days).

Conclusion The curves for the overall and disease-free survivals show that SCPL can guarantee oncological safety comparable to that of total laryngectomies in diseases in the intermediate stage and in carefully-selected advanced stages.
The Clinical Profile, Early Warning Score, and Outcome of Children Aged 0–12 Years Referred to a Tertiary Care Hospital in North India
Authors: Eswaramoorthy Brinda , Gupta Ratan , Bhatt Meenakshi , Roy Manas Pratim
Published: July 2021

Pediatric patients are referred for multiple reasons, either for better therapeutic services or diagnostic purposes. The clinical condition of patients at the time of referral can significantly affect the outcome of such patients and there is not much data on this aspect. The overall objective of this study was to study the demographic and clinical profile, the causes for referral, and the outcome of pediatric patients being referred to a single tertiary care hospital. This was a prospective observational study done in the Department of Pediatrics of a single tertiary care hospital in North India over the course of 1 year. Patients referred from other health facilities in the age group 0 to 12 years who were admitted in the pediatric ward of the hospital were enrolled. The primary objective was to study the clinical profile and outcome (mortality) of these patients. The secondary objectives were to study the referral pattern of the referred patients, causes for referral, and the severity of illness at the time of admission as assessed by Irish Pediatric Early Warning Score (PEWS) and its correlation with the outcome. The outcomes were categorized as: discharge, death, left against medical advice, referred to other centers, others. Early warning scores are useful to measure the severity of disease and to follow patients' progress. The Irish PEWS score was used in this study to provide a rapid measure of the degree of sickness. Respiratory system disorders and neonatal illnesses were the most common illnesses observed. Most patients had low disease severity as per Irish PEWS score. The overall mortality rate among the referred patients was 19.25%. Patients with younger age, higher scores, neonatal illnesses, and neurological disorders had higher risk of mortality. Training of health personnel at primary and secondary levels in the commonly encountered illnesses will improve provision of care at the local level and decrease low risk referrals.
Knowledge, Attitudes, and Perceptions about Antibiotic Stewardship Programs among Neonatology Trainees
Authors: Kalu Ibukunoluwa C. , Mukhopadhyay Sagori , Dukhovny Dmitry , Young Rebecca , Guzman-Cottrill Judith A.
Published: July 2021

Objective Antibiotic stewardship should be an essential component of neonatology training as neonatal intensive care units (NICU) have unique stewardship needs. Our aim was to assess neonatology fellowship trainees' knowledge, attitudes, and perceptions about antibiotic stewardship to inform sustainable curriculum development.

Study Design We distributed an electronic survey to neonatology fellows in the United States over 4 months (January–April 2018) via Accreditation Council for Graduate Medical Education program directors.

Results Of 99 programs in the United States with an estimated 700 fellows, 159 (23%) fellows from 52 training programs (53%) responded to the survey and 139 (87%) provided analyzed responses. Majority of respondents were training in southern (59; 42%) and northeastern (43; 31%) regions and were equally spread across all 3 years of training. One hundred (72%) respondents reported an antibiotic stewardship program (ASP) in their institution. While 86% (120/139) were able to identify the components of an ASP, 59% (82/139) either did not or were unsure if they had received antibiotic stewardship training during fellowship.

Furthermore, while answering case studies, 124 (89%) respondents identified the optimal antibiotic for methicillin susceptible Staphylococcus aureus (MSSA) infection and 69 (50%) respondents chose appropriate empiric antibiotics for neonatal meningitis. Notably, fellowship training year was not significantly related to the proportion of incorrect knowledge responses (p = 0.40). Most survey respondents (81; 59%) identified small group sessions as the most useful teaching format, while others chose audit and feedback of individual prescribing behavior (52; 38%) and didactic lectures (52; 38%). Finally, ninety-five (69%) respondents preferred trainee-led ASP interventions targeting focal areas such as antifungal and surgical prophylaxis.

Conclusion Antibiotic stewardship is a critical part of neonatology training. Neonatology fellows report variation in access to ASP during their training. Fellows prefer dedicated trainee-led interventions and stewardship curriculum taught within small group settings to promote targeted NICU ASP.

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Predicting Adverse Outcomes in Monochorionic-Diamniotic Twins: The Role of Intertwin Discrepancy in Middle Cerebral Artery Doppler Measurements and the Cerebroplacental Ratio
Authors: Mok Thalia , Afshar Yalda , Platt Lawrence D. , Guo Rong , Rao Rashmi R. , Pluym Ilina D. , Silverman Neil S. , Han Christina S.
Published: July 2021

Objective This study was aimed to evaluate the role of intertwin discrepancy in middle cerebral artery peak systolic velocity (MCA-PSV) and cerebroplacental ratio (CPR) for the prediction of adverse outcomes in monochorionic-diamniotic (MCDA) twin pregnancies.

Study Design A retrospective cohort study of MCDA pregnancies that underwent ultrasound surveillance at a perinatal referral center from 2007 to 2017. Intertwin MCA-PSV discrepancy (MCA-ΔPSV-MoM) was defined as the absolute difference of MCA-PSV multiple of the median (MoM) for gestational age between twins. Intertwin CPR discrepancy (CPR-Δ) was defined as the absolute difference of CPR between twins. The maximum MCA-ΔPSV-MoM and CPR-Δ before and after 26 weeks of gestation were assessed as predictors of pregnancy and neonatal outcomes through simple logistic regression models and Pearson's correlation coefficients. Receiver operating characteristic (ROC) curves were generated to determine the predictive value of maximum MCA-ΔPSV-MoM and CPR-Δ.

Results A total of 143 MCDA pregnancies met inclusion criteria. There was a significant association between MCA-ΔPSV-MoM at <26 weeks and the development of twin anemia-polycythemia sequence (TAPS; p = 0.007), intrauterine fetal demise (IUFD; p = 0.009), and neonatal intensive care unit (NICU) admission (p < 0.05). MCA-ΔPSV-MoM at ≥26 weeks was associated with the development of TAPS (p < 0.001). CPR-Δ at <26 weeks was associated with the development of twin-twin transfusion syndrome (TTTS; p = 0.03) and NICU admission (p = 0.02). MCA-ΔPSV-MoM at ≥26 weeks was highly predictive of TAPS (area under curve [AUC] = 0.92). A cut-off of 0.44 would identify TAPS with 100% sensitivity and 73% specificity.

Conclusion In MCDA pregnancies, intertwin MCA and CPR discrepancies are associated with adverse pregnancy and neonatal outcomes, including TAPS, TTTS, IUFD, and NICU admission. Evaluation of intertwin MCA and CPR differences demonstrated the potential for clinical predictive utility in the surveillance of MCDA twin pregnancies.

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