bluuebunny/crossref_metadata_2025 huggingface dataset:
Undistorted, (Un)fair Competition, Consumer Welfare and the Interpretation of Article 102 TFEU
Authors: Chirita Anca Daniela
Published: April 2022

This article explains the Lisbon Treaty’s provisions relating to competition policy and offers a dynamic interpretation of Article 102 Treaty on the Functioning of the European Union (TFEU), which could justify the consideration of an effects-based approach to those anti-competitive practices that are most harmful to the final consumers under the economic theory of consumer welfare. The implications of ‘consumerprotection requirements’ must shed special light on Article 12 TFEU. Therefore, this article examines the possibility of shifting the courts’ teleological interpretation of Article 102, which is based on Protocol 27’s ‘undistorted competition’, towards a legal balancing test of the Treaty’s objectives. It also highlights the interpretation of undistorted competition within the internal market and the interplay between EU ‘free’ and fair and unfair competition rules. The balance of EU competition law should, therefore, be performed between Article 119 TFEU’s free competition or economic freedom-based competition and Article 12 as ensuring a ‘high level of protection’, as embedded in the Treaty, for the final consumers. This article explains how consumer-protection requirements must be defined narrowly so that Article 12 may be applied to Article 102. Article 12 can, therefore, mandate a high level of consumer protection for the final consumers in implementing such a specific policy as the abuse of dominance.
Comparative Analysis of Competition Laws on Buyer Power in Korea and Japan
Authors: Choi Yo Sop , Fuchikawa Kazuhiko
Published: April 2022

Competition authorities frequently focus more on the effects of the power of sellers than the power of buyers. Competition laws and policies that address the issue of buyer power are also diverse across different jurisdictions. This raises difficult problems for assessing the practice of buyer power. The competition authorities in the Republic of Korea (henceforth, Korea) and Japan have scrutinized a number of cases of buyer power involving large retail businesses. This article examines the current application of the laws relating to buyer power in Korea and Japan, by a comparative study, in order to contribute to improved implementation of competition law. This article analyses the existing competition laws on buyer power and their implementation in Korea and Japan to discern the common issues arising from their similar regulatory structure. These include: (1) the problem of overlap between the provisions on abuse of market dominance or monopolization and the provisions on unfair business practices (UBPs); (2) the problem of the presumption of superior bargaining position of large retail businesses; and (3) the issue of balancing tests of the positive and negative effects of buyer power. We argue that the distinctive approaches to buyer power under the competition laws of Korea and Japan reflect incentives different from those of other competition regimes with regard to the different legislative structure. This article finally gives further suggestions focusing on practical matters.
Competition Law versus FRAND Terms in IT Markets
Authors: Weber Rolf H.
Published: April 2022

Standardization changes our daily life - makes it more comfortable. Because of standardization, cellular phones or computers from different brands can communicate with each other. In other important economic fields, standardization also plays a very crucial role, from electricity plugs to railway tracks. As standardization becomes more and more important, the tension between intellectual property rights (IPR) (e.g., patent law) and competition law increases, as, for example, discussed in relation to FRAND (fair, reasonable and non-discriminatory) terms. This article focuses in the first part on the importance of standardization and regulation. After that, the FRAND commitment will be discussed. Further to the patent hold-up problem, the paper tackles issues of fairness and reasonableness of royalties before or after a technology has been implemented in a standard. Looking at the abusive behaviour in the technology markets in the third part, the paper shows that FRAND is one instrument to restore competition, if actively enforced by competition authorities.
Structural Remedies in EU Antitrust and Merger Control
Authors: Wang Wei
Published: April 2022

In both antitrust and merger cases, remedies serve the same purpose, namely to stop the infringement of competition and restore competition. However, the practice of remedy policy in these two areas is varied, for example, structural remedies are preferred in merger cases but strictly limited in antitrust. This article analyses the extremely different positions of structural remedies in antitrust and merger control. It also reviews the facts and remedies of the E.ON Electricity case, the first antitrust decision with structural remedies adopted or imposed by the European Commission. It argues that EU competition law is not a coherent system for while antitrust enforcement is too weak, merger control is too strong. Furthermore, this article argues that the deterrent power of Article 102 should be reinforced to increase its weight in fighting unilateral anticompetitive behaviours, but merger control should show more tolerance to the efficiency-enhanced mergers.
Recidivism in EU Antitrust Enforcement: A Legal and Economic Analysis
Authors: Wils Wouter P. J.
Published: April 2022

Recidivism has, in the last few years, attracted much attention and controversy in the context of EU antitrust enforcement. The treatment of recidivism by the European Commission and the EU Courts has often been criticized, and the observed incidence of recidivism has led to some questioning of the overall effectiveness of EU antitrust enforcement. This article first clarifies the concept of recidivism and then analyses the treatment of recidivism as an aggravating circumstance in setting the amount of fines, the interplay between recidivism and leniency, and the difficulty of drawing conclusions as to the overall effectiveness of EU antitrust enforcement from the observed incidence of recidivism.
Margin Squeeze in the Telecommunications Sector: A More Economics-based Approach
Authors: Gohari Ramin Silvan
Published: April 2022

A margin squeeze occurs when a vertically integrated company, dominant in the supply of an indispensable upstream input, pursues a pricing policy which prevents downstream competitors from trading profitably, thereby leading to their ultimate exclusion from the downstream market.

In the telecommunications sector, where large ex-State firms still enjoy considerable market power, margin squeeze has long been frequent. Interestingly, the United States and the European Union have tackled this problem in considerably different ways. Dismayed by the idea of an antitrust court intervening in a company's price setting, the US Supreme Court held that margin squeeze was exclusively the domain of regulation. Conversely, the Court of Justice of the European Union has endorsed a modern economics-based approach enabling competition authorities to engage in a coherent and verifiable antitrust assessment of the price differentials that potentially amount to a margin squeeze.

This paper will argue that (1) the economics-based approach is the right solution in the European context, but that (2) this approach will only lead to convincing results if it includes a rigorous and transparent analysis of the effects on competition and consumers.
Strategic Underinvestment as an Abuse of Dominance under EU Competition Rules
Authors: Faella Gianluca , Merlino Pietro
Published: April 2022

The latest frontier of the essential facility doctrine under EU competition law is the use of antitrust rules to impose on dominant firms a duty to invest in infrastructure development. While a genuine lack of capacity has traditionally been considered an objective justification for a refusal to grant access to an essential facility, the decisions issued by the Italian Competition Authority in Eni/TTPC and by the Commission in GDF Suez and Eni have questioned the dominant firms' freedom to decide whether, to what extent and under what conditions to invest in infrastructure development. In all the above-mentioned cases, the antitrust authorities were ultimately concerned with the dominant firms' alleged failure to make adequate investments in infrastructure development, as a consequence of the conflict of interest inherent in vertical integration. However, the objections raised by the Italian Competition Authority and by the Commission rest on profoundly different - and, to a certain extent, contradictory - grounds. Whereas the Eni-TTPC decision appears to have been heavily influenced by an extremely complex and peculiar set of facts, the GDF Suez and Eni decisions were based on the essential facility doctrine. The broad and flexible interpretation of this doctrine set forth by the Commission seems to have further lowered the threshold above which antitrust authorities may find abusive a refusal to grant access to an important facility. Furthermore, the Commission introduced a notion of strategic underinvestment based on the independent facility operator test, which seems extremely discretionary and difficult to apply.
Beyond Legal Transplant: Chinas Shopping Around Approach and Formation of Anti-Monopoly Law
Authors: Wang Lei , Krizic Ivo
Published: April 2022

The aim of the article is to analyse the internal and external drivers in the formation of new competition regimes. Drawing on the concepts of external governance and international policy diffusion, the article takes the enactment of China’s Anti-Monopoly Law (AML) as a case study to scrutinize the various channels through which emerging competition policy regimes have been shaped. It first illustrates the limits of recent research suggesting that the AML is essentially the product of EU competition rule export. Recognizing the specific features of China’s competition regime, we then investigate the domestically driven process of inspiration from abroad and customization to domestic conditions. By highlighting the diversity of sources in domestically driven rule selection, the article makes a first step towards capturing the complex diffusion process in international competition policy.
Non-Controlling Minority Shareholdings and EU Merger Control
Authors: Gassler Martin
Published: April 2022

Acquisitions of non-controlling minority shareholdings do currently not trigger the mandatory notification obligation of the EU Merger Regulation (EUMR) Although the Commission can partly apply Articles 101 and 102 TFEU to those acquisitions, it takes the view that the lack of a notification obligation constitutes an enforcement gap that it wants to close by expanding the jurisdictional scope of the EUMR The Commission’s main supporting argument is an economic one and based on various theories of harm. This article examines how strong, robust and convincing the economic case made by the Commission is and whether it justifies the additional regulatory and administrative burden that would be entailed by such expansion.
Competition, Market Power and Third-Party Tracking
Authors: Ezrachi Ariel , Robertson Viktoria H.S.E.
Published: April 2022

The prevalence of third-party tracking in our modern ecosystem cannot be ignored. Trackers, on our websites and apps, enable multi-sourced data gathering, at distinct volume, variety, velocity and veracity. While numerous operators engage in tracking, the majority of these trackers are controlled by a small number of data giants. In this article we consider the rise and growth of this industry, the power it has bestowed on a handful of platforms, and the possible implications for consumer welfare and competition.
Why Managers Engage in Price Fixing? An Analytical Framework
Authors: Monnier-Schlumberger Constance , Combe Emmanuel
Published: April 2022

This article analyses the incentives for a manager to engage in a cartel, by mobilizing the framework of the ‘economics of crime’. We apply a cost-benefit analysis, relating to the decision of starting and/or remaining in a cartel, at an individual level, including psychological and behavioural factors. It also examines the various solutions – both at company and public authority level – to limit individual incentives to engage in this type of practice, and the role of public policy, in the broad sense of the term, in preventing these behaviours.

antitrust policy, public policy, cartels, criminal antitrust enforcement, leniency, dissuasive fines, whistleblowing, illegal Behaviour, corporate fraud, incentives
COVID-20: The Comfort Letter Is Dead. Long Live the Comfort Letter?
Authors: Henry David , Buhart Jacques
Published: April 2022

On 8 April 2020 the European Commission issued its first comfort letter for a competitor collaboration in the context of its Temporary Framework in response to Covid-19. The issuance of this comfort letter is remarkable, particularly given the paradigm shift from the system of comfort letters before 2003 under Regulation 17 towards a system of self-assessment under Regulation 1/2003. While the EC has since ushered in comprehensive guidance – via block exemptions and guidelines – to assist businesses with the task of self-assessing their compliance with the EU competition rules, such guidance still leaves too much room for error und uncertainty. This is notably the case with respect to non-full function joint ventures, and in particular those that are long-term, complex and high in value. A corollary of this is that, rather than enter into pro-competitive collaboration for fear of antitrust repercussions, companies may prefer to desist. With a view to achieving enhanced legal certainty for such joint ventures, and capitalizing on the good work it is currently doing under the Temporary Framework, the EC may wish, therefore, to give meaningful thought to the introduction of a more generalized system of comfort letters – at least for non-full function joint ventures.

COVID-19, Temporary Framework, comfort letter, non-full function joint venture, Regulation 17, legal certainty, Regulation 1/2003, Article 101(3), self-assessment, Informal Guidance Notice
The German Facebook Saga: Abuse of Dominance or Abuse of Competition Law?
Authors: Weber Franziska , Van den Bergh Roger
Published: April 2022

This article provides a critical analysis of the German Facebook case and stresses the limits of competition law. Facebook’s terms and conditions regarding the use of Off-Facebook data were qualified as an exploitative abuse at various stages of the German Facebook proceedings. However, it is far from certain that Facebook would have written its terms any different if it was operating on a competitive market. From an economic viewpoint the market failure at hand is a pervasive information asymmetry rather than market power. Therefore, it is doubtful that the correct response lies within competition law. If competition rules must be rewritten in order to cope with market failures in digital markets, there is a serious risk that the abuse found is not an abuse of market power but an abuse of the market power provisions in competition law. Alternative routes that can be found in consumer contract, unfair competition or data protection laws might be viable options. The latter rules can be applied without a complicated finding of causality between market dominance and the use of ‘unfair’ contract terms. Admittedly, also the information paradigm can be called into question but amending rules of contract law avoids Herculean interpretations of competition law that go against a broadly supported ‘more economic approach’. Abusing competition law or enhancing contract law to improve the efficiency of digital markets, that is the question.

Facebook case, goals of competition law, market failures, data law, information disclosure, consent, signing-without-reading problem, abuse of dominance, unfair contract terms, unfair commercial practice
Predicting the Future With Social Media
Authors: Kenny Richard
Published: April 2022

In recent years, social media has become ubiquitous and important for social networking and content sharing. And yet, the content that is generated from these websites remains largely untapped. In this paper, we demonstrate how social media content can be used to predict real-world outcomes. In particular, we use the chatter from Twitter.com to forecast box-office revenues for movies. We show that a simple model built from the rate at which tweets are created about particular topics can outperform market-based predictors. We further demonstrate how sentiments extracted from Twitter can be further utilized to improve the forecasting power of social media
Direct Direct Apology Strategies and Their Lexicogrammatical Realizations in English Conversations
Authors: Ngo Thi Hien Trang , Luu Quy Khuong
Published: April 2022

One of the most prevalent speech acts across languages and cultures is apologizing. It plays an important role in conversations which helps maintain social relationships. Many researchers in this field have proposed several apology strategies; however, this article aims to examine the direct apology strategies and the lexicogrammatical realizations of utterances, including apologies in English conversations. This is a descriptive qualitative study that gathered data from conversations extracted from romance and family film scripts. This study was also supported with quantitative information in order to seek the answers to three research questions. The findings show that expression of regret was the most prominent direct apology strategy, which the characters took advantage of in English-language conversations in film scripts. In terms of lexico-grammar, the utterances with the occurrence of sorry and its other realizations appeared most frequently.
A Study of Mobile Devices’ Acceptance in Developing EFL Listening Skill among Vietnamese High School Learners
Authors: Nguyen Thi Mo , Teng Huei Chun
Published: April 2022

This research explored mobile devices' acceptance in EFL listening skills among Vietnamese high school learners by utilizing the updated Unified Theory of Acceptance and Use of Technology (UTAUT). The data collection method used was semi-structured interviews and quantitative surveys with 260 students from several high schools located throughout central and southern Vietnam. It was revealed that high school learners in Vietnam had a positive perspective toward the integration of mobile devices to develop their EFL listening skills and showed their readiness to adopt these educational tools in the future to this skill, owing to the educational benefits offered by these devices and the fruitful achievement achieved by learners. The findings also indicated that the constructs of the UTAUT positively correlated with each other. Specifically, effort expectancy, performance expectancy, facilitating condition, social influence, behavioral intention, and attitude had a positive correlation with one another. Moreover, the outcomes suggested that this model could explain up to 63% of the variance in learners' behavioral intention to adopt mobile devices to enhance the development of their EFL listening skills. Furthermore, the strongest predictor of behavioral intention was attitude, followed by performance expectancy and facilitating condition. Additionally, performance expectancy was discovered to best predict attitude, subsequently facilitating condition and social influence. Based on the main findings, some implications were addressed.
Polymorphism in promotor region of IL6 gene as a predictor for severity in COVID -19 patients
Authors:   Medical Microbiology & Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Aladawy Shaimaa , Adel Lamiaa ,   Medical Microbiology & Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Abdel Salam Shimaa ,   Medical Microbiology & Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Raafat Riham ,   Chest Diseases Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt., Khattab Mona ,   Medical Microbiology & Immunology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Published: April 2022

SARS-CoV-2 is the causative agent of coronavirus disease started in 2019 (COVID-19). IL-6 gene is located on chromosome 7. A considerable number of polymorphisms was identified in the IL-6 gene. Polymorphism in IL-6–174C allele is associated with a higher level of IL-6 production and this may lead to severity of in COVID-19 patients. We intended to investigate the role of polymorphism in the promotor region of IL-6 gene as a predictor for disease severity in COVID-19 patients. Fifty patients diagnosed with COVID-19 and classified into moderate and severe groups and twenty apparently healthy controls were enrolled in the study. Genotyping for IL-6 gene (-174G/C) was done by using TaqMan SNP genotyping assay for all studied groups. The distribution of different IL-6-174G/C genotypes among COVID-19 patients was 76% for GG genotype, 22% for GC genotype and 2% for CC genotype. Whereas the distribution of genotypes among the control group was 80% for GG genotype, 20% for GC genotype and 0.0% for CC genotype. The G allele distribution was 87% and 90% in the patients and control groups, respectively, while the C allele was 13% and 10% in the patients and control groups, respectively. There was no significant statistical association between different genotypes, severity and treatment outcome in the patients group. In conclusion, this study showed no relation between -174G/C IL-6 gene polymorphism and disease, in COVID-19 patients.
Descripción y análisis del uso del Componente de Salud Dental del Índice de la Necesidad de Tratamiento Ortodóncico en pacientes en dentición mixta y permanente joven
Authors: Limongi Vallenilla Isabella , Marcano Torrents Gisela Eugenia , Méndez Pedro , Medina Díaz A. Carolina
Published: April 2022

El Índice de Necesidad de Tratamiento Ortodóncico (IOTN) permite cuantificar la necesidad de tratamiento dependiendo de la severidad de la maloclusión, tomando diferentes indicadores específicos de maloclusión. Objetivo: describir y analizar el uso del Componente de Salud Dental del Índice de Necesidad de Tratamiento Ortodóncico en pacientes en dentición mixta y permanente joven. Materiales y métodos: estudio de revisión narrativa que se basó en la búsqueda de artículos científicos en las bases de datos: PubMed, Scielo, ResearchGate, ScienceDirect, DOAJ y Scopus. Resultados: El IOTN es un índice que aporta datos importantes para clasificar y categorizar las necesidades de tratamiento ortodóncico y patologías oclusales según la severidad, en la indicación de tratamiento ortodóncico; además ha sido utilizado como herramienta epidemiológica y se debe tomar en cuenta la utilidad que tiene para los servicios públicos. Incluye diferentes indicadores específicos de maloclusión, avalados como necesidades terapéuticas, clasificándolos según su severidad: overjet o sobremordida horizontal, overjet inverso o sobremordida horizontal negativa, mordida cruzada anterior y posterior, contactos dentarios desplazados, mordida abierta anterior y posterior, overbite o sobremordida vertical, oclusión pre y post normal, hipodoncia, diente impactado, diente retenido, labio y paladar hendido u otras malformaciones craneofaciales, dientes parcialmente erupcionados, inclinados e impactados contra dientes adyacentes, dientes supernumerarios, agenesia dental. Conclusión: El IOTN es un índice concreto, práctico y reproducible por odontólogos entrenados. Su uso favorece el diagnóstico oportuno de maloclusiones y la determinación de necesidad de tratamiento de cada paciente, priorizando las presentaciones más severas de maloclusión en la planificación terapéutica
Valor del protocolo abreviado de resonancia magnética de mama en el cribado de pacientes de moderado / alto riesgo.
Authors: Ramírez Hernández Yariadny Alejandra , Capecchi Alcira
Published: April 2022

El cáncer de mama es el más común entre las mujeres en todo el mundo: representa el 16% de todos los cánceres femeninos. Se diagnostica a más mujeres con cáncer de mama que ningún otro cáncer y se ha convertido de nuevo en la principal causa de cáncer de todo el mundo desplazando al de pulmón (1). En 2020, la Organización Mundial de la Salud (OMS) reportó más de 2,2 millones de nuevos casos y 685.000 mujeres fallecieron como consecuencia de esa enfermedad., cerca de una de cada 12 mujeres enfermarán de cáncer de mama a lo largo de su vida. La detección precoz sigue siendo la mejor estrategia para mejorar el pronóstico del cáncer de mama, y la mamografía sigue siendo el método estándar de detección en mujeres mayores de 40 años, con una sensibilidad del 70% y una especificidad del 92% en la población general.  Diferentes estudios han demostrado que la detección con mamografía tiene un efecto sobre la mortalidad por cáncer de mama. A pesar de esto, la mamografía ha demostrado un bajo rendimiento en la detección de cáncer en pacientes con tejido mamario denso, para contrarrestar este problema, se han propuesto otras modalidades de estudios de imagen, como la tomosíntesis, la cual es una variación de la mamografía que genera imágenes tridimensionales, el ultrasonido mamario, que es útil como estudio complementario e imágenes por resonancia magnética (RM), que actualmente se propone como una alternativa eficaz de detección en la población de alto riesgo.
Experiencia de Reconstrucción Funcional en Cirugía de Cabeza y Cuello
Authors: Mijares Briñez Alirio Jose , Sánchez G Aída del Carmen
Published: April 2022

Objetivo: Evaluar preservación funcional pacientes sometidos a cirugías reconstructivas de cabeza y cuello de la unidad de cabeza y cuello del CMDLT, enero-diciembre 2021. Metodología: Estudio observacional, descriptivo, tipo serie de casos, longitudinal contemporáneo. Se evaluaron pre y post quirúrgica las funciones de apertura y cierre oral, fase I y II deglutoria, articulación del lenguaje oral, competencia velofaríngea, indemnidad de nervios laríngeos recurrentes y superior por aducción y abducción de cuerdas vocales, indemnidad motora branquial del nervio facial, espinal e hipogloso. Resultados: 40 pacientes que totalizan 52 procedimientos. 55% pacientes masculinos y 45% femeninas; promedio de edad 49, 95 años. Los procedimientos fueron 7 resecciones oncológicas de tumores en cavidad oral, 5 resecciones en pirámide nasal y senos paranasales, 2 resecciones oncológicas de tumores faríngeos, 2 laringectomías parciales, 11 tiroidectomías, 15 disecciones cervicales, 10 resecciones oncológicas de tumores de glándulas salivales mayores. 4 pacientes con eventualidades post operatorias; 2 compromiso de la articulación de la palabra y 2 pacientes con parálisis transitoria del nervio facial; 90% de mantenimiento de función en el postoperatorio inmediato y 98% en el postoperatorio mediato. Conclusiones: Modalidades reconstructivas van desde el cierre primario hasta colgajos libres.  Mejores resultados oncológicos, y funcionales se traducen en mejor en la calidad de vida de los pacientes y reinserción social. Palabras claves: Reconstrucción, resultados funcionales, cáncer de cabeza y cuello.
Filial Nationalism: How the Trump Administration Impacted Chinese International Students
Authors: Lin Fiona
Published: April 2022

Historically, Chinese international students have chosen the United States as their top destination to study abroad. Many of those ultimately return to their mother country, despite years of Western education, hoping to integrate China into the developed world. In 2011, Vanessa Fong depicted this strong moral attachment as “filial nationalism”. However, this idea took on a different form under the Trump administration – the desire to study in the United States diminished. During the pandemic era, Chinese descendants retain a strong sense of belonging to their mother country, but their interest in the United States has significantly declined. By examining the stringent visa restrictions, increased anti-Asian sentiments, and the United State’s immediate response to COVID-19 – factors that contribute to Chinese international students’ growing reluctance to study in the United States – this essay draws on Fong’s previous longitudinal study and analyzes filial nationalism in recent contexts.
Emotional Analysis in Designing Tourism Experiences Through Neuromarketing Methods: The Role of Uncontrollable Variables and Atmosphere: A Preliminarily Study
Authors: Giraldi Luca , Sestino Andrea , Cedrola Elena
Published: April 2022

The role of emotions in the tourist experience is becoming increasingly important in designing experiences to guarantee maximum involvement and satisfaction for tourists/customers. Previous literature has shown how atmosphere (e.g., visual, auditory, olfactory, tactile variables) may influence consumers’ satisfaction toward the proposed tourist experience. However, in some offers (e.g., theatrical performances, theme parks, outdoor experiences), such a relationship may be influenced by the role of “uncontrollable” variables, as for those variables related to the weather condition. Though an experimental research design based on a neuromarketing tool (face-coding), this paper is aimed to shed light on those variables in influencing consumers’ emotions, and thus their satisfaction regarding their experience. More specifically, the study has been conducted by testing a non-invasive emotional analysis tool able to associate in real-time the facial expressions of the participants with the emotions captured during the performance (e.g., as for disgust, fright, anger, boredom, neutral, surprise, happiness), as well as the emotional valence such as positivity or negativity of the emotion experienced. Results enlighten the role of tourism atmosphere in positively influencing consumers’ emotions, and thus their satisfaction also explaining the role of uncontrollable variable in magnifying such effect. Essential insights for marketers and managers in designing tourism experiences are discussed.
Nonoperative management of high-grade splenic injury. A review of the literature and case report
Authors:   ", Socea Bogdan ,   Sf. Pantelimon",   ",   Emergency Clinical Hospital, Department of  General Surgery, ",   ",   Carol Davila",   ",   University of Medicine and  Pharmacy, Bucharest, Bogaciu Cristiana ,   "Sf. Pantelimon"" Emergency Clinical Hospital, Department of  General Surgery, Carap Alexandru C. ,   "Sf. Pantelimon"" Emergency Clinical Hospital, Department of  General Surgery, ""Carol Davila"" University of Medicine and  Pharmacy, Bucharest, Baleanu Vlad D. ,   "Sf. Pantelimon"" Emergency Clinical Hospital, Department of  General Surgery, Davitoiu Dragos V. ,   "Sf. Pantelimon"" Emergency Clinical Hospital, Department of  General Surgery, ""Carol Davila"" University of Medicine and  Pharmacy, Bucharest, Tenea Cojan Tiberiu S. ,   University of Medicine and Pharmacy of Craiova, Department of Surgery, CFR Hospital of Craiova, Paun Ion ,   University of Medicine and Pharmacy of Craiova, Department  of Surgery, CFR Hospital of Craiova, Constantin Vlad D. ,   "Sf. Pantelimon" Emergency Clinical Hospital, Department of General Surgery, "Carol Davila" University of Medicine and Pharmacy, Bucharest
Published: April 2022

Splenic injuries causedby traumatic events are common in the emergency departments, mostly because the spleen is frequently affected in trauma. The lesions of the spleen can be diagnosed using a contrast enhanced computed tomography and based on the results, the injury of the spleen is graded. The management of the patient can be operative or nonoperative. The choice of treatment is decided by the hemodynamic stability of the patient.
Current treatment of posttraumatic stress disorder – A review of therapeutic guidelines and good practice recommendations
Authors:   Dr. Carol Davila University of Medicine and Pharmacy, Dr.Carol Davila University Emergency Central Military Hospital, Universitatea Titu Maiorescu, University of Bucharest, Vasiliu Octavian , Vasile Daniel , Mangalagiu Andrei , Petrescu Bogdan , Candea Cristian , Tudor Corina , Ungureanu Daniela , Miclos Madalina , Draghici Alina , Florescu Catalina , Bratu-Bazic Roxana
Published: April 2022

A unique approach to the treatment of posttraumatic stress disorder (PTSD) is difficult to support, because of the complexity and heterogeneity of this pathology. Multiple evidence-based guidelines for PTSD treatment exist, elaborated by prestigious institutions around the world, but a certain level of the inconsistency of their recommendations appears when these sources are compared with each other. Therefore, a review of current guidelines and extraction of the most supported by evidence recommendations is considered important for clinical practice, due to the need to approach such complex cases as PTSD-diagnosed patients in a stepwise manner. Structured monitoring of the clinical status during the treatment is also an important and rather neglected aspect of the case management in PTSD, and the necessity of follow-up visits for efficacy and tolerability should be taken into consideration. Psychotherapy (especially cognitivebehavioral oriented therapies and eye movement desensitization and reprocessing therapy) is supported by evidence as a first-line approach, as well as certain antidepressants, like the selective serotonin reuptake inhibitors and venlafaxine. Many second-line pharmacological agents and psychotherapies are also available, but there is an obvious need for more pragmatic trials with PTSD patients.
Osteoporosis and the fracture risk in systemic lupus erythematosus
Authors:   Department of Internal Medicine and Rheumatology “Dr. Carol  Davila” University Central Emergency Military Hospital,  Bucharest, Romania, Ciobica Mihai , Ionescu Oana ,   Department of Internal Medicine and Rheumatology “Dr. Carol  Davila” University Central Emergency Military Hospital,  Bucharest, Romania, Sandulescu Bianca ,   Department of Internal Medicine and Rheumatology “Dr. Carol  Davila” University Central Emergency Military Hospital,  Bucharest, Romania
Published: April 2022

Osteoporosis is a systemic skeletal condition, characterized by a microarchitectural degradation of bone density and quality, giving low resistance and an increased risk of fracture. Osteoporosis is an important public health problem, with considerable medical, social and economic impact. Data accumulated in recent years demonstrate a significant incidence of osteoporosis in the group of patients with major collagen diseases; of these, Systemic Lupus Erythematosus (SLE) is the prototype of autoimmune disease in which osteoporosis and associated complications have a significant clinical impact. Although additional studies are needed to deepen the relationship between SLE - osteoporosis - associated fractures, we believe that these patients should be managed from the early stages of the disease.
Medical devices in current medicine
Authors:   Carol Davila University of Medicine and Pharmacy, Military Medical Research Center  “Titu Maiorescu” University, Bucharest, Romania, Ordeanu Viorel , Ionescu Lucia ,   Military Medical Research Center, Bucharest, Romania, Dumitrescu Victoria ,   Military Medical Research Center, Bucharest, Romania, Pricop Roxana ,   Military Medical Research Center, Bucharest, Romania, Neagu Razvan ,   Military Medical Research Center, Bucharest, Romania, Popescu Diana ,   Military Medical Research Center, Bucharest, Romania
Published: April 2022

The treatment of diseases is based on pharmacological and non-pharmacological means, but adequate devices are needed for their application. Medicine uses a wide range of medical devices. Currently, many medical devices are used, many of them being disposable. As recognition of the importance of medical devices, the national authority of the drug is the ANMDM (National Agency for Medicines and Medical Devices). Medical devices are indispensable for therapy, and their evolution has led to an extraordinary diversification of the field and the emergence of industry related to the pharmaceutical industry, with specific laws and regulations.
Emergency surgery for complicated colorectal cancer – What we choose: a retrospective cohort study
Authors:   Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Constantin Georgiana , Firescu Dorel ,   Dunarea de Jos University, Faculty of Medicine and Pharmacy, Galati, Romania   Sf. Ap. Andrei Clinical Emergency County Hospital, Galati,  Romania, Voicu Dragos ,   Dunarea de Jos University, Faculty of Medicine and Pharmacy, Galati, Romania, Stefanescu Bogdan ,   Dunarea de Jos University, Faculty of Medicine and Pharmacy, Galati, Romania   Sf. Ap. Andrei Clinical Emergency County Hospital, Galati,  Romania, Mihailov Raul ,   Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Serban Cristina ,   Dunarea de Jos University, Faculty of Medicine and Pharmacy, Galati, Romania   Sf. Ap. Andrei Clinical Emergency County Hospital, Galati,  Romania, Panaitescu Eugenia ,   Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, Bîrlă Rodica ,   Carol Davila University of Medicine and Pharmacy, Bucharest, Romania  Sf. Maria Clinical Hospital, Bucharest, Romania, Constantinoiu Silviu ,   Carol Davila University of Medicine and Pharmacy, Bucharest, Romania  Sf. Maria Clinical Hospital, Bucharest, Romania
Published: April 2022

Introduction: Despite the progress that has been made regarding the diagnosis, a worrying percentage of patients are still admitted in an emergency, with complicated colorectal tumors, which often require interventions without a curative visa. The study aims to analyze the factors involved in choosing the type of surgical treatment. Patients and methods: We included in the study a group of 431 patients admitted and operated in an emergency for complicated colorectal cancer in the Surgery II Clinic of the Clinical Emergency County Hospital “Sf. Ap. Andrei” from Galați, between 2008-2017. We retrospectively analyzed the patients’ data and we made statistical correlations between the type of emergency surgery and epidemiological, clinical, paraclinical, and intraoperative factors. Results: Colostomy was mainly practiced in older patients.
Comparative study on the independent learning activity of young people in the bachelor's and master's programs
Authors:   Department of General Medicine, Medical Military Institute, Bucharest, Romania, Trifu Antonia I. , Costea Radu V. ,   Department of General Surgery, „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Bejan Roxana T. ,   Teaching Staff Training Department, The National University of  Physical Education and Sports, Bucharest, Romania
Published: April 2022

During the late adolescence, it can be reached the highest level of mental operative functions and other intelligent human manifestations. Abstract mental operations can be done at this level: synthesis of syntheses, generalization of generalizations, abstraction of abstractions. Students go through many attempts to find which is their personal style of learning new materials, new contents. The study was conducted on a number of 31 participants. The group was divided into two subgroups: 16 students in the 5th year at Faculty of General Medicine and 15 master students in the second year at University of Sports, Sports Performance program. The used instrument consists of 21 questions (11 questions are about the individual studying process of the participants and 10 are about their beliefs about the teaching process of academics in courses), along with 4 more questions related to personal data. It is an opinion questionnaire. The teaching style of academics differs: those of Faculty of General Medicine are focusing on a lecture type style (75%), and University of Sports on an interactive style (67%). We discovered differences in the process of self-learning: between continuous and discontinuous style. For medical students, there was a longer distribution of the self-taught learning process; instead, University of Sports students organize their learning time in the last part of the semester. University of Sports students are more concerned with on the development and refinement of their personal practical skills, but also of the subjects they work with (kids or athletes), their goal being to accumulate their own experience as rich as possible from working with as many individuals and less to take from the experience of other colleagues. The coach-athlete/sports teacher-pupil relationship is more personalized and longer-lasting than the doctor-patient relationship.
Therapeutic decision of laparoscopy and its benefits as a gold standard in acute cholecystectomy
Authors:   Emergency University Hospital, Bucharest, Romania, Balasescu Simona A. , Tanasescu Ciprian ,   “Lucian Blaga” University Sibiu, Faculty of Medicine, 3rd Clinic Department, Sibiu County Emergency Clinical Hospital, Romania, Sabau Alexandru D. ,   “Lucian Blaga” University Sibiu, Faculty of Medicine, 3rd Clinic Department, Sibiu County Emergency Clinical Hospital, Romania, Comandasu Meda ,   Emergency University Hospital, Bucharest, Romania, Sabau Dan ,   “Lucian Blaga” University Sibiu, Faculty of Medicine, 3rd Clinic Department, Sibiu County Emergency Clinical Hospital, Romania
Published: April 2022

Background: Acute cholecystitis is the most frequent complication of cholelithiasis and counts for one third of surgical emergencies. Aim: The study evaluates the outcomes and limits of laparoscopic cholecystectomy in acute cholecystitis. Materials and methods: A retrospective study was performed for 2 years, between 01.01.2016-31.12.2017 in the 2nd Surgery Department of the Sibiu County Emergency Clinical Hospital, on hospitalized patients with acute cholecystitis, who underwent surgery. The severity of acute cholecystitis was analyzed using the Tokyo Guidelines (TG13 / TG18) severity risk scale. The preoperatory evaluation of the anesthetic-surgical risk was based on American Society of Anesthesiologists Physical Status Classification (ASA PS) and Charlson Comorbidity Index (CCI) (9). Statistical analysis was performed to analyze the outcomes and limits of laparoscopic cholecystectomy and the risk factors for conversion and open surgery. Results: Out of the 262 patients in the study group, most of the patients (61%) were diagnosed with moderate acute cholecystitis, while 67 patients (26%) were diagnosed with mild form and 34 (13%) with severe acute cholecystitis. Laparoscopic cholecystectomy was performed in 96.1% of cases with no conversion to open surgery. The postoperative complications were ligature slippage (1.9%), main bile duct injury (1.9%), postoperative hemorrhage (3.9%) and surgical site infections (2.4%), most of them being managed conservatory. Conclusions: Laparoscopic cholecystectomy can be performed nowadays with minimal morbidity in acute cholecystitis. Knowledge of various factors predicting possible conversion helps in adequate pre-operative selection and counseling for open procedure with further reduction in the overall morbidity of laparoscopic cholecystectomy.
Golden hour of sepsis: Can we do more?
Authors:   “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania, Dogaru Sebastian , Jurcuț Ciprian ,   “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania, Teușdea Caius B. ,   “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania, Rocşoreanu Alexandru ,   University of Medicine and Pharmacy, Craiova, Romania, Purcaru Florea ,   University of Medicine and Pharmacy, Craiova, Romania
Published: April 2022

Introduction: Sepsis is a life-threatening organ dysfunction due to a dysregulated host response to an infection1 and also an important worldwide health problem. Recent progresses in understanding pathogenesis are reflected in increasing emphasis put on time (Sepsis Update 2018 decreased the time for diagnosis and treatment from 3- 6 hs Sepsis2 to 1 hour). The aim of the study was to combine an early warning score (increased sensitivity- NEWS2) and a biomarker (increased specificity- presepsin) in order to detect earlier an acute illness (infection) before becoming life-threatening. Materials and methods: It was a retrospective, single-center observational cohort study of 125 consecutive patients who were diagnosed with systemic inflammatory response syndrome between July 2016 and July 2018 at Emergency Department of “Dr. Carol Davila” Central Military Emergency University Hospital, Bucharest, Romania in order to determine sooner, which patient will further develop a sepsis. We used the area under receiver–operator characteristic curves (AUC) to assess the overall discriminatory power of NEWS2, MEDS and presepsin in detecting sepsis, septic shock and the probability of death on admission and compared them with combined scores between NEWS2 and presepsin. Results: Using a combined score and a simple algorithm, the NEWS2 score had changed (12,8%) for 16 patients. For 10 out of 95 (10,52%) without sepsis and 6 out of 30 (20%) of septic patients, more points were added to NEWS2 meaning that more septic patients were diagnosed before an infection become life-threatening Conclusions: In the present study, we have tried to assess the impact of a monitoring score and a rapid POCT biomarker, in a condition when time is of critical importance. Using a verified early warning score, NEWS2, with increased sensibility and low specificity and presepsin, POCT biomarker with increased specificity, we diagnosed sepsis earlier in a number of cases.
The role of the communication in changing health behaviors
Authors:   Department of Marketing and Medical Technology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Petrescu Dodu G. , Răducu Raluca ,   Department of Marketing and Medical Technology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Soare Cristina ,   Department of Marketing and Medical Technology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Purcărea Victor L. ,   Department of Marketing and Medical Technology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: April 2022

The communication in the field of health can be defined as a communication strategy used to inform and influence individual and community decisions with the aim of improving and enriching personal and community behaviors and public health practices. It includes studying public health attitudes and behaviours to determine the type, frequency and format of the messages.
An organizational chart of an Emergency Health Operation Center
Authors:   Army Share Fund Hospital of Athens, Greece, Zafeirakis Athanasios , Efstathiou Panagiotis ,   National Health Operations Centre of the Hellenic Ministry of Health, Athens, Greece
Published: April 2022

Nowadays, a wide range of natural and man-made disasters, disease outbreaks and pandemics give rise to health emergencies at a global level. Thus, a health security strategy is urgently required through central planning. At the national level, that vision can be implemented with a properly organized and fully functional Emergency Health Operation Center (EHOC). The main executive sections of an EHOC are Command, Planning, Operations, Logistics, Administration, Communications/Intelligence, and Reporting/Briefing. Each of the above sections has several functions and sub-functions, all operating according to a concrete legal basis and detailed operating procedures.