The Role of Uterine Artery Doppler in the Second and Third Trimesters for Prediction of Preeclampsia and Fetal Growth Restriction Developed as a Consequence of Placental-Mediated Diseases.

Placenta-mediated pregnancy disorders represent a disease that includes preeclampsia (PE) and the birth of small for gestational age (SGA) children, these conditions increase the risk of mortality and morbidity both maternal and fetal/neonatal, in the short and long-term. METHODS: The prospective study included 106 patients in whom ultrasound Doppler scans of uterine artery (UtA) were performed in the 2nd trimester between 20.0-23.6 weeks of gestation and the 3rd trimester between 28.0-32.6 weeks of gestation. RESULTS: In the second trimester, the average of the UtA-PI percentiles was statistically significant (p<0.05) in correlation with PE and SGA, as in the third trimester. Statistically significant (p<0.05) was also the correlation of UtA-PI >95 percentile with the development of PE and SGA. On the other hand, the present notch, in the two trimesters studied, analyzed as a single index, did not present a statistically significant association (p>0.05). CONCLUSIONS: The results of our study showed that UtA-PI Doppler is the best predictor of preeclampsia considering the association of intrauterine growth restriction, as most studies have found.

Intraplacental Villous Artery Doppler can Improve the Ability to Predict Placenta-Mediated Disease.

OBJECTIVE: Evaluation of Intraplacental Villous Artery Doppler (IPVA) as a predictive factor compared to umbilical artery (UA) Doppler in placenta-mediated disease (PMD). METHODS: This prospective study included a group of 106 pregnant women, of which 76 patients constituted the PMD group: preeclampsia (PE) and small for gestational age (SGA), and 30 pregnant women constituted the control group. IPVA and UA Doppler evaluation was performed in 2 pregnancy periods: 20.0-23.6 weeks, and 28.0-32.6 weeks of gestation. RESULTS: From the study of maternal characteristics and risk factors for the presented pathology, we found that no studied risk factor was statistically involved in the evolution toward PMD during pregnancy. In the control group, we noticed a decrease in IPVA PI and RI, along with an increase in gestational age, while in the PMD group, these indices increased. Both in the 2nd and the 3rd trimester, we had a significant statistical difference between the two groups (p<0.001). Regarding the degree of prediction of the changes that occurred at this level, we found a good statistical correlation. A higher degree of positive predictability is noted, for IPVA-PI, but also for UA-PI, but with better sensitivity (72.27%) for UA PI in the 2nd trimester. CONCLUSIONS: We can conclude that both Doppler measurements, IPVA and UA can be used to evaluate and detect pregnancy complications that belong to PMD, preeclampsia, and/or fetal growth restriction.

The path of universities to sustainability: Students perspectives during the COVID-19 pandemic.

Background: The COVID-19 pandemic baffled the traditional educational system and the face-to-face educational process, shifting to the online environment. Almost all university activities were carried out online for a period of time, which put pressure on university strategies, including sustainability. To maintain the international ranking of universities applying a sustainability strategy, the largest and most representative university in Romania continued to implement the principles of sustainability in its activities during the COVID-19 pandemic, thus fostering a positive, strong, and trustworthy image amongst its main group of stakeholders, namely students. Objective/Aim: The aim of this paper is to determine to what extent students related to the university's sustainable strategy during the COVID-19 pandemic and to assess whether students could rely on their university to integrate sustainability-related strategies into the overall university strategy. Methods/Instruments: The authors propose a conceptual model to generate trust in the sustainable practices, which is analyzed with the help of structural equations in SmartPLS. Results: The results highlight the fact that the students continued to adopt sustainability principles during the pandemic, expressing their preference that the university continue to implement its sustainability strategy, although the focus was on the safety measures generated by the new context. This strategy focusses on sustainable practises, green mobility, and consumption, and, of course, on the sustainable initiatives that address them. Conclusions/implications: The article presents research based on stakeholder theory, emphasizing the numerous implications for higher education institutions, which can adopt different good practices with a view to improving stakeholder trust and satisfaction.

Gender Discrimination Insights in Romanian Accounting Organisations.

The paper investigated gender inequalities in the accounting profession in the specific context of an eastern European country, in the past heavily dominated by men, but now with a substantial number of women. Thus, we used a questionnaire survey explored the relationship between women's perception of discrimination and institutional and individual characteristics. Institutional factors such as rewards practices, opportunities, and access to top positions in organisations influence women's perception of gender discrimination. Concerning the intersectionality of individual characteristics interaction, our results revealed that women professionals with higher academic achievement and children are more likely to report discrimination. In contrast, women professionals with a higher-ranking position in organisations and those working in the public sector are less likely to report it compared with those from the private sector. These findings are of interest from a theoretical perspective to those who explore gender-related issues in general and in the case of accounting organisations. They are also helpful from a practical standpoint regarding the management of these accounting organisations, which should ensure gender-equitable policies for employees.

Maternal obesity and placental pathology in correlation with adverse pregnancy outcome.

Maternal obesity is associated with increased maternal and fetal morbidity and mortality, with an increased risk of gestational diabetes mellitus (GDM) and preeclampsia (PE). This prospective study histopathologically analyzes the placentas obtained from 34 pregnant obese women studied between October 2016 and May 2020. The 10 cases of term placentas from obese pregnancies with GDM and the 12 cases with PE were examined by the Hematoxylin-Eosin (HE), Masson's trichrome (MT) and Periodic Acid-Schiff-Hematoxylin (PAS-H) classical stainings, and by the immunohistochemical evaluation and compared to placentae from uncomplicated term obese pregnancies (12 cases). We did not meet placental histopathological (HP) abnormalities that we could classify as characteristic only for the state of obese pregnancy, but we did find placental changes associated with PE and GDM, in the context of obese pregnancy. In the case of association with PE, there were common lesions, manifested by intra- and perivillous fibrinoid deposition, calcification, and placental infarction area, to which were added numerous syncytial knots. In the case of obese pregnancy associated with GDM, we found, in addition to common placental lesions of obesity, intravillositary vascular edema and in the terminal villi appearing chorangiosis. This study revealed a number of HP changes that occur in maternal obesity, even in uncomplicated obese pregnancies. A characteristic of obese pregnancies associated with PE was the presence of numerous syncytial knots, and in obese pregnancies associated with GDM, the most common HP lesion was placental chorangiosis. Certainly, we cannot conclude that these HP lesions are specific to a particular pathology, but they belong primarily to the status of maternal obesity.

Doppler Uterine Artery Ultrasound in the Second Trimester of Pregnancy to Predict Adverse Pregnancy Outcomes.

PURPOSE: To determine in uterine artery (UtA) the mean pulsatility index (PI), systolic/diastolic (S/D) ratio and the presence/absence of notch in the second trimester of pregnancy, with normal or abnormal pregnancy outcome. MATERIAL AND METHODS: We performed an analysis of 135 cases with high risk pregnancy in Obstetrics and Gynecology Department of The Municipal Hospital Filantropia, Craiova, between October 2016 and May 2020. The ultrasound evaluation in the second trimester was performed during the second trimester morphology scan, or after this, but up to 24 weeks of pregnancy. RESULTS: The study showed only in the case of early preeclampsia (PE) a statistical significance for mean PI-UtA percentiles in the second trimester. In the other studied categories of pregnancy outcome, even we did not have a statistical significance, we found a specificity of 75% and positive predictive value of 88.89% in late PE. The presence of notch in the second trimester was statistically significant (p value <0.05) in the case of premature birth (PB) and early PE. A positive predictive value of 77.50% we found only in case of late PE. CONCLUSIONS: Our results show that routine Doppler screening of the uterine arteries during the second trimester did not make an accurate prediction of fetal growth restriction, preeclampsia or preterm birth. However, we believe that the present study results prove that this screening may select a population with increased risk of adverse outcome, which would give them the opportunity to benefit from an early intervention.

Impact of Digitalization on Customers' Well-Being in the Pandemic Period: Challenges and Opportunities for the Retail Industry.

Order increases, supply chain disruptions, changing customer behavior, store closures, and more that have been caused by the coronavirus epidemic (COVID-19) will undoubtedly affect the online commerce forms of business. The coronavirus pandemic has a significant impact on digitalization and customer experience and well-being in mobile commerce. Since the beginning of the coronavirus pandemic, online sales and the number of online shoppers using wireless internet-enabled devices have increased tremendously. The article develops, an experimental study that captures COVID-19 and digital commerce's impact in terms of customers' experience and well-being during the pandemic period. The study explores the synergy between technology evolution and the effects of the COVID-19 pandemic on customers' behavior based on survey data collection and the technology acceptance model (TAM). The results reveal that, for millennials, digital commerce seems to be the typical way of shopping and paying in the pandemic period since the oldest generations adopted in a smaller proportion the use of mobile devices for shopping and payments. Besides, retailers are confronted with great challenges raised by millennials' expectations. The result confirms four of the six hypotheses based on the technology acceptance model (TAM). As a result, it shows that the easiness of use, trust, mobility, and customer involvement influences the behavioral intention of the customer to use mobile commerce, and that usefulness and customization does not influence the behavioral intention.