bluuebunny/crossref_metadata_2025 huggingface dataset:
History of polio vaccination in Italy
Authors: Crovari Pietro
Published: June 2024

Polio, as a social disease, was first noted in Italy after the First World War (1915-18), with a consistent upward trend in the number of reported cases (Table 1, Figure 1). This situation has led to important research being undertaken in several National Hygiene Departments, in particular those located in Milan (Giovanardi, Monaci, Bergamini), Genoa (Petrilli, Agnese, Crovari), Palermo (D’Alessandro, Dardanoni), and Padua (Vendramini, Majori, Gasparini). Studies such as these, have examined the epidemiological and virological character of the illness in order to determine modalities for disease prevention. These studies demonstrated that all three poliovirus serotypes were circulating in Italy, with a higher prevalence (as a cause of paralytic disease) of poliovirus type 1 (about 80%), followed by type 3 (about 15%) and then type 2 (about 10 %). The presence of healthy carriers of the virus was very common in children (2-3%).The evidence of neutralizing antibodies in patients of different age groups confirmed that poliovirus infection was widespread. About 90% of the population over 14 years of age had antibodies against all three serotypes..
CONSORT 2010 Statement: updated guidelines for reporting parallel group randomised trials
Authors: Schulz Kenneth F. , Altman Douglas C. , Moher David
Published: June 2024

he CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on www.ijph.it.
Expression of apoptosis related genes bax, bcl-2 and bcl-X in human gastric cancer: early results of an investigation
Authors: D’Ugo Domenico , Ricci Riccardo , Boccia Stefania , Persiani Roberto , Arzani Dario , Maggiano Nicola Giuseppe , Molino Nunzio , Ricciardi Gualtiero , Romano-Spica Vincenzo
Published: June 2024

Background. Evidences indicate an involvement of apoptosis related genes in gastric carcinogenesis. Westudied the gene and protein expression patterns of bcl-2, bax and bcl-X in samples of gastricadenocarcinoma. The apoptotic index values, histological type, differentiation grade, cancer stage andlymph node status were statistically analysed for possible correlations with expressional data.Methods. Thirty specimens of gastric cancer and respective normal control gastric mucosa were collectedfrom patients with the diagnosis of gastric adenocarcinoma who underwent a curative gastrectomy. bcl-2,bax and bcl-XL mRNA and protein levels were respectively determined by reverse transcription PCR (RT-PCR)and western blot using monoclonal antibodies for immunodetection.Results and conclusions. We observed a significant suppression of bax with an increase of bcl-XL at proteinand mRNA levels. The presence of lymph node metastases was statistically related to the loss of baxoverexpression. Bcl-XL was mostly up-regulated in intestinal/mixed types of gastric carcinoma. Theexpression patterns described confirm the role for these apoptosis genes in gastric adenocarcinoma.
Genotyping of the genus Proteus by rpoB sequence analysis
Authors: Giammanco Giuseppe , Pignato Sarina , Grimont Patrick A.D. , Grimont Francine , Giammanco Giovanni M.
Published: June 2024

Background. The genetic relationship among different species within the genus Proteus has still not beenclarified and previous studies by rRNA gene restriction patterns (ribotypes) suggested a high geneticvariability in the presently recognised nomenspecies.Methods. The usefulness of rpoB sequencing for inter- and intraspecies discrimination in the genus Proteuswas evaluated on 11 type and clinical strains belonging to the four described species: P. penneri, P. vulgaris,P. mirabilis, and P. myxofaciens.Results. The rpoB sequencing proved able to characterise the different species, showing six well definedrpoB sequence groups in the 1153 bp region analysed. P. myxofaciens and P. mirabilis could be clearlydifferentiated from the types and clinical strains of the other species showing sequence divergences of 19.5-23% and 6.6-7.6%, respectively. Two groups of P. vulgaris sequences could be described, one of themincluding the new strain type, differing from each other by 3.3-3.6% of their nucleotides (nt) and for both ofthem 6.5-6.8% nt differences from the stand-alone former P. vulgaris strain type were found. P. penneridiffered by only 2.3-3% from all P. vulgaris strains, however, differed from the former P. vulgaris strain typeby 5.5-5.8%.Conclusions. Our results confirm previous ribotyping data regarding the validity of the presently recognisednomenspecies within the genus Proteus, but provides further evidence for the existence of geneticdifferences within the P. vulgaris species.
The network of the Regional Health Observatories in France
Authors: Ledésert Bernard
Published: June 2024

The Regional Health Observatories (RHOs) were created in France in the 1980’s. They exist in each of the 26regions. Their principal mission is to assist in the decision making process by the undertaking of in-depthanalyses of the populations’ health status. To achieve this aim they catalogue and validate existing data,promote surveys when there is a lack of information, disseminate the collected information and conductevaluations of public health interventions.Around 400 people work in the observatories (241 full-time equivalents) with various expertise includingpublic health doctors, statisticians, sociologists, demographers, geographers, economists etc. More than40% of the budget of the RHOs comes from the government while 21% comes from the local executive.RHOs work with all the regional and local institutions concerned with health programs and policies. Themain role of the RHOs in this context is to identify the health needs, to describe health related behavioursand to describe the utilisation of the health care system. The analysis of the different kinds of workconducted shows the great diversity of the subjects treated by the observatories.The creation in 1989 of the “Fédération Nationale des Observatoires Régionaux de Santé” (FNORS)strengthened the links within the RHOs. Its role is to represent the RHO network and to facilitate theharmonisation of the inter-RHOs projects. Recently, the FNORS increase its position to represent RHOs at theEuropean level by taking part in EU projects and to promote the creation of a European network of regionalhealth observatories.
Polycyclic aromatic hydrocarbons (PAHs) in traditional smoked dairy products from Campania (Italy)
Authors: Cirillo Teresa , Milano Nunzia , Amodio Cocchieri Renata
Published: June 2024

The smoked mozzarella and caciocavallo cheeses occupy a significant area among the traditional productsin the Campania region. Smoked and non-smoked mozzarella and caciocavallo cheeses were screened forthe presence of polycyclic aromatic hydrocarbons (PAHs). Total PAH concentration in non-smoked mozzarellaranged from 59.11 to 160.05 μg kg-1 wet weight (w.w.) and in that smoked from 67.49 to 399.90 μg kg-1 w.w.The total PAH content in non-smoked caciocavallo was between 36.70 and 248.59 μg kg-1 w.w.; in thesmoked cheese, it varied from 72.52 to 1643.18 μg kg-1 w.w. The benzo(a)pyrene (BaP) values in all cheesessmoked by liquid smoke were higher than the permissible limit for BaP of 0.03 μg kg-1 for foods aromatisedwith liquid smoke.
Public health preparedness evaluation and measurement
Authors: Savoia Elena , Morano Jamie , Cote David , Rampal Sanjay , Villa Diego , Testa Marcia
Published: June 2024

Dear Sir;Public health preparedness refers to the ability of different local, state, and federal entities to carry out a prompt,effective response to any public health threat.[1] Indeed,it is clear that the term “threat”could embracea myriad of elements. Recently, the main focus has been on bioterrorism, defined as the terrorist use of chemical, biological, radiological, nuclear or explosive weapons of mass destruction.
However, preparedness also involves other threats such as seasonal influenza epidemics, earthquakes or electricity failures. Programs aimed at improving the level of preparedness of different types of agencies (such as law enforcement, public health agencies, fire services, emergency medical services etc.) in case of terrorist attacks could largely improve the overall ability of the public health system in addressing any threat to health, in particular those related to infectious diseases.
Increasing the collaboration between human and animal medicine: an effort of the Federation of European Academies of Medicine (FEAM)
Authors: Blum Hubert , Villari Paolo , Frati Luigi
Published: June 2024

Human medicine and animal medicine have developed as "one medicine" starting from the times in which their bases were laid until the mid 18th century when specialisation proved necessary.The separation has been the logical consequence of the construction of different fields of action, made necessary by the evolution of the disciplines and of the social and economic context, but common areas have remained relevant and are strongly required by modern developments...
HTA of genetic testing for susceptibility to venous thromboembolism in Italiy
Authors: Betti Silvia , Boccia Antonio , Boccia Stefania , Casella Claudia , Ciminello Angela , Cocchella Alessandro , Compagni Amelia , Coviello Domenico , D’Andrea Elvira , De Vito Corrado , De Stefano Valerio , Di Maria Emilio , Di Pietro Maria Luisa , Giorgio Elisa , Gualano Maria Rosaria , Ivaldi Giovanni , Izzotti Alberto , Manzoli Lamberto , Marzuillo Carolina , Melegaro Alessia , Miani Anna , Ricciardi Walter , Rossi Elena , Simonelli Benedetto , Tarricone Rosanna , Teleman Adele Anna , Uliana Vera , Vercelli Marina , Villari Paolo , Za Tommaso
Published: June 2024

Venous thromboembolism (VTE) is a condition in which a thrombus (a solid mass of blood constituents) forms in a vein. VTE represents an extremely common medical problem manifested as either deep venous thrombosis (DVT) or pulmonary embolism (PE) affecting apparently healthy as well as hospitalized patients. Often PE is the physiopathological consequence of the DVT of low extremities vessels, in particular of the calve......
Walking across evidence and sustainability of public health policies -do we need a new journal?
Authors: Ricciardi Walter , Corrao Giovanni
Published: June 2024

Despite the title, this is not an announcement of a new journal. With the first issue of 2013, the Italian Journal of Public Health will change its name, after ten years, and Epidemiology, Biostatistics, and Public Health (EBPH) is ready to pick up the baton.With the launch of Epidemiology, Biostatistics, and Public Health, the Italian Journal of Public Health incorporates another existing journal: Biomedical Statistics and Clinical Epidemiology.The two main reasons for this change lie both in the title of the new journal. The first one refers to public health as the key of our scientific and editorial policy.EBPH aims to be a support for the International scientific community in its efforts to reduce the negative impact on public health of the current economic situation, and most specifically to provide scientific evidence to serve as a basis for the difficult economic and financial choices now required in any Public Health policy.
Caregiver burden from caring for impaired elderly: a cross-sectional study in rural Lower Egypt
Authors: Attia Salama Rasha Aziz , Abou El-Soud Faiza Ahmed
Published: June 2024

Background: increased life expectancy and an aging population have made home care for the elderly a major responsibility for families. Caring for a chronically ill or physically disabled person has been referred to as physically or emotionally stressful, placing the caregiver at a heightened risk of burden. This study aimed to identify factors related to caregiving burden among caregivers who care for their disabled older family members.
Methods: a cross sectional descriptive study was conducted from October 2008 to January 2009 in two randomly selected villages of Shebin El-Kom Menoufiya, Egypt. In an interview setting, questionnaires were used to collect the required data from 288 primary caregivers. Independent variables included the demographic characteristics of caregivers and care recipients, the severity of care recipients’ functional abilities, financial adequacy and caregivers’ degree of social support. Hierarchical regression was used to predict the levels of caregiver burden. The objective of the study was adequately explained to participants and their consent was obtained with assured confidentiality.
Results: caregivers who had little informal social support, inadequate financial resources and more caregiving hours were more likely to experience intense caregiving burden. Burden was also positively associated to the functional disabilities of care recipients and the degree of caregiver burnout. The results of this study indicated that the female spouse was the most common caregiver within the sample, which indicates that cultural norms in Egypt still affect caregiving burden.
Conclusions: identifying predictors of caregiver burden promotes a more comprehensive understanding of burden experiences when caring for older adults, and this may help prevent their deterioration to burn out syndrome
Power estimation for multiple co-primary endpoints: a comparison among conservative solutions
Authors: Lucadamo Antonio , Accoto Nadia , De Martini Daniele
Published: June 2024

The problem of estimating the power of the multivariate Intersection Union test (IUT) is studied. Four classical parametric solutions and a bootstrap non-parametric one, providing statistical lower bounds (i.e. one directional confidence intervals) for the power, are considered. The performances of these techniques in several bivariate IUT settings are compared through a simulation study. All solutions are biased, since their actual coverage probabilities are higher than the nominal one. The bootstrap solution shows the smallest bias, and the variability of its estimates is the lowest. Moreover, the bias of the bootstrap solution reduces faster than those of the other techniques when the pilot sample size, or the correlation, or the rate between the two non-centrality parameters increases. Also, the non-parametric bootstrap solution can be improved by calibration, with a considerable bias reduction.
High Dimensional Regression on Serum Analytes
Authors: Li Yuanzhang , Schwarz Emanuel , Bahn Sabine , Yolken Robert , Niebuhr David W
Published: June 2024

Regression of high dimensional data is particularly difficult when the number of observations is limited. Principal Component Analysis, canonical correlation analysis and factor analysis are commonly used methods to reduce data dimensions, but usually cannot find the most significant linear combination. The goal is usually to find a particular partition of the space X consisting of all independent factors. In this paper, we propose an approach to high dimensional regression for applications where N>K or N<K, where N is the sample size, k is the dimension of space X. The approach starts by finding the most significant linear combination and one of the most insignificant directions to decompose the sample space into two subspaces and reduce the dimension. Further, we examine the contributions of individual variables to those most significant vectors by the coefficients of the combinations to reduce the total number of variables in the selected space without losing the power of the prediction. We use the proposed approach to determine the potential association of 51 serum analytes with schizophrenia using data derived from a case control study (n=208). Numerical results demonstrate that the proposed approach can significantly improve dimension reduction.
“Successes and failures of health policy in Europe over four decades. Diverging trends, converging challenges”. Edited by Johan Mackenbach and Martin McKee.
Authors: Boccia Stefania , Ricciardi Walter
Published: June 2024

The volume represents one of a series of books produced by the European Observatory on Health Systems and Policies, and it is directed to public health practitioners, health policy makers, and public health scientists both in Europe and elsewhere. It aims to depict...
The Structural Relationship Among Self-leadership, Career Preparation Behaviors, Social Support, and Major Satisfaction of Nursing College Re-entry Students
Authors:   Korea Univ. Institute of Educational Research, Kim Hee Dong , Kim Jhong Yun
Published: June 2024

In this study, we aimed to understand the structural relationships among self-leadership, social support, major satisfaction, and career preparation behaviors of university students who re-entered nursing college. We set out to examine the mediating effects of social support and major satisfaction on the relationship between self-leadership and career preparation behaviors. The results confirmed that self-leadership among university students re-entering nursing college significantly and indirectly affects career preparation behaviors through social support and major satisfaction. This underscores the crucial role of self-leadership in enhancing career preparation behaviors among university re-entry students. Additionally, social support and major satisfaction were found to mediate career preparation behaviors, with major satisfaction showing a significant influence. These findings imply the need for comprehensive programs and support systems that consider not only self-leadership but also social support and major satisfaction to enhance career preparation behaviors among nursing college re-entry students. Therefore, it is expected that this study will contribute to the development of effective strategies and policies to improve the career preparation behaviors of university re-entry students.
Failure analysis of Fiber Metal Laminate channel section column under axial compressive pulse loading
Authors: Zaczynska Monika
Published: June 2024

The study aims to analyse the dynamic buckling phenomenon and assess the role of the stress tensor components in the failure process of a short Fiber Metal Laminate column under axial compressive dynamic loading. The investigation is focused on a channel-section profile composed of three aluminium layers and two doubled composite plies [Al/0/90/Al/90/0/Al]. The numerical analysis was performed on the finite element model, which was validated by experimental static buckling tests. Employing a progressive failure algorithm, this analysis incorporated the material property degradation method and Hashin’s criterion as the damage initiation criterion. Failure initiation in metal layers was based on the HuberMises-Hencky failure criterion. Based on the conducted analyses, it was concluded that the dominant forms of destruction in the FML structure are yielding in the metal layers due to excessive compressive stresses and the failure of the matrix in composite plies as a result of compressive and shear stresses. Through a thorough examination of the stress tensor components, critical stresses contributing to aluminum plastic deformation and laminate failure mechanisms were identified.
The EU’s Digital Markets Act: Regulatory Reform, Relapse or Reversal?
Authors: Boscheck Ralf
Published: June 2024

As of 7 March 2024, the EU Commission began to enforce its controversial Digital Markets Act (DMA). This article sheds light on the recent debate. It lists the dos and don’ts of the DMA as well as stakeholder reactions to them before tracing some of the underlying motivations and reasoning that emerge from the EU’s current policy reversal with reference to dealing with abuse of dominant positions in line with Article 102 of the Treaty on the Functioning of the European Union. Following this, the paper reviews economic aspects of digital platforms, concerns about market foreclosure and essential facility as well as appropriate remedies before closing with a discussion of the challenges in stipulating and enforcing efficient rules to govern digital platforms. It is argued that the DMA ought to be rewritten to stipulate clear and cogent legal standards, return to a strengthened system of ex post control and provide platforms with the opportunity to deliver efficiency defenses as part of corporate self-regulation.
Criminal Law Assessments of the Exploitation of Prostitution Practised by Humanoid Robots
Authors: Lachowski Jerzy
Published: June 2024

The subject of this study is the criminal law issue of exploiting prostitution practised by humanoid robots. Interest in this issue stems from two main reasons. Firstly, the development of new technologies, including artificial intelligence capable of self-education, analysis of the surrounding reality, and decision-making necessitates the consideration of its legal subjectivity. Secondly, the emergence of brothels employing humanoid robots prompts reflection on the criminal responsibility of those who benefit from the prostitution facilitated by them. This article aims to highlight the phenomenon of using humanoid robots in prostitution, offer a criminal law assessment of such behaviour from the perspective of Polish criminal law, and suggest the direction for the development of domestic criminal law to accommodate this phenomenon in the future. Additionally, it addresses the issue of criminal liability for harm caused by a humanoid robot equipped with artificial intelligence while providing sexual services. The article predominantly employs the dogmatic-legal method, performing an exegesis of the provisions of Article 204 of the Criminal Code in the context of the issue signalled. The analyses have concluded that this norm does not encompass in which the perpetrator facilitates, induces prostitution of a humanoid robot or derives financial benefits from such activities, despite such behaviour being detrimental to morality, the fundamental good protected under Article 204 of the Criminal Code. De lege lata, a humanoid robot may also not be subject to criminal liability if it harms a person using its sexual services, as such an ‘essence’ does not align with the current structure of crime and the concept of criminal punishment. However, the liability of manufacturers or users of such devices is not ruled out. It should be noted that as humanoid robots become more autonomous, holding producers or users criminally liable for damages they cause becomes less justifiable, and the applicability of artificial intelligence liability similar to the criminal liability of legal persons becomes more relevant.
Fear and Agitation as the Normative Elements of Legitimate Self-Defence Excess
Authors: Grudecki MichaŁ , Sitarz Olga
Published: June 2024

The authors of this publication have explored the importance of justifying fear and agitation underpinning the transgression of necessary self-defence. According to Article 25 § 2 and 3 of the Criminal Code, they identified five scenarios, differing in how a perpetrator’s mental state is determined, affecting the criminal law consequences of unlawfully infringing on or exposing the aggressor’s legal interests. The authors validated the preliminary hypothesis that the legislator assumed legitimate self-defence excess results from fear or agitation due to the circumstances of the assault, necessitating procedural confirmation. Their occurrence leads to the defender’s impunity, regardless of the type of legal interests infringed and the extent of legitimate self-defence excess. A shortfall in the mental state circumstances of a defender, as referred to in Article 25 § 3 of the Criminal Code in a specific factual state, opens the possibility of applying a general, complementary provision, i.e., Article 25 § 2.
Criminalisation of the So-Called Forced Marriage in the Polish Criminal Law
Authors: Kosonoga-Zygmunt Julia
Published: June 2024

This article discusses the issue of so-called forced marriages, the criminalisation of which was introduced into Polish criminal legislation by the Act of 13 January 2023 amending the Code of Civil Procedure and some other acts. Introducing the provisions of Article 191b into the Criminal Code aims to fulfil the obligation arising from Article 37 of the Council of Europe Convention on Preventing and Combating Violence against Women and Domestic Violence of 11 May 2011 (Journal of Laws of 2015, item 961). In addition to outlining the statutory features of new types of crimes, the article addresses issues such as criminal liability, the concurrence of regulations, and the issue of the so-called cultural defence.
Formation of Some Elements of the Right to Defence in Misdemeanour Proceedings
Authors: Sowiński Piotr Krzysztof
Published: June 2024

The text analyses normative solutions concerning the right to defence in Polish proceedings in cases of offences. It discusses the formation of selected elements of the right to defence, from the pre-war solutions to modern times. The author highlights the autonomy of the solutions in force in the 2001 Code of Proceedings in Misdemeanour Cases, and their similarities to the right to defence in criminal cases, constituting the most comprehensive model of this right.
Permission for Municipalities to Establish and Finance Prizes and Awards for Athletes in Electronic Sports
Authors: Kuczkowski Przemysław
Published: June 2024

The article, original in nature, was devoted to the issue of awards and prizes for e-sports players. The motivational financial instruments in question are regulated in the Sports Law, specifically in Article 31. The author has attempted to solve the legal problem of finding an answer to the question of the legal possibility for municipalities to establish and finance prizes and awards for e-sports players under Article 31 of the Sports Law. Due to the singular and causal works in the field of e-sports funding, which do not address the issue of establishing and funding prizes and awards for e-sports players under Article 31 of the Sports Act, the elaboration of this issue within the framework of the article will, in the author’s opinion, undoubtedly enrich the current literature on the subject.

The introductory considerations focus on presenting the essence of the definition of sport and attempt to qualify e-sports as a sport under the Sports Act, which is significant for the possibility of local authorities establishing prizes and awards. The key views of the literature, judicial decisions, and the state of the law in this area were presented. Investigations in this area have led to the conclusion that, with a few reservations, it is possible to qualify e-sport as a sport. Subsequently, the focus was on the legal aspects concerning the possibility for municipalities to establish and finance prizes and awards for e-sports players. The problem concerning the understanding of competition under the Sports Act was resolved, and it was pointed out that e-sports players, despite the lack of a Polish e-sports association, can participate in sports competitions under the Sports Act. In addition, the problematic premise concerning the importance of a given sport for a local authority has been clarified. The final considerations in this area have allowed de lege ferenda postulates to be formulated.

The analysis is based on legal norms and statements of doctrine and jurisprudence. The article contains considerations concerning the normative and dogmatic sphere as well as the sphere of law application by administrative courts. The research has a national character. In this article, the dogmatic-legal method has been applied, consisting of the analysis of legal regulations on the establishment and financing of awards and prizes for players of electronic sports.

The subject matter discussed is divided into several main editorial units. The different parts correspond to the main outline of the problem and its relation to important scientific and practical issues.
The Impact of the Kakhovka Dam Destruction on the Water Temperature in the Lower Reaches of the Dnipro River and the Former Kakhovske Reservoir
Authors: Vyshnevskyi Viktor І. , Shevchuk Serhii А.
Published: June 2024

The results of the studies devoted to the consequences of the Kakhovka dam destruction and the empting of the Kakhovske reservoir are presented. The water regime of the lower reaches of the Dnipro River was studied, in particular, the water temperature. The remote sensing data on spatial features of water temperature are given. Significant changes in water temperature are shown both in the lower reaches of the Dnipro River and in the former Kakhovske reservoir. In the first days after the destruction of the dam, due to the mixing, the surface water temperature at the mouth of the Dnipro River dropped significantly. Then the water temperature in the lower reaches of the river approached to that one observed before the destruction. In turn, the former Kakhovske reservoir became a network of river branches and lakes that cannot be compared with the former reservoir. The Dniprovske Reservoir, located upstream, affects the water temperature of this territory, especially the largest branch.
VOSviewer Analysis of Studies on Software Selection in the Logistics Sector
Authors: Doganer Duman Bukra , Adak Mehmet , Güleç Alican
Published: June 2024

Outsourcing in logistics is an important step to reduce costs and increase operational efficiency. In this sense, it is possible to come across outsourcing in many areas of logistics processes. One of the outsourcing steps is the decision to select the software. Choosing the right software can affect the market share of the organization and the implementation time, effort, and cost. The findings of this research will help the marketing and sales teams of software product companies to develop key points and also enable end users to make informed decisions in selecting software packages for the organization. In this study, the studies in the literature were examined through the Scopus database, and co-citation analysis was performed using the VOSviewer program. As a result of the analysis, the articles analyzed were divided into four clusters and explained.
Pathophysiology of paraneoplastic rheumatologic syndromes- could be involved in the diagnosis of a pulmonary adenocarcinoma?
Authors: Budin Corina Eugenia , Pătrîntașu Dariana Elena , Hédi-Katalin Sárközi , Cocuz Iuliu Gabriel , Ianoși Edith Simona , Cotoi Ovidiu Simion
Published: June 2024

Paraneoplastic syndromes are diseases caused by malignancies without direct anatomical relationship with it and it is crucial to realize that paraneoplastic phenomena are not caused by metastases. A paraneoplastic phenomenon can be the first indicator of cancer in an undiagnosed individual, and in severe cases lead to fatality. Various paraneoplastic rheumatological syndromes are associated with malignant neoplasms. Although they occur within various forms of malignancy, they most often suceed lung cancer, and adenocarcinoma stands out as the most prevalent histological subtype within pulmonary cancer. This article focuses on the understanding of paraneoplastic syndromes, particularly regarding paraneoplastic rheumatic syndromes due to their challenging differentiation from idiopathic rheumatic disorders.
Systemic inflammation and obstructive sleep apnea syndrome (OSA): the role of C–reactive protein (CRP)
Authors: Pintilie Adriana-Loredana , Zabara-Antal Andreea , Vasilache-Antohi Paula , Tau Victoria , Stoian Adelina , Trofor Antigona Carmen , Crisan-Dabija Radu
Published: June 2024

The presence of sleep-related disorders, particularly obstructive sleep apnea syndrome (OSA), instigates pathological changes during sleep, giving rise to frequent hypoxic episodes that generate elevated levels of a broad spectrum of inflammatory cytokines. C-reactive protein (CRP), a biomarker signifying the presence and intensity of inflammation, is frequently detected in elevated serum or plasma concentrations, correlating with the number of respiratory events, especially in moderate and severe forms, across both adults and children. Various available therapeutic approaches demonstrate the capacity to diminish serum levels, although the minimum duration of usage typically extends between 2-6 months. In the case of older individuals, OSA commonly coexists with additional conditions, further augmenting the baseline inflammatory level. This accelerated disease progression amplifies mortality rates, incurs heightened costs, and significantly diminishes the overall quality of life.
Enhancing Pulmonary Care: The Pivotal Role of Segmentation and Automated Analysis in Advanced Pulmonary Imaging
Authors: Gheorghiu Radu Marian , Tita Alexandra , Stan Iustina Violeta , Comanici Valentina Daniela , Craiu Mihai
Published: June 2024

In the field of medical imaging, techniques like computed tomography (CT), magnetic resonance imaging (MRI), and X-rays are essential for diagnosing and monitoring diseases, particularly in pulmonary pathology. A significant development in this area is the application of automated segmentation and machine learning, enhancing the accuracy in diagnosing lung diseases, such as lung cancer. However, there remains a knowledge gap in fully understanding the potential and limitations of these technologies, especially across diverse clinical conditions and datasets. To address this gap, the paper delves into the integration of artificial intelligence with conventional imaging techniques, focusing primarily on the use of convolutional neural networks (CNNs) and transformer-based models in automated segmentation. This approach is pivotal in improving the detection rates and accuracy of diagnoses in complex pulmonary diseases. Findings indicate that AI-enhanced imaging significantly advances the early detection of pulmonary diseases, notably lung cancer, and reduces the time until diagnosis. Yet, challenges such as the necessity for diverse and comprehensive training data and the generalizability of algorithms, persist. Moreover, ethical considerations in the deployment of AI technologies in healthcare are crucial. In conclusion, while these technologies mark substantial progress in pulmonary imaging, it is essential to find the balance between technological advancements and ethical considerations. This balance is key to ensuring effective and equitable healthcare, maximizing the benefits of AI in medical imaging while maintaining patient trust and privacy.
DLCO and Spirometry in non-small cell lung cancer patients receiving EGFR-TKI in Indonesia
Authors: Sutarto Riyadi , Yunus Faisal , Zaini Jamal , Faisal Hana Khairina Putri
Published: June 2024

Introduction

EGFR-TKI is the treatment of choice in non-small cell lung cancer (NSCLC) with EGFR mutation in exon 19 or 21. The influence of EGFR-TKI therapy on lung function is still unrecognizable in NSCLC patients.

Objectives

This prospective study aims to examine the influence of EGFR-TKI therapy on lung function of lung adenocarcinoma patients with a single mutation in EGFR exon 19 or 21 at Persahabatan National Respiratory Center Hospital Jakarta, Indonesia. The pulmonary function test (PFT), including spirometry and diffusing capacity (DLCO), was performed before and after three months of EGFR-TKI therapy. After three months, the patients were divided into groups based on the Response Evaluation Criteria in Solid Tumors (RECIST) criteria and the change of PFT was compared before and after therapy.

Results

Among twenty lung cancer patients enrolled, we found increase of predicted mean FVC value from 60.6% to 68.25% (p=0.03), mean predicted FEV1 value from 59.7% to 67.05% (p=0.036), mean DLCO from 11.55 ml/minute/mmHg to 13.72 ml/min/mmHg (p=0.004), and predicted DLCO from 53.4% to 63.85% (p=0.03). The increase of mean predicted DLCO was greatest in the partial response group, which was 16.43% (p=0.056).

Conclusion

This study found that the majority of NSCLC patients with single EGFR exon 19 or 21 mutation had significantly improved lung function after EGFR-TKI therapy. Lung function test might become a beneficial tool to evaluate the effectiveness of EGFR-TKI in NSCLC patients, especially in clinical setting where computerized tomography (CT) scan is not available.
Blue light and its effects on sleep
Authors: Diaconu George-Alexandru , Iordăchel Cătălina Maria , Coca Cătălin , Feraru Nicolae , Gheorghevici Constantin , Zisu Dănuț , Emilia Șandru , Burdușel Beatrice , Popa Andreea , Munteanu Ioana
Published: June 2024

Short wavelenght light (blue light) contributes to dysregulations of the circadian cycles. In an era where most of the light sources were replaced by Light Emitting Diodes (LEDs), a new problem regarding sleep quality and nictemeral cycle appears. Even though blue light is currently being used a treatment for sleep dysregulations and insomnia (through cycle altering), this stimuli activates the melanopsin secretory mechanism via photoreceptor cells and thus supresses the pineal secretion of melatonin. Melatonin plays a crucial role in provoking pre-sleep symptoms, inducing and maintaining sleep, improving sleep quality and multiple other effects dependant to the organ, such as being an antioxidant or its protective atribute against diabetes. This paper is a general review of the literature and brings to a single place multiple studies about the importance of sleep, physiology of melatonin secretion and the effect of light exposure on those aforementioned.
Severe restrictive syndrome in context of bilateral diaphragmatic paralysis - case series
Authors: Diaconu Lorena-Nicoleta , Bobocea Raluca , Macri Anca , Valu Bianca , Popa Ionela
Published: June 2024

The authors present a miniseries of two clinical cases of bilateral diaphragmatic paralysis, of different etiologies, which provide the opportunity to discuss the particularities of the clinical manifestations, the paraclinical investigations necessary to establish a positive diagnosis, the elements of differential diagnosis, the general therapeutic principles addressed to respiratory failure secondary to diaphragmatic paralysis.
Interstitial lung diseases computer-aided imaging diagnosis, using complex networks
Authors: Adriana Trușculescu , Versavia Ancușa , Laura Broască , Diana Manolescu , Camelia Pescaru , Cristian Oancea
Published: June 2024

The article aims to explore how a Complex Network (CN) computer-aided technique targeted for interstitial lung disease (ILD) approach can enhance the work of clinicians and if a CN-based computer-aided diagnosis can provide new data to help manage ILDs more successfully. The CN technique is used to evaluate the progression of the disease by analyzing relevant axial HRCT slices and dynamic CN evaluation using the relative speed for each layer. The article presents the results from a study of 65 patients with interstitial lung disease (ILD), comprising 18 females with a mean age of 59.35 years (ranging from 34 to 76). The initial clinical diagnosis was idiopathic pulmonary fibrosis (IPF) in 28 patients (43.07%), Non-Specific Interstitial Pneumonia (NSIP) in 11 patients, and other ILDs in the remaining patients. Each CT scan fulfilled the criteria for high-resolution CT with constant characteristics across the group. All patients underwent imagistic follow-up for at least 11 months, and additional data were provided for each investigation. The cohort was chosen based on concordant lung function decline and imaging evolution decline. The article concludes that the complex network approach provides both a qualitative visual map and quantitative metrics to enhance ILD diagnosis and progression tracking. The results suggest that a CN-based computer-aided diagnosis can provide new required data to manage ILDs more effectively. This approach may enable clinicians to make more precise conclusions regarding the structure of the analyzed lung area, which can help tailor disease management strategies to individual patient profiles.
Baseline characteristics in patients with interstitial lung diseases as predictors for progression: a real life study
Authors: Teodorescu-Drăghicescu Ștefan , Strâmbu Irina
Published: June 2024

Interstitial lung diseases (ILDs) comprise a large number of different diseases, some of the patients having a progressive evolution toward irreversible fibrosis. The aim of this study is to identify baseline clinical, functional, and imaging characteristics at the date of the diagnosis, that could predict the evolution toward fibrosis.

This is a retrospective descriptive study that included 126 patients diagnosed and followed-up in Department 5 of the Institute of Pneumophtisiology “Marius Nasta” Bucharest between 2014 and 2022.

The authors recorded baseline demographics, symptoms, lung function tests (forced vital capacity – FVC and diffusion capacity – DLCO), high resolution CT (HRCT) imaging features. Patients were followed-up at 6 and 12 months. According to decline in lung function or imaging worsening, patients were divided in2 groups: progressors (60 patients) and non-progressors (26 patients). Baseline characteristics of the 2 groups were compared.

Results: There is an important delay since onset of symptoms to diagnosis (a mean of 17 months). Lower baseline FVC, smoking history, presence of traction bronchiectasis and/or honeycombing and male gender were associated to progressive lung fibrosis.
Autoimmunity in context of exposure to SARS-Cov2 virus
Authors: Negoescu Iris-Andreea , Moșteanu Ioana-Mădălina , Simionescu Anca , Parlițeanu Oana , Arlet Alina , Iordache Cicerone , Voinescu Daniel , Croitoru Alina , Mahler Beatrice
Published: June 2024

Introduction

The immune response in patients with SARS-CoV2 infection is an incompletely elucidated pathophysiological challenge. There are more and more cases in which COVID-19 vaccination induces autoimmune side effects, of course, in a selected population. What are the criteria that induce such a response? How can it be prevented? These are questions that the medical world must answer.

Material and Methods

A 28-year-old male patient presented with repeated small hemoptysis accompanied by pleuritic pain, which started suddenly 2 days prior. From the patient’s history, we note autoimmune thyrotoxicosis triggered by the administration of the second dose of the anti-SARS-CoV2 vaccine, but also a recent COVID-19 episode. At the time of hospitalization, slightly elevated serum values of D-dimers were noted, and the CT examination identified multiple unilateral filling defects in the middle and small right pulmonary arteries, accompanied by a ground-glass opacity suggestive of a pulmonary infarction and possible bilateral stenosis of the subclavian arteries. The extended immunological panel was negative, but genetic tests have identified two thrombophilic gene mutations. Functionally, a discrete decrease in lung volumes and a slight impairment of alveolo-capillary diffusion was observed. The clinical, imaging and functional evolution was favorable under anticoagulant treatment.

Discusions

The predisposition for thrombosis in COVID-19 is determined by at least two distinct processes, subsegmental and segmental vessel occlusion and microvascular in situ immunothrombosis. Pulmonary thromboembolism occurs more frequently in the first weeks after diagnosis, but cases farther from the acute moment have also been reported in literature, including in patients with mild forms of the disease.

Certain adjuvant components of the vaccines, as well as the SARS-CoV2 virus itself, can trigger autoimmune reactions in genetically predisposed individuals.

Conclusion

Patients with active or recently recovered COVID-19 should be considered at an increased risk of pulmonary embolism when they present with specific symptoms, even without the existence of other risk factors.
The use of simple pulmonary function tests in the post-COVID-19 pulmonary improvement prediction: lessons from a single-center study
Authors: Bartczak Krystian T. , Milkowska-Dymanowska Joanna , Piotrowski Wojciech J. , Bialas Adam J.
Published: June 2024

Introduction

Despite the evolving knowledge about COVID-19 convalescents, there is still not enough data to validate simple methods of identifying the non-improvers. Our objective: to look for bad prognostic factors in long-COVID.

Methods

We conducted a prospective observational study among previously hospitalized patients with COVID-19. Individual characteristics were gathered and pulmonary function tests - spirometry and lung transfer for carbon monoxide (TL,CO) – were performed twice, approximately one and three months after hospitalization from COVID-19. Control radiological examinations were repeated and compared at the time of the study.

Results

After dividing the study group (30 patients) according to improvement in forced vital capacity (FVC) and/or TL,CO we observed that the forced expiratory volume in the first second (FEV1) acquired from spirometry accurately indicates clinical improvement with the area under the curve (AUC) of 0.892 (95% CI 0.73 – 1). Notable differences were found in estimated total lung capacity (eTLC) and radiological score as well.

Conclusions

Our findings suggest that simple spirometry with FEV1 assessment performed in the post-COVID period helps select individuals with impaired recovery that should presumably be referred to a respiratory specialist and pulmonary rehabilitation.
Pneumocystis Pneumonia misdiagnosed as Pulmonary Tuberculosis in a patient with repeatedly false-negative HIV tests
Authors: Bodoarcă Samuel , Bodoarcă Diana , Tabacu Emilia , Strâmbu Irina
Published: June 2024

Pneumocystis jirovecii pneumonia, previously known as Pneumocystis carinii Pneumonia (PCP), is a fungal infection most commonly encountered in immunocompromised patients and, in some cases, can be life-threatening. Patients at risk include those with cancer, HIV positive, transplant recipients, and those under immunosuppressive therapies. There are no specific signs or symptoms for PCP and its differential diagnosis includes other viral or bacterial pneumonias and also Tuberculosis, the latter especially in high endemic areas. We present the case of a 32 year-old female patient who presented to the hospital for dyspnea and cough, treated for Pulmonary Tuberculosis, and eventually diagnosed with Pneumocystis Pneumonia, in spite of her multiple false-negative HIV tests.
URINE ANALYSIS OF ETAWA BREED GOATS IN SUKAWATI DISTRICT, GIANYAR REGENCY BALI
Authors: Arni Safitri Gusti Putu , Sagung Kendran Anak Agung , Surya Heryani Luh Gde Sri , Komang Ardana Ida Bagus , Suarsana I Nyoman , Widyastuti Sri Kayati , Dary Mufa Romy Muhammad
Published: June 2024

Etawa crossbreed goats (Capra aegagrus hircus) are livestock that are starting to be developed among breeders. In goat farming there are health problems that arise both clinically and subclinically, including disorders of the urinary tract. This study aims to determine the clinical condition of Etawa crossbreed goats (PE) in Sukawati District, Gianyar Regency by using urine examination. This study used 30 urine samples from Etawa crossbreed goats at the Raka Etawa Farm. A total of 10-30 ml of urine is taken using the mid-stream method and collected in a urine container which is then tested using a dipstick pad. This research is an observational study with a cross sectional study design using a purposive sampling method. Based on the results of the examination, data was obtained in the form of specific gravity (BJ) with a range of 1,005-1,010 and an average of 1.00567; pH in the range 8-9 and an average of 8.867; a total of 18 samples were found to contain proteins in the range 15-30 and an average of 15.83; and negative results were found in the parameters glucose, negative bilirubin, ketones, erythrocytes, urobilinogen, nitrites and leukocytes. These results indicate that the clinical condition of Etawa crossbreed goats (PE) is healthy (not sick) through urine examination in the form of physical examination and dipstick. It is necessary to carry out additional examinations in the form of examination of urine sidemen and bacterial culture, as well as measuring the specific gravity (BJ) using a refractometer to obtain a more accurate value.