bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurement and Difference Analysis of Total Factor Productivity of Strategic Emerging Enterprises in China
Authors: Huang Lipeng , Geng Xiangyan , Liu Chuanming
Published: April 2022

Improving the total factor productivity of strategic emerging enterprises is of great significance for promoting the optimization and upgrading of the industrial structure and achieving high-quality economic development. Based on the data of 2,760 strategic emerging enterprises of China a-share listed companies from 2014 to 2016, this study uses Levinsohn and Pertrin(LP) method to measure the total factor productivity of China's strategic emerging enterprises, and analyzes regional differences in total factor productivity of strategic emerging enterprises. The results showed that during the sample study period, the total factor productivity of China's strategic emerging enterprises decreases first and then increases. From the perspective of different regions, the total factor productivity of strategic emerging enterprises in the four regions showed a "stepwise distribution", the total factor productivity of strategic emerging enterprises in the East, Central and Western regions showed a downward trend, and the total factor productivity of strategic emerging enterprises in the central region showed a downward trend and then an upward trend. From the perspective of regional heterogeneity, Beijing, Shanghai, Guangdong, Shandong, Jiangsu and other provinces have higher total factor productivity of strategic emerging enterprises. However, the total factor productivity of strategic emerging enterprises in Xinjiang, Gansu, Guangxi, Yunnan, Shaanxi and other provinces and cities is low. In order to promote the total factor productivity of strategic emerging enterprises, we can increase R&D investment, link financing constraint and pay attention to regional development differences.
Una revisión sistemática sobre las variables relacionadas con las habilidades sociales y la creatividad en el periodo de la adolescencia
Authors: González Moreno Alba , Molero Jurado María del Mar
Published: April 2022

Social skills and creativity are two vitally important constructs in the development of adolescents, since through the correct development of both, young people are able to resolve conflicts appropriately and establish quality interpersonal relationships. Scientific evidence reveals that the existence of studies that treat both constructs together is scarce, so the objective of this work is to identify which variables are related to social skills and creativity in the adolescent population. This study has followed a systematic review methodology, where a search has been carried out in the Web of Science, Scopus and PsyCINFO databases from two differentiated searches: one focused on social skills and the other on creativity. The results show the diversity of variables that have been related to both social skills and creativity, thus being able to establish which ones have been studied in both constructs: academic performance, stressors and self-esteem. It is proposed to establish a series of educational strategies to work on these factors with adolescent students, due to the benefits of having good levels of social skills and creativity.
El efecto de autolicencia moral: Cuando la conducta virtuosa facilita la conducta inmoral
Authors: Bilbao Itziar , Conejero López Susana , Pascual Jimeno Aitziber
Published: April 2022

La investigación empírica de las dos últimas décadas, realizada fundamentalmente con muestras de EEUU y de Europa occidental, revela que el hecho de actuar de forma virtuosa puede hacer que posteriormente las personas actúen de forma moralmente más dudosa. A este fenómeno se le ha denominado efecto de autolicencia moral. En el presente artículo se revisa la evidencia empírica sobre dicho efecto, así como las explicaciones teóricas que se han propuesto para el mismo: el modelo de las credenciales morales y el modelo de crédito, en el que se incluyen la teoría de la autorregulación y la teoría de la compleción. Asimismo, se analiza el problema de la posible contradicción entre este efecto y la tendencia a la autoconsistencia moral. Finalmente, se examina la fuerza del efecto y en qué medida este es generalizable a distintas culturas. El artículo se cierra con un apartado de conclusiones en el que se reflexiona sobre las implicaciones del fenómeno.
Efficacy and tolerability of antibiotic augmentation in schizophrenia spectrum disorders – A systematic literature review
Authors:   Department of Psychiatry, „Dr. Carol Davila” Central Military  Emergency University Hospital, Bucharest, Romania, Vasiliu Octavian
Published: April 2022

Background: A large number of augmentation agents have been tried in patients with schizophrenia spectrum disorders, because negative and cognitive symptoms are difficult-to-treat with current pharmacological agents, and because the high percentage of treatment-resistant cases requires new therapeutic solutions. Inflammation is one of the supposed pathophysiological mechanisms in schizophrenia; therefore, antibiotics have been explored as add-on agents. No systematic review or meta-analysis about the efficacy of antibiotics in psychotic disorders has yet been conducted. Objectives: To assess if the use of antibiotics as add-on to current antipsychotic treatment may improve core symptoms of schizophrenia spectrum disorders, global clinical status, overall functionality, and if this augmentation strategy is well tolerated. Methods: A systematic literature review was conducted, including papers published between 1980 and 2018, which have been found in the main electronic databases (PubMed/MEDLINE, CINAHL, NCBI, Embase, Thomson Reuters/Web of Science). The keyword search strategy was formulated using the following paradigm: „schizophrenia spectrum disorders”/ „schizophrenia”/ „schizo-affective disorder”/ „schizophreniform disorder”, AND „antibiotics”/ all the names of currently marketed antibiotics classes. This review was registered to PROSPERO database with the protocol number CRD42019119152. Results: Based on reviewing the selected trials regarding the efficacy of antibiotics over core symptoms of schizophrenia, only two agents were detected – minocycline and D-cycloserine. Minocycline as add-on to antipsychotic treatment was associated with mixed results, while regarding the efficacy of d-cycloserine either no significant difference, or superiority to placebo over negative and cognitive symptoms was reported. Minocycline had an overall effect over the clinical impression that was not distinguishable from placebo, although there was one trial supporting the efficacy of this antibiotic. The impact of minocycline over the global functioning when added to antipsychotic in patients with schizophrenia was mixed, with one positive and one negative trial (moderate to high quality designed trials). D-cycloserine had no significant impact over global clinical status or patients’ overall functionality. Conclusion: From all the data reviewed and hierarchized resulted that larger trials are needed in order to confirm the efficacy of antibiotics as add-on to antipsychotics over negative and cognitive symptoms of schizophrenia spectrum disorders.
Compliance of school doctors’ practice with medical legislation
Authors:   “Carol Davila” University of Medicine and Pharmacy,  Department 14 - Orthopaedics and Anaesthesiology, Discipline of  Medical Law Aspects and Malpractice, Bucharest, Romania, Paun Silviu , Vasile Luiza M. ,   “Carol Davila” University of Medicine and Pharmacy, Faculty of  Medicine, Bucharest, Romania, Birsanu Sinziana ,   Bucharest Bar, Lawyer, Nanu Codrut A. ,   "Carol Davila” University of Medicine and Pharmacy,  Department 14 - Orthopaedics and Anaesthesiology, Discipline of  Medical Law Aspects and Malpractice, Bucharest, Romania
Published: April 2022

School doctors’ practice comprises specific aspects governed by legal rules. Knowledge and compliance with the applicable legislation are necessary in order to ensure respect of the patient’s rights, to avoid claims of medical malpractice and to assure medical act’s quality. The present study investigated compliance of school doctors’ practice with the applicable legal requirements. All respondent doctors violate the applicable legal requirements. Future quantitative research is necessary to measure the amplitude of the identified vulnerabilities.
"Intraoperative parathyroid hormone assay in patients with primary hyperparathyroidism"
Authors:   Elias Emergency Clinical Hospital, Bucharest, Romania, Nitipir Cornelia , Alecu Lucian ,   General Surgery Clinic, Agrippa Ionescu Emergency Clinical  Hospital, Bucharest, Romania, Savu Iulian ,   General Surgery Clinic, Emergency Clinical Hospital, Bucharest,  Romania, Musat Madalina ,   C.I. Parhon Endocrinology Institute, Bucharest, Romania, Tulin Raluca ,   General Surgery Clinic, Agrippa Ionescu Emergency Clinical  Hospital, Bucharest, Romania, Socea Bogdan ,   St. Pantelimon Emergency Clinical Hospital, Bucharest, Romania, Tulin Adrian ,   General Surgery Clinic, Agrippa Ionescu Emergency Clinical  Hospital, Bucharest, Romania
Published: April 2022

Introduction: Currently, parathyroidectomy represents the elective surgical treatment and the only one curative that relieves the patient of metabolic complications and improves the quality of life of the patient. Intraoperative confirmation of PTH is required to reflect the fact that the correct parathyroid gland has been extracted. Material and method: The study is retrospective. The period on which the data was gathered over a period of 2 years. The values of the PTH assay were obtained from blood drawn from the ipsilateral cephalic vein of the hyperproductive parathyroid gland: 1. at the moment of anesthesia induction; 2. at identification; 3. at 10 minutes after the extraction; 4. at 20 minutes after extraction. Results: We identified a number of 25 patients operated for primary hyperparathyroidism. Preoperative values of PTH were 380pg/mL with a maximum value of 821 pg/mL. PTH values decreased by 55% at 5 min, 68% at 10 minutes and 74% at 15 minutes. A marked reduction in PTH values occurred after the first 5 minutes while the interval between 10-15minutes associated a variation of only 8-10% decrease. Conclusion: Intraoperative PTH assay is a useful technique to predict the success of the intervention. The technique is standard although some issues have been raised and are still under discussion.
Metformin – old treatment for diabetes, new treatment for psoriasis
Authors:   Carol Davila University of Medicine and Pharmacy, Bucharest, Romania Emergency University Hospital Bucharest, Bucharest, Romania, Serban Bogdan , Diaconu Camelia C. ,   Carol Davila University of Medicine and Pharmacy, Bucharest,  Romania  Clinical Emergency Hospital of Bucharest, Bucharest, Romania, Stanescu Ana Maria A. ,   Carol Davila University of Medicine and Pharmacy, Bucharest,  Romania, Costache Daniel O. ,   Carol Davila University Central Emergency Military Hospital,  Bucharest, Romania, Costache Raluca S. ,   Carol Davila University of Medicine and Pharmacy, Bucharest,  Romania   Carol Davila University Central Emergency Military Hospital,  Bucharest, Romania, Cirstoiu Catalin ,   Carol Davila University of Medicine and Pharmacy, Bucharest,  Romania  Emergency University Hospital Bucharest, Bucharest, Romania
Published: April 2022

Metformin was a revelation in the treatment of patients with type 2 diabetes, being widely used, with remarkable outcomes. Lately, research has greatly expanded the indications of metformin treatment, which can be used not only in diabetes but also in many other conditions. Although still debatable, several studies have shown the beneficial effects of metformin treatment in patients with psoriasis. This article is a review of the latest data of scientific literature about the effects of metformin administration in patients with diabetes and psoriasis, but also in nondiabetic patients with psoriasis.
Antibiotherapy: latest current affairs – state of the art 2019
Authors:   Military Medical Research Center, Bucharest, Romania “Titu Maiorescu” University, Bucharest, Romania, Ordeanu Viorel , Ionescu Lucia E. ,   Military Medical Research Center, Bucharest, Romania, Dumitrescu Victoria G. ,   Military Medical Research Center, Bucharest, Romania, Pricop Roxana G. ,   Military Medical Research Center, Bucharest, Romania, Neagu Razvan ,   Military Medical Research Center, Bucharest, Romania, Popescu Diana M. ,   Military Medical Research Center, Bucharest, Romania
Published: April 2022

Given the continuous growth of the bacterial resistance phenomenon, the appropriate choice of antibiotherapy represents an important step in the treatment and prophylaxis of infectious diseases. Depending on the symptomatology, the dose required for the effective treatment of an infection may vary. Inadequate dosing not only reduces the effectiveness of the antibiotic, but also promotes the emergence of resistant bacterial strains. Also, too high of a dose increases the toxic side effects of antibiotics. Therefore, a personalised antibiotherapy according to: the patient's clinical status, body mass, associated chronic diseases, etc. represents a promising approach in the treatment of infectious diseases. The purpose of this study is to present the most important current affairs regarding the emergence of new antibiotics, the maximum doses recommended by the latest version of the ""European Committee on Antimicrobial Susceptibility Testing"" (EUCAST - version 9/2019) and providing an indication on whether these antibiotics are used in Romania.
The effect of implementing collaborative care model on diet compliance in hemodialysis patients
Authors:   School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran, Habibzadeh Hossein , Pourteimour Sima ,   School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran, Gharaaghaji Asl Rasool ,   Department of Community Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran, Kazemi Sahar ,   School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran
Published: April 2022

Non-compliance to diet and increased fluid intake can lead to unpleasant side effects and premature mortality in hemodialysis patients. Intervention strategies in educational and cognitive-behavioral domains can be used to improve diet compliance and restrict fluid intake in hemodialysis patients. The present study aimed to implement a participatory care model on diet compliance in patients undergoing hemodialysis referred to the Urmia Hemodialysis Center of Urmia in 1397. The present study is an experimental-randomized study that was performed on 60 patients undergoing diet without hemodialysis referring to Urmia Hemodialysis Center of Urmia. From 175 patients undergoing hemodialysis based on laboratory parameters of non-compliance patients and 60 patients were selected based on simple randomization and were randomly divided into intervention and control groups. After intervention steps of participatory care, diet compliance of the two groups was compared using the results of the comparable laboratory parameters. Analysis of the results of the present study showed that the collaborative care model significantly improved the results of laboratory parameters related to diet compliance in the intervention group compared to the results of the laboratory parameters before the intervention and the control group.
Artificial Intelligence in cardiovascular medical imaging
Authors:   Carol Davila University Central Emergency Military Hospital Bucharest, Romania, Stanciu Silviu , Tache Irina ,   French National Institute of Health and Medical Research, U703, Politehnica University Of Bucharest, Faculty of Engineering and Management of Technological Systems, Siemens Corporate Technology, Siemens SRL, Supelec Campus de Rennes, Technical Educational Institute of Athens, Universitaty Politehnica of Bucharest Faculty of Automatic Control and Computers, Gurzun Magdalena , Sorici Alexandru ,   University POLITEHNICA of Bucharest, Croitoru Alexandru ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Cuzino Dragos ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Tudor Diana ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Sorin Sorin ,   University of Illinois Chicago, USA
Published: April 2022

Artificial Intelligence (AI) has become an important tool for computer-aided diagnosis of medical imaging. This review aims to provide an overview for clinicians, explaining the relevant aspects of artificial intelligence and machine learning (ML) and presenting up-to-date applications of AI and ML techniques to medical imaging methods such as angiography, magnetic resonance, and echocardiography. For each imaging method, we present the acquisition process, the types of diagnostic test interpretation, and the challenges related to them, as well as how AI/ML techniques, have improved the process of decision making. A summary of selected works applying AI/ML techniques to medical imaging is organized into a table, which highlights the scope of the study, the dataset used, the details of each approach as well as the measured results, including objectives and criteria. The overall benefits of AI in medical imaging are extracted based on the diverse applications and high evaluation scores. In the end, cardiologists should have an advanced understanding of using AI to integrate clinical data and making the final decision in diagnosis.
Clinical and therapeutic particularities of acute gallstones disease during COVID-19 pandemic
Authors:   University Emergency Hospital Bucharest, IVth Surgery  Department, Bucharest, Romania, Balasescu Simona , Trotea Andra ,   University Emergency Hospital Bucharest, IVth Surgery  Department, Bucharest, Romania  “Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania, Margaritescu Dragos ,   University of Medicine and Pharmacy Craiova, Romania, Sabau Alexandru ,   "Lucian Blaga" University, Faculty of Medicine, Sibiu, Romania
Published: April 2022

Gallstones disease (GD) is a common pathology, with an incidence of approx. 20% in developed countries, a third of these cases being symptomatic. The paper aims to identify the diagnostic and therapeutic features of acute manifestations of gallstones during the COVID-19 pandemic. Materials and method: A retrospective, comparative study was performed of the cases presented to the emergency room (ER) and hospitalized for acute manifestations of gallstones in April-June 2020 vs similar period of 2019. The data regarding clinical form, associated pathology, therapeutic management were analyzed from the ER presentation register, hospitalization sheets and surgical protocols. Results: During the COVID-19 pandemic, the number of hospitalized cases for acute cholecystitis and other acute manifestations of GD was significantly lower than in the same period last year (21 vs 49 patients). In both study groups the main form of presentation was acute catarrhal cholecystitis (52.4% vs 63.2%). During the SARS-Cov-2 pandemic, we report an increased incidence of complicated forms, mainly hydrops (23.8% vs. 4.1%, p <0.05) and angiocholitis (19% vs. 4.1%, p <0.05). Conservative treatment was chosen more frequently during the pandemic (48% vs. 29%). For operated patients, laparoscopic cholecystectomy was the main option, performed in 85.7% in both groups. Conclusions: We maintain that laparoscopic cholecystectomy remains the gold standard for acute cholecystitis, even in the COVID-19 pandemic, as it guarantees the best outcomes for the patients. Conservative management may be an option for mild cases, but it carries the risk of recurrence of symptoms and increased incidence of severe complications.
Normal pressure hydrocephalus – Diagnosis and therapeutic challenges
Authors:   Department of Neurosurgery, Carol Davila University Central  Emergency Military Hospital, Bucharest, Romania, Chirtes Alin , Mures Teofil ,   Department of Neurosurgery, Carol Davila University Central  Emergency Military Hospital, Bucharest, Romania, Mitrica Marian ,   Department of Neurosurgery, Carol Davila University Central  Emergency Military Hospital, Bucharest, Romania
Published: April 2022

Normal pressure hydrocephalus – Diagnosis and therapeutic challenges
The seasonal incidence of intracranial hemorrhages
Authors:   Department of Neurosurgery, Carol Davila University Central  Emergency Military Hospital, Bucharest, Romania, Mitrica Marian , Dumitru Razvan ,   Department of Medical-Surgical and Prophylactic Disciplines,  Faculty of Medicine “Titu Maiorescu” University, Bucharest,  Romania, Sirbu Carmen ,   Department of Medical-Surgical and Prophylactic Disciplines,  Faculty of Medicine “Titu Maiorescu” University, Bucharest,  Romania  Department of Neurology, Carol Davila University Central Emergency Military Hospital, Bucharest, Romania  E Al Ain Educational Zone, European Academy of Neurology, European Brain Council (https://www.braincouncil.eu/),, European Cooperation in Science and Technology, National Council for Development and Innovation
Published: April 2022

Objective: Cerebrovascular Accidents (CVAs) represent the second most prominent cause of death globally, surpassed only by ischemic heart diseases, thus constituting a significant economic burden for healthcare systems. Despite this, little is known about the correlation between the different times of the year and intracerebral hemorrhages. This review investigates said link, as well as seek to identify whether vascular risk factors (i.e. diabetes and high blood pressure) vary through seasons. Method: This paper undertakes the study of 97 patients, all of whom have suffered a hemorrhagic CVA and were hospitalized and treated within the Central Military Emergency University Hospital’s Department of Neurology in Bucharest, in the period between 29th of June, 2017 and 29th of July, 2019. The scope of this study is to optimize prophylaxis within the groups most susceptible to the imminent danger of an intracranial hemorrhage during a certain season. Results: Our study has shown that the season with the highest values of morbidity and mortality is autumn, followed closely by spring. Conclusion: Given the set of yielded data, which is mirrored in the case of risk factors, we conclude that the results vary slightly from those put forward in the literature. Therefore, whilst hemorrhaging CVAs have a consequential impact upon society, both through the disastrous effects of the incident per se, and its disabling nature in the long-term, a positive percentage of them could be avoided by changing one’s behavior during the high-risk periods
Assessment of patient satisfaction with primary health care in a military setting: A cross-sectional study from Turkey
Authors:   Gendarmerie and Coast Guard Academy, Primary Health Care Centre, Ankara, Turkey, Kokcu Alper
Published: April 2022

Background and Aim: Information on patients' experiences with and evaluations of health care is considered an essential outcome indicator to assess the quality of health care. This study aims to evaluate patient satisfaction with primary health care in a military setting. Methods: This cross-sectional study was conducted at the primary health care center located in a military setting, in Ankara, Turkey. A total of 3080 military personnel who received primary care in the last 12 months formed the population of the study. Turkish version of the European task force on patient evaluations of general practice care (EUROPEP) questionnaire was administered to the participants. Results: In the study, 2677 participants were reached with a response rate of 86.9%. The mean satisfaction rate (MSR) of clinical behaviour (69.3%) was higher than the MSR of the organization of care (58.4%). The MSR of the overall questionnaire was 67.1%. Significant differences were observed in the mean satisfaction scores of patients according to their descriptive characteristics including gender, age level, troop type, and the doctor providing the care. Conclusions: This study highlights the low patient satisfaction levels, which may have resulted from the fact that the study population was young and relatively healthy, and that there was no possibility of choosing the general practitioner. The EUROPEP questionnaire, which is an internationally validated and standardized instrument, can also be used to improve primary health care in military settings.
Total knee arthroplasty radiographic evaluation via a Bayesian belief network. A pilot study
Authors:   ", Cirstoiu Catalin ,   Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania   Department of Orthopedics and Traumatology, University Emergency Hospital, Bucharest, Romania, Cretu Bogdan ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania   Department of Orthopedics and Traumatology, University Emergency Hospital, Bucharest, Romania, Serban Bogdan ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania   Department of Orthopedics and Traumatology, University Emergency Hospital, Bucharest, Romania, Iordache Sergiu ,   “Carol Davila” Unne and Pharmacy, Bucharest, Romania   Department of Orthopedics and Trauiversity of Medicimatology, University Emergency Hospital, Bucharest, Romania, Cursaru Adrian ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania   Department of Orthopedics and Traumatology, University Emergency Hospital, Bucharest, Romania, Cristea Stefan ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania   Department of Orthopedics and Traumatology, Pantelimon  Emergency Hospital, Bucharest, Romania, Eremia Anca ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania   Department of Emergency, University Emergency Hospital,  Bucharest, Romania, Nica Silvia ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania   Department of Emergency, University Emergency Hospital,  Bucharest, Romania
Published: April 2022

In an attempt to standardize the X-ray analysis and to create relevant correlations between it and the functional results, we present a pilot model of an artificial neural network based on a Bayesian belief network (BNN) designed for the automatic analysis of anteroposterior X-ray of the knee following total knee arthroplasty and more precisely the analysis of the tibial component. A prospective analysis was conducted in which 30 patients were analyzed and two groups resulted: the first was made up of 12 cases considered “normal” by the examiners (optimal positioning and cementation) and the second one, which was considered “pathological” (incorrect positioning or cementation) and included 16 cases. Based on 22 points established on the tibial component several geometric sizes (calculated parameters) were computed. Several parameters were compared and the results were up to 75% accuracy, 81.25% sensitivity, and 66.7% specificity. BBNs can be a solution for X-ray evaluation of total knee arthroplasty and can improve the understanding of its evolution. It needs confirmation in time, its accuracy rising with the number of patients introduced in the analysis algorithm.
CoViD-19 disease, Romanian health system response to outbreak and economic impact
Authors:   The Bucharest University of Economic Studies, Romania, Bostangiu Laura , Iordache Alexandru ,   Fundeni Clinical Institute, Bucharest, Romania, Garofil Nicolae ,   Carol Davila University of Medicine and Farmacy, Bucharest,  Romania, Costache Raluca ,   Carol Davila University of Medicine and Farmacy, Bucharest, Romania
Published: April 2022

The pandemic called COVID-19 disease has an exponential course since the first cases were reported showing in 9th of May, 2020, more than 4 million cases of COVID-19. United States and European Council (EC), together with other European Union institutions, were closely monitoring the situation in order to take quick action. Objective: The aim of this article is to analyze the response to COVID 19 pandemic outbreak in term of strategy and money flow of Romanian health system in order to identify the strength and weakness and prepare for other similar provocative challenges. Global and national strategy: United States Government is delivering a comprehensive package of services to support international partners around the world in combatting this disease adding American expertise for global benefit, saving lives by improving international partners abilities to respond to the COVID-19, and reducing secondary impacts. Meanwhile European Union is focused on 6 major coordinates limit the spread of the virus, ensure and provide medical supplies, decrease negative economic impact, support jobs, promoting research and help European citizens to repatriate. Despite all negative elements a proper and relatively quick response of Romanian Public Health System was noticed and the taken measures were harmonized and synchronized with the European coordinates, prioritize initiatives, build an action plan, establish a communication plan, workforce optimization and management strategy. Conclusion: Global shock needs global response, with little or no government interventions, economic costs will be huge.
Therapeutic and diagnostic considerations in multiple eruptive clear cell acanthoma
Authors:   ”Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania  Department of Dermatology, ”Elias” University Emergency Hospital, Bucharest, Romania, Șandru Florica , Teodorescu Cezara ,   Department of Dermatology, Valcea Emergency Hospital, Ramnicu Valcea, Romania, Constantin Maria ,   ”Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania   Department of Dermatology, Colentina Clinical Hospital,  Bucharest, Romania, Dumitrașcu Mihai ,   ”Carol Davila” University of Medicine and Pharmacy, Bucharest,  Romania   Department of Obstetrics and Gynecology, University  Emergency Hospital, Bucharest, Romania, Miulescu Raluca ,   Department of Dermatology, ”Elias” University Emergency  Hospital, Bucharest, Romania, Popa Adelina ,   Department of Dermatology, ”Elias” University Emergency Hospital, Bucharest, Romania
Published: April 2022

Clear cell acanthoma represent a benign solitary epidermal tumor of the clear glycogen containing epithelial cells, which is quite common in dermatologic practice. The etiology of this tumor formation is not known exactly at the moment. Clinically, the lesion appears as a single reddish papule or papule-nodule and the characteristic of this lesion is represented by a peripheral scaling collarette. Although solitary lesions represent the most common form of presentation of the acanthoma with clear cells, less than thirtieth cases of multiple clear cell acanthoma, from two up to four hundred lesions, have been described in the medical literature to date. The diagnosis based on clinical features frequently needs to be supported using a dermoscopy exam and, in most cases, a histopathology exam is required. The treatment consists is complete removal (standard surgical excision, cryotherapy, electrofulguration alone, carbon dioxide laser or shave removal or curettage followed by electrofulguration). For the cases with multiple lesions, cryotherapy, or topical 5- fluorouracil are preferred. We present the case of a 62-year-old male patient, presented to our Dermatology Department for multiple asymptomatic rounded papules and multiple exophytic nodular tumor formations (approximate fifteen), on the lower extremities, which had occurred approximately two years previously and gradually increased in number.
Leadership skills in surgeons: a review of the literature
Authors:   Klinik für Orthopädie und Unfallchirurgie, Franziskus Hospital  Harderberg, Niels Stensen Kliniken, Sopu Alexandra , Aple Juergen ,   Klinik für Orthopädie und Unfallchirurgie, Franziskus Hospital  Harderberg, Niels Stensen Kliniken
Published: April 2022

Clinicians, professors of medicine in general, students, and professionals from the health sciences tend to focus their efforts on technical training related to their discipline in practice as well as activities that produce some benefit direct or personal satisfaction. It is unusual to devote time and effort to training in areas such as teaching or expand their skills in sociological and organizational aspects. Would you like to take a course on strategic planning if not a director or officer of the hospital? Manage time in your schedule for a workshop on communication and conflict management? Have room in your schedule for educational activities on leadership, organizational change, and diffusion of innovations, science or science complexity of implementation? Generally, doctors and teachers do not spend much time on these activities (at least voluntarily) because we feel that what we have learned from these topics on personal experience is enough. Effective teamwork, not only in the operating room but also throughout the perioperative route is considered an important and critical component of the safety and effectiveness of surgical care and leads to good results and quick recovery of surgical patients. Therefore, considerable efforts have been made to understand how teams work within the route of surgical care and to improve teamwork. The simple act of bringing together some experts does not guarantee that turned out an expert team. Given the evidence suggests that teamwork in the operating room sometimes is far from harmonious and effective, the importance of training the surgical team to work effectively is receiving international acceptance as a key strategy to maximize safety in surgery. This systematic literature review aims to present a review of literature that focuses on the importance and role of leadership skills in the surgeon and how these skills can play a significant role in increasing the quality of care and patients’ safety in operating room (OR) settings.
Couvelaire-Uterus: literature review and case report
Authors:   Clinic of Obstetrics and Gynecology, Diakonie Klinikum, Schwäbisch Hall, Germany, Cobec Ionut M. , Rempen Andreas ,   Clinic of Obstetrics and Gynecology, Diakonie Klinikum, Schwäbisch Hall, Germany
Published: April 2022

Uteroplacental apoplexy or Couvelaire uterus is a rare complication in the spectrum of the life-threatening placental abruption. We report a 29-year-old pregnant woman who had a placental abruption complicated with the rare condition of Couvelaire uterus, with an delivery per uterus-sparring cesarean section. The early diagnosis and proper medical management of placental abruption through uterus-sparring cesarean section present the best outcome for mother and child.
The effect of Dexmedetomidine on sedation of patients undergoing openheart surgery in a military hospital
Authors:   Atherosclerosis research center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Zavareh Seyed , Lak Marzieh ,   Trauma research center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Published: April 2022

Background: Dexmedetomidine facilitates patient communication with the ICU nurses, and is a valuable drug for use in patients undergoing mechanical ventilation due to a reduction in the duration of mechanical ventilation and prevalence of delirium. Objectives: In this study, investigators aimed to compare the effect of Dexmedetomidine with placebo on sedation in patients undergoing open-heart surgery. Methods: In this double-blind clinical trial, 69 patients with open-heart surgery who underwent a cardiopulmonary bypass pump, were randomly assigned into two groups of Dexmedetomidine (group D) and placebo (group P). At the end of the operation, patients in groups D and P respectively received 1 µ / kg infusion of Dexmedetomidine and normal saline in 10 minutes. In case of a lack of proper sedation, midazolam with the doses of 1 mg titration was used up to reaching the goal of sedation. Also, for pain relief, morphine titrated at a dose of 1 mg was Injected, and dosage was recorded in both groups. In each shift, patients were examined for delusions by the nurse involved in their care, using the “Confusion Assessment Method for the ICU (CAM-ICU)”. For patients with delirium, 1 to 5 mg of Haloperidol was used. Also, the length of stay in the ICU was recorded. Results: There was no significant difference between the two groups in systolic blood pressure, diastolic blood pressure, and heart rate at different stages of treatment.
The assessment of the vitamin D deficiency between the patients with acute coronary syndrome and those with stable coronary artery disease in a military hospital
Authors:   Atherosclerosis Research Center, Baqyiatallah University of  Medical Sciences, Tehran, Iran, Khodaparast Morteza
Published: April 2022

Background: A few studies compared the vitamin D deficiency condition between the patients with the acute coronary syndrome (ACS) and those with stable coronary artery disease. The present comparative study aimed to assess the vitamin D deficiency status between the patients with ACS and those with stable coronary artery disease. Methods: This cross-sectional study was performed on 200 consecutive patients with the diagnosis of ACS or stable coronary artery disease. Serum Vitamin D level was measured by immunoassay and its serum level was categorized as normal (> 30 ng/ml), insufficient (20 to 30 ng/ml), and deficient (< 20 ng/ml). Results: Overall, 103 patients were categorized as stable angina group, 74 had unstable angina, 10 had STEMI, and 13 had NSTEMI. There was no difference in serum vitamin D3 level across the four groups including stable angina group (13.81 ± 15.13 ng/ml), unstable angina group (15.13 ± 11.11 ng/ml), STEMI group (21.58 ± 19.87 ng/ml), and NSTEMI group (18.67 ± 13.07 ng/ml) (p = 0.276). No difference was also found in the mean vitamin D3 level between the groups with new MI (15.98 ± 12.44 ng/ml versus 14.01 ± 15.31 ng/ml, p = 0.318). In total, 8.5% had normal vitamin D levels and 9.0% had vitamin D insufficiency, while the majority of patients (82.5%) were vitamin D deficient. The vitamin D deficiency was comparable in the patients with stable angina compared to those in ACS groups. According to ROC curve analysis, measuring serum vitamin D3 had a moderate value to discriminate stable angina from ACS (AUC = 0.651). In this regard, the best cutoff point for serum vitamin D3 level to discriminate stable angina from ACS was 9.0 ng/ml yielding a sensitivity of 70.1% and a specificity of 57.3%. Conclusion: The measurement of vitamin D and thus the presence of vitamin D deficiency have no sufficient power to discriminate ACS from stable coronary artery disease.
The value of lipid profile in asthma-obstructive sleep apnea overlap
Authors:   University of Medicine and Pharmacy Carol Davila Bucharest, Romania, Oțelea Marina R. , Trenchea Mihaela ,   University Ovidius Constanţa, Romania; Constanța Clinic Pneumophtisiology Hospital, Constanța,  Romania, Handra Claudia M. ,   University of Medicine and Pharmacy Carol Davila Bucharest, Romania; Clinic for occupational Diseases, Colentina Clinical Hospital,  Bucharest, Romania, Rașcu Agripina ,   University of Medicine and Pharmacy Carol Davila Bucharest, Romania; Clinic for occupational Diseases, Colentina Clinical Hospital,  Bucharest, Romania, Arghir Oana C.
Published: April 2022

The asthma obstructive sleep apnea overlap is a clinical entity relatively new and the association with a dysfunctional plasma lipid profile is not known. Aim. In this study, we compared the serum lipid profile in asthma-obstructive sleep apnea overlap syndrome to those in asthma and obstructive sleep apnea patients. Methods. A cross-sectional study of 97 cases of which 26 patients had only asthma, 51 were diagnosed with OSA, and 20 were identified with A-OSA overlap. The lipid profile included the total cholesterol, HDL-cholesterol, triglycerides, the LDLcholesterol. The Casteli indexes I and II and the atherogenic plasma index were calculated. Results. The patients with asthma- obstructive apnea overlap were older (55.55 years vs 53,73 years in obstructive sleep apnea and 51,04 years in asthmatics), mostly obese (95%), and had a significantly higher average of BMI (38.11 vs. 35.64 and 28.8, respectively). Asthma- obstructive apnea overlap was at higher risk of cardiovascular disease than asthmatics, in respect to the lipid profile: the levels of HDL-cholesterol were lower, triglycerides were higher, and the values of Castelli index I and II were higher. Conclusions. Based on our results, we confirm that age and BMI contribute to the risk of A-OSA overlap. The major differences in the common markers of the serum lipid profile are lower HDL-C and higher triglycerides. As a clinical implication, both Castelli indexes could provide additional value for cardiovascular risk and should be monitored in A-OSA overlap.
Assessment of traumatic injuries in 1028 patients referred to the Ayatollah Taleghani Hospital from the Sarpul-Zahab earthquake
Authors:   Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Ahmadpour Fathollah , Fazelinezhad Shahriar ,   Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Saravi Hooman R. ,   Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran, Khoshmohabbat Hadi ,   Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Mahmoodi Sadrollah ,   Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Manoochehry Shahram ,   Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran, Rasouli Hamid Reza ,   Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
Published: April 2022

Introduction: Investigating and recognizing the epidemiological structure of earthquake damages in earthquake-prone countries is of great importance. The aim of this study was to evaluation of traumatic injuries in1028 patients referred to the Ayatollah Taleghani Hospital from the Sarpul-Zahab earthquake (November 12, 2017). Method: This study is a cross-sectional study that includes 1028 traumatic patients from the Kermanshah earthquake. The patients, including outpatients in the emergency department, admitted in orthopedic, general surgery and neurosurgery, or even patients who needed to be transferred to other treatment centers. Result: Of the 1,028 patients, 488 were men (47.5%). The number of men with high injury severity was 51 (10.4%) and the number of women with high severity of the injury was 58 (10.7%). The average age of the injured was 33.04±15.01 years. The mean ISS measure in this study was 8.9±1.6. A total of 109 (10.6%) had scores above 17. The number of cases with head and neck injury was 328 (24%), 233 cases (17%), chest 114 (8.3%), The abdomen or pelvis is 190 (13.9%), the spine is 200 patients (14.6%). After examining the type of trauma in 1791 injuries, 1074 injuries (59.9%) had penetrating trauma and 717 injuries (40.1%) of blunt trauma were calculated. Of patients with severe trauma, 83 patients suffered severe injuries (7.7%) and in patients with blunt trauma, 68 patients suffered severe injuries (9.4%). The mortality rate was 5 (0.5%). Conclusion: This study established a fracture pattern in the referred patient of the Sarpul-Zahab earthquake to the Ayatollah Taleghani Hospital and is practical for clinicians to increase understanding of this natural disaster and permits superior selection of the triage management and therapeutic process.
The Cladding Problem: Establishing and Assessing Safe Building Envelopes
Authors:   Thomas Bell-Wright International Consultants, Chhabra Abhishek
Published: April 2022

Worldwide, the negative impacts of fire on cladding materials has increased over the years as buildings grow taller and the complexities of ownership, liability, and responsibilities increase. This paper discusses how the UAE fire code (UAE Fire and Life Safety Code of Practice) has effectively utilized proven conformity assessment standards—specifically ISO/IEC 17025, ISO/IEC 17065, and ISO/IEC 17020—to create robust mechanisms that drastically reduce fire safety hazards for building envelopes.
Governance of Knowledge in Management Systems Applications
Authors: Atkas Tolga
Published: April 2022

As organizations seek to become increasingly competitive and innovative, knowledge management systems are emerging as critical assets. This article reviews how knowledge is portrayed in management system standards, examining the relationship and how it reflects on the governance of organizations. The framework of ISO standards mentioned in this article is useful for organizations that aim to develop a mature roadmap to business resilience and continuity.
Projectbesluit? Nee, dank je
Authors: ten Heuw E.W. (Ewout)
Published: April 2022

Projectbesluit? Nee, dank je

Auteur gaat in op het kerninstrument projectbesluit en staat stil bij de vraag of het projectbesluit de ook destijds veronderstelde logische opvolger kan zijn van het projectplan op grond van de Waterwet. Hij geeft een interessante inkijk in de praktijk van de waterbeheerder, met name hoe deze projecten voorbereidt en beschrijft hoe besluitvorming over waterschapsprojecten nu plaatsvindt, hoe dat met toepassing van het projectbesluit het geval zal zijn onder de Omgevingswet, en of een vergunning eigen werken een alternatief kan zijn voor het projectbesluit.
On Pair-Wise s*-Compactness in Bitopological Spaces
Authors: Mahmood Sabiha
Published: April 2022

The main goal of this paper is to create special types of compactness on topological spaces and on bitopological spaces , where we studied the concepts of s*-compactness and pair-wise s*-compactness. Also, we study the characterizations and basic properties of s*-compact spaces and pair-wise s*-compact spaces.
A Reform Process and Enlightenment of Online and Offline Hybrid Teaching of Engineering Cost Major——Taking Wuhan Institute of Engineering Science as an example
Authors: Huang Ying
Published: April 2022

In order to explore the development trend of online and offline hybrid teaching reform in the new situation of engineering cost major, this paper took the engineering cost major of Wuhan Institute of Engineering Scinece as an example, studied its teaching development process since enrollment, and then put forward some practical development strategies from the aspects of classroom positioning and teaching design.
Using Tablets to Enhance the Teaching and Learning Environment in Landscape Architecture: A Pilot Study
Authors: Griesel Gerhard , Price Christine
Published: April 2022

Higher education has a responsibility to empower students to cope with technology-driven changes in the labour market. Subsequently there has been a trend in higher education to shift from lecturer-centered to student-centered pedagogies. With this in mind, through a pilot study we sought to investigate the impact of tablets in landscape architectural design education. A series of learning activities using a range of tablet applications was designed for the 25 Foundation and 20 First year landscape students who participated in the pilot study. Data collection included three student questionnaires, student reflections, two focus groups and the digital outputs of the activities themselves. The findings showed how tablets can play a role in enhancing the learning environment: redefining learning spaces; influencing pedagogies and; encouraging shifts in lecturer and student roles. The innovative nature of the tablets produced unexpected effects, providing insights into students’ perceptions of the landscape design process and learning environment. These insights have influenced our teaching practices and developed an understanding of the role in which tablets can contribute to a dynamic teaching and learning environment.