Background and Objectives: Neutrophil-to-lymphocyte ratio (NLR), a very low cost, widely available marker of systemic inflammation, has been proposed as a potential predictor of short-term outcome in patients with intracerebral hemorrhage (ICH). Methods: Patients with ICH admitted to the Neurology Department during a two-year period were screened for inclusion. Based on eligibility criteria, 201 patients were included in the present analysis. Clinical, imaging, and laboratory characteristics were collected in a prespecified manner. Logistic regression models and receiver operating characteristics (ROC) curves were used to assess the performance of NLR assessed at admission (admission NLR) and 72 h later (three-day NLR) in predicting in-hospital death. Results: The median age of the study population was 70 years (IQR: 61–79), median admission NIHSS was 16 (IQR: 6–24), and median hematoma volume was 13.7 mL (IQR: 4.6–35.2 mL). Ninety patients (44.8%) died during hospitalization, and for 35 patients (17.4%) death occurred during the first three days. Several common predictors were significantly associated with in-hospital mortality in univariate analysis, including NLR assessed at admission (OR: 1.11; 95% CI: 1.04–1.18; p = 0.002). However, in multivariate analysis admission, NLR was not an independent predictor of in-hospital mortality (OR: 1.04; 95% CI: 0.9–1.1; p = 0.3). The subgroup analysis of 112 patients who survived the first 72 h of hospitalization showed that three-day NLR (OR: 1.2; 95% CI: 1.09–1.4; p < 0.001) and age (OR: 1.05; 95% CI: 1.02–1.08; p = 0.02) were the only independent predictors of in-hospital mortality. ROC curve analysis yielded an optimal cut-off value of three-day NLR for the prediction of in-hospital mortality of ≥6.3 (AUC = 0.819; 95% CI: 0.735–0.885; p < 0.0001) and Kaplan–Meier analysis proved that ICH patients with three-day NLR ≥6.3 had significantly higher odds of in-hospital death (HR: 7.37; 95% CI: 3.62–15; log-rank test; p < 0.0001). Conclusion: NLR assessed 72 h after admission is an independent predictor of in-hospital mortality in ICH patients and could be widely used in clinical practice to identify the patients at high risk of in-hospital death. Further studies to confirm this finding are needed.

Abstract-The dynamics of a river channel targets the interdependency relations between water, relief and sediments, as well as their effects within the fluvial system. This paper presents the dynamics of some fluvial islands (islets) from the river channel of the Danube between Giurgiu-Russe and Călăraşi-Silistra localities, corresponding to a part of the lower sector of the Danube, which constitutes the border between Romania and Bulgaria. The islets are fixed sedimentary deposits, stabilized, with a vegetation cover depending on the soil formation degree. We use the term "ostrov", as specified on the cartographic materials published in Romanian

Through time, both natural and cultural heritage have unfortunately been under threat due to multiple environmental and human-induced factors, which are likely to trigger various hazards such as soil erosion, landslides, or land collapse. The analysis of old cartographic material, aerial imagery, and satellite imagery has been used in multiple studies to observe and understand the changes that archaeological sites have undergone over the last centuries. These efforts are intended, among other things, to raise awareness of the threats affecting cultural heritage and prevent damages and preserve tangible evidence of the distant past. In this study, historical maps and satellite imagery were analyzed to observe how the landscape in the Mostiștea Valley (Romania) has been used over the last 230 years and how the land use has affected the cultural heritage. Land cover and land use (LCLU) changes in the Mostiștea Valley have occurred due to numerous natural and anthropic forces. These changes have resulted in the damage of tangible heritage in the area with varying degrees of intensity. The results of this study allow the quantification of the magnitude of these changes and their impact on different sites in the region.

Background: The burden of stroke is high in Romania and data regarding access to post – stroke rehabilitation are almost non–existent. We aimed to determine the percentage of patients who benefited from post–stroke rehabilitation and to describe the most common rehabilitation settings. Methods: A structured telephone-based questionnaire regarding access to post–stroke rehabilitation therapy and outcomes was administered to all patients with ischemic stroke who benefited from reperfusion therapy in a tertiary center in 2019. Results: 211 stroke patients received reperfusion therapy during the studied period. Out of these, 208 patients were included in the initial analysis and 109 patients were deemed eligible for post–stroke rehabilitation therapy. 57 patients (55.8%) performed post–stroke rehabilitation. In-hospital rehabilitation was reported by 35 patients (32.1%) with a median length of hospital stay of 14 days. 28 patients (25.6%) performed home based physical therapy with a median frequency of 3 sessions per week. 12 patients (11.1%) were admitted to nursing homes. Compared to stroke patients who did not perform in–hospital rehabilitation, those who did were younger (median age 65 years vs. 73 years, p=0.01) and more likely to have moderate–severe post–stroke disability (mRS score 3 – 5 at discharge 80% vs. 59.4%, p=0.03). mRS score at discharge ≤ 2 was a significant predictor for not pursuing post-stroke rehabilitation (p < 0.001). Conclusion: Approximately 50% of the stroke patients treated with reperfusion therapies were eligible for post–stroke rehabilitation and approximately 50% of them had access to rehabilitation therapy while only 30% had access to in-hospital rehabilitation. Keywords: Stroke rehabilitation; Eastern Europe; Romania; Rehabilitation Center; Physical Therapy,

Paracetamol can induce hypothermia in humans and rodents. The study’s aim is to review the mechanisms of paracetamol-induced hypothermia in rodents or the results issued from in vitro studies on the same species’ tissues (in doses that do not produce hepatic impairment) using the latest developments published in scientific journals over the last 15 years. Available human studies are also analysed. An extensive search in PubMed databases exploring the hypothermic response to paracetamol was conducted. 4669 articles about paracetamol’s effects on body temperature in mice or rats were found. After applying additional filters, 20 articles were selected for review, with 9 of them presented in tabular forms. The analysis of these articles found that the hypothermic effect of paracetamol is due to the inhibition of a cyclooxygenase-1 variant, is potentiated by endothelin receptor antagonists, and can be mediated through GABAA receptors and possibly through transient receptor potential cation channel subfamily A member 1 via N-acetyl-p-benzoquinone imine in the central nervous system. Human studies confirm the in vivo and in vitro experiments in rodents regarding the presence of a hypothermic effect after high, non-toxic doses of paracetamol. Further research is required to understand the mechanisms behind paracetamol’s hypothermic effect in humans.