Some glucagon-like peptide-1 receptor agonists (GLP-1 RAs), first used in the treat-ment of type 2 diabetes mellitus (T2DM), have been approved for the treatment of obe-sity in patients with or without T2DM (liraglutide – LIR, semaglutide - SEM, and tir-zepatide - TIR). Social media had an important influence on the off-label use of GLP-1 RAs for obesity, especially for SEM. We analysed the Google queries related to SEM to assess people's interest in this drug. We also investigated the occurrence of adverse drug reactions (ADRs) by searching the EudraVigilance database (EV) for Individual Case Safety Reports (ICSRs) that reported SEM as the suspected drug and performed a descriptive and a disproportionality analysis. Data obtained for SEM were compared to other GLP-1 RAs. SEM had the highest proportions of searches on Google associated with the term “weight loss” and presented the lowest number of severe ADRs, but it also had the highest number of ICSRs reported in EV. Even though no unexpected safety issues have been reported for it until now, SEM has a high tendency for overdose reports. The most frequent off-label use was reported for SEM and TIR. In order to lower the ADRs’ risks, the off-label use should be reduced and carefully monitored.

The term immersive technology refers to various types of technologies and perspectives that are constantly changing and developing. It can be used for different purposes and domains such as: education, healthcare, entertainment, arts, and engineering. This research paper aims to examine which training method is more effective between the traditional approach, using PowerPoint and the immersive technology approach, through mixed reality using a HoloLens 2 device. The experiment involves comparing two groups of students who received different training methods: the first group saw a PowerPoint slide with an image of the human muscular system, while the second group saw a 3D hologram of the human body that showed the same muscle groups as in PowerPoint. The researchers wanted to test whether mixed reality devices could enhance students' cognitive functions and to investigate if the IQ of the participants had any influence in the effectiveness of the teaching method. The main finding of this study is that the instructions given with mixed reality technology, via the Microsoft HoloLens 2 device, are more appropriate for participants who have an IQ score below 100 points. For the other participants, with an IQ score above 100 points, the PowerPoint support was more suitable.

The research presented in this article is based on a strategic approach to a rural area in the mountainous region of Romania and is underwritten by specialists in the economy of mountainous regions in order to elaborate relevant solutions to complex problems relating to sustainable development. In essence, the research underlines and promotes the particularities of performing research for the identification and valuation of endogenous resources, that is, creating relevant strategic options for the durable development of the mountainous region, centered on the renewal of economic activities related to the existent endogenous resources, by using methods, work techniques, and instruments of strategic analysis. These factors are subordinate to the process of harmonization to the requirements of community development and environmental protection according to the new strategy for the development of the European Union 2020 (European Green Pact). This pact also emphasizes the necessity of involving the different factor categories of local accountability, promotion, activation, and the development of specific economic activities of different local contexts of sustainability. The research methodology used involves a case study whose complexity necessitated the use of quality and quantity research methods in order to underline specific elements of the rural area in the Romanian mountainous region. Specifically, we used a strategic diagnosis of the Romanian mountainous region using the PESTEL and SWOT models. In order to have relevant strategic options available, the continuity of research was achieved through the use of SOR analysis, creating a problem tree and an objectives tree.

Software systems are often maintained by a group of experienced software developers, in order to ensure that faults which may bring the system down are less likely. Large turnover in organizations such as CERN makes it important to think of ways of onboarding newcomers on a technical project rapidly. This paper focuses on optimizing the way that people get up-to-speed on the business logic and technologies used on the project, using a knowledge-imbued large language model that is enhanced using domain-specific knowledge from the group or team’s internal documentation.

This paper investigates the possible failure modes of the product development process in production companies that are active in the B2C markets with a focus on household products. Since these cases require short lead times and are difficult to differentiate, in many instances the end result will not be the desired one and could affect profitability for a season or for good. A model of these possibilities is created and an approach to plan contingencies for their solutioning is proposed in the article. The main guideline is to switch from failure probability determination to accepting failure as inevitable and using digital solutions to reinforce the development process in order to offset its impact. For this goal, an Industry 5.0 Abatement Factor (abbreviated IFAF) is introduced in the contingency planning approach, that factors in the evaluation the low cost of digital instruments and the proper mix of Technology, Humans and AI (abbreviated THAI). The new working procedure based on these concepts and their interlinkages is discussed based on specific examples.

The present study explored whether exposure to complex childhood trauma (CCT) is reflected in the resting-state electroencephalography (EEG) temporal alpha power of complex trauma-exposed adolescents, given the association of temporal alpha with fear circuitry (learning and conditioning) in a sample of 25 adolescents and similar controls, ages 12-17 years. Both trauma and psychopathology were screened or assessed, and resting-state EEG was recorded, following a preregistered protocol for data collection. Temporal alpha power, corresponding to T5 and T6 electrode location (10-20 international system), was extracted from resting-state EEG in both eyes-open and eyes-closed conditions. We found that in the eyes-open condition, right, but not left, temporal alpha was significantly higher in adolescents exposed to CCT, relative to healthy controls, suggesting that childhood trauma exposure may have a measurable impact on alpha oscillatory patterns, specifically in the right temporal region. Our study highlights the importance of considering neural markers, such as temporal alpha power, in understanding the long-term consequences of CCT exposure in developmental samples, with possible important clinical implications in guiding neuroregulation interventions.

Background and Objectives Neurofibromatosis 1 (NF1 MIM # 162200), also known as von Recklinghausen disease, is among the most common autosomal dominantly transmitted disorders characterized mainly by neurocutaneous manifestations such as café au lait spots, intertriginous freckling, various types of neurofibromas (cutaneous neurofibromas or plexiform tumors), neurological manifestations, and bone abnormalities. It occurs with an incidence of 1:3000–1:4000 cases. Cone-rod dystrophies belong to the large group of retinal dystrophies, a highly heterogeneous group of disorders clinically manifested mainly by damage to cone and rod cells and have a broad spectrum of clinical manifestations. Many genes are involved in their etiology, with more than 100 currently identified, including the CRX gene responsible for the autosomal dominant form of cone-rod dystrophy (ad CORD). Materials and Methods: The authors present an intriguing case of a patient diagnosed with Neurofibromatosis type 1 (NF1) as an infant and ocular involvement (myopia and astigmatism onset at age 15), which yielded a surprising molecular testing result. Results: Molecular DNA analysis identified a rare occurrence of two mutational variants, including a pathogenic variant in the NF1 gene, c.3871-2A, and a likely pathogenic variant in the CRX gene c.119G>A. Conclusions: The authors present this case to highlight the surprises offered by molecular testing in a condition where the diagnosis is usually based on clinical criteria, thus providing patients with competent genetic advice.

This scientific paper explores the increasingly widespread use of collaborative robots in the industrial environment, highlighting them as a solution to challenges related to the high costs of human labour and the associated management difficulties. The authors focus on the process of defining requirements for the implementation of collaborative robots, providing strategies based on mathematical management models. This approach translates into significant benefits for companies, such as cost reduction, quality improvement, and increased operational efficiency. Additionally, the paper proposes an innovative mathematical model for assessing total costs, budgeting, profitability, and electric power consumption associated with the operation of collaborative robots. This model allows for a comparison between the costs involved in using human labour and those associated with collaborative robots, providing critical information for technological investment decisions. The efficiency of this mathematical model is demonstrated through a practical application, where collaborative robots were integrated into a production environment, and costs and efficiency were evaluated compared to the use of human labour. This scientific paper provides a systematic and efficient approach to implementing collaborative robots in industrial processes, benefiting from strategies based on mathematical management models and an original mathematical model for evaluating performance and associated costs.

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS). Multiple noninvasive respiratory support modes are currently available in Romania, but little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). We aimed to identify the usage extent and clinical application of nHFOV in Romania. A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. The questionnaire was addressed to the leaders of all level III Romanian NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10-17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%), heated, humidified high flow nasal cannula (HHHFNC) (61.9%), and nHFOV (11/21 units; 52.4%); 5/11 units reported frequent nHFOV use (in 2 or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). 10/11 units reported setting a mean airway pressure (MAP) equal to the CPAP level plus 1-2 cmH₂O on rescue nHFOV after CPAP failure. Both dedicated equipment (45.5%) and hybrid ventilators (63.6%) were used for nHFOV delivery, with face/nasal masks and short binasal prongs being the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV; none of the units mentioned pneumothorax as an adverse effect. Only 3 of the NICUs had a written protocol for nHFOV use. Initial, minimum, and maximum amplitude and initial and minimum MAP settings used were significantly higher with hybrid ventilators as compared to dedicated equipment (p<0.05). Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. A need for training for nHFOV use was identified, and efforts are needed at the national level to develop courses and training sessions, including using simulation workshops, to offer more information on optimal nHFOV use in clinical practice.

Background and Objectives: The purpose of this study was to investigate whether early surfactant administration affects the status of ductus arteriosus (DA) in preterm infants ≤32 weeks of gestational age (GA) within 24 hours of birth. Materials and Methods: It is a prospective study conducted from March 15, 2022, to November 15, 2023, in a tertiary academic center. In-born infants ≤ 32 weeks of gestation (n = 88) were enrolled. The study group was further divided into surfactant (n=44) and non-surfactant (n=44) subgroups. Results: 76% of the preterm infants who received surfactant therapy (RRR = 0.839) recorded an increase in Kindler Score at 24 hours of life (1-RR = 1-0.24 = 76%). Surfactant administration was significantly associated with decreased pre-ductal diastolic pressure (29.9 mmHg vs. 34.8 mmHg, p=0.0231), post-ductal diastolic pressure (28.7 mmHg vs. 32.2 mmHg, p=0.0178) pre-ductal MAP (41.6 mmHg vs. 46.5 mmHg, p=0.0210) post-ductal MAP (41.0 mmHg vs. 45.3 mmHg, p=0.0336). There were no significant changes in ductus arteriosus parameters at 24 hours of life. Conclusions: Early surfactant administration does not affect the status of ductus arteriosus in preterm infants ≤32 weeks of gestational age at 24 hours of life.