bluuebunny/crossref_metadata_2025 huggingface dataset:
A Bride Run Free Movement of People in the EU, the Fundamental Right to Family, Family Reunification, and the Case of Denmark
Authors: Balnaves Hugo
Published: September 2021

Danish legislation has made it increasingly difficult for Danish citizens who have not exercised their free movement (static EU citizens) to have their third country national (TCN) family member(s) reside with them in Denmark under family reunification. On the other hand, EU citizens (mobile EU citizens) who have exercised their free movement and reside in Denmark with their TCN family member(s), have access to far more generous EU family reunification legislation. This article explores the extent to which reverse discrimination effects Danish citizens compared to mobile EU compatriots living in Denmark and how this interacts with EU citizenship rights such as free movement and the fundamental right to family life.
Equal Pay and EU Public Procurement Law – Case Study of Mandatory Icelandic ÍST85 Standard
Authors: Andhov Marta , Bergsson Bergþór
Published: September 2021

From 2018, it became mandatory to obtain the Icelandic Equal Pay Standard (ÍST85) for all companies with 25+ employees annually operating on the Icelandic market. It has been unclear to what extent – if any – the ÍST85 can be applied in public procurements. This article analyses whether the ÍST85 is compliant with the relevant European Union internal market law, particularly public procurement law. The growing intensity of nudges to include and verify social elements in public procurements can be observed throughout the EU. The analysis of the Islandic case study bears relevance as it can be applied to the EU Member States and other EEA/EFTA States, contemplating similar approaches in their procurements. Section 1 introduces ÍST85. Section 2 analyses the relationship between EEA and EU law, showcasing that this article's analytical outcomes provide lessons applicable beyond Iceland. Section 3 examines how equal pay is regulated under EU law. Section 4 conducts an internal market analysis of ÍST85 compliance by examining the Treaties provisions on free movement. Section 5 introduces the EU public procurement law and examines ÍST85 compliance with Directive 2014/24/EU. Section 6 tests the application of ÍST85 to the Posted Workers Directive. Section 7 concludes the article.
Farewell to the EU Charter: Brexit and Fundamental Rights Protection
Authors: Galimberti Marco
Published: September 2021

Twenty years after its drafting and more than one decade after its entry into force, the Charter of Fundamental Rights of the European Union has ceased to be part of British law as a consequence of Brexit. Looking into this issue raised by the UK withdrawal from the European Union, the essay sheds some light on the legal status and impact of the EU Bill of Rights in the British legal order. Against this background, the article detects a connection between the UK Supreme Court’s case law and the jurisprudence of the Court of Justice of the European Union on the direct effect of the Charter. From this perspective, the analysis highlights the implications of the UK departure from the Charter and disentanglement from the Luxembourg case law, thus arguing that they may weaken the standards of fundamental rights protection.
Prediksi Tingkat Produksi Buah Kelapa Sawit dengan Metode Single Moving Average
Authors: Irawan Feri , Sumijan S , Yuhandri Y
Published: September 2021

Palm oil is one of the largest agricultural products in Indonesia and has a high economic value and can improve the welfare of oil palm farmers. The amount of oil palm fruit production is not always stable or increasing, but increases up and down which is influenced by many factors. This study aims to estimate the average amount of oil palm fruit production every year and prepare anticipatory steps in the event of a decrease in oil palm fruit production. The image processed in this study was the production of palm fruit in a few years which was generated from the results of oil palm plantations. Furthermore, data is processed using the Single Moving Avarage method. This method is a method of forecasting or predictions using a number of actual data to generate predictive values ​​in the future. The results of testing on the single moving average method can be seen forecasts of oil palm fruit production in 2021 using Moving Averge 3 of 200.749 tons with Mean Absolute Deviation 19.604, Mean Squared Error  456.963.281  and Mean Absolute Percent Error 10,0%. Moving Averge 4 was  206.771 tons with the Mean Absolute Deviation  27.333, Mean Squared Error  752.202.579 and Mean Absolute Percent Error 14,2%. Moving Averge 5 was  210.908 tons with Mean Absolute Deviation  26.890, Mean Squared Error  723.072.100 and Mean Absolute Percent Error 14.1%. The test results using the Single Moving Average method can be concluded that forecasting using Moving Average 3 can be used because the relative error level is smaller than Moving Average 4 and 5, with the value of the Mean Absolute Percent error of 10.0% and Mean Absolute Deviation 19.604.
Domestic Cells, State of health Tester, Charger (Open Source)
Authors: Sivert A. , Carriere S. , Betin F. , Dondon Ph.
Published: September 2021

In France, the annual average purchases per person is 19 primary household batteries and 2 rechargeable batteries. Despite the obligation for each battery seller to have a collection point, only 50% of these domestic accumulators are recycled in France. Among the numerous reasons that users do not use home rechargeable NiMH batteries to their discharge limits, this article will mainly discuss the lack of easy-to-use and inexpensive function testing. An "open source" tester-loader with many possibilities is proposed. In particular, a test by the linear regression method making it possible to reduce the test duration of NiMH batteries from 6 hours to 1.5 hours to check the energy capacity of each accumulator is presented. Since 2019, lithium-ion batteries in domestic cases have been marketed with few characteristics provided by manufacturers on their obsolescence and their capacities. In this article we present performance tests carried out to verify the energy capacity as a function of the output current.
A study of Epidemiological Characteristicsand Weather Elements influencing COVID-19 Positive Autopsy Cases Studied at B.H.U, Varanasi, U.P
Authors: Deepa Durga Roy  , Manoj Kumar Pathak
Published: September 2021

The ongoing Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic has prevailed andcontinues to persist in the country and the world despite all preventive and regulatory measures taken by thegovernment, health care and at an individual level. It does beg the question, why?It can be safely attributed to the fact that we are still learning about the epidemiological factors, thevirological characteristics, clinical profile and the transmission dynamics of the disease. The situation isparticularly challenging when we are coupling research to answer these questions while taking on board,precautionary measures to contain the tumultuous morbidities and mortality by rationing the scarce resourcesand manpower. The present study aims to provide an auxiliary insight into the epidemiological, topographicand weatherelements influencing COVID-19 from the 34 COVID-19 positive dead bodies sent for autopsyto Department of Forensic Medicine at Institute of Medical Sciences, Banaras Hindu University from 1 Feb2020 to 31 March 2021. It also examines the counter productiveness for autopsy in certified cases of deathwith COVID-19 positive status in a common mortuary setup in India.
Regression Formula for Stature Determination from Percutaneous Tibial Length among the Female Meitei Population of Manipur
Authors: Haobijam Rita Devi  , Memchoubi Phanjoubam  , Seram Elizabeth Devi  , Uma Adhikari
Published: September 2021

Stature is one of the important parameters for personal identification when only parts of human body, such aslimbs are available for identification as in cases of natural disasters, rail and aircraft accidents, wars and terroristbombings. Studies have reported significant differences in proportion of limb dimensions due to hereditary,environmental, ethnic and dietary factors, which also influence the stature of a person. Therefore, populationspecificformulae are necessary for estimation of stature in medico-legal cases. A cross-sectional study wasconducted on Indigenous Manipuri Meitei female subjects between the age group of 21-25years. ‘Meitei’is the majority community in the state. The calculated sample size was 72. Considering a dropout rate of5%, a total of 75 Meitei female subjects were studied in Department of Forensic Medicine and Toxicology,Regional Institute of Medical Sciences, Imphal. The study period was from August 2018 to July 2020.The findings of the study have been used in estimating the stature from Tibial Height by deriving a newRegression Formula which is specific for the population. The following is the developed regression equationof stature of female (Y) on her tibial length (X): Y= 107.83 + .60 X +.71. It will be of immense importancein medico-legal investigations thereby benefitting the society in general.
Study of Acute Effect of Caffeine on Cognition among Adults- An Exploratory Intervention Trial
Authors: Krishnan S  , Smisha Mohan  , Jeneth Berlin Raj T  , Manikandan S
Published: September 2021

Introduction/Background: Information processing has substantial role in performing intellectual activitiessuch as thinking, reasoning, remembering, imagining, or learning. Caffeine being a CNS stimulant improvesmental performance, especially on alertness, attention, concentration and learning depending on the quantityof intake. In the present study, an attempt is made to study the effect of caffeine on cognitive processing inhealthy individuals.Methodology: This cross sectional study was conducted in 50 subjects at Mahatma Gandhi Medical College& Research Institute. MOCA questionnaire was utilized to assess the level of cognition of each subject.Visual reaction time, auditory reaction time and critical fusion frequency prior and after consumption of 75mg of caffeine in 200 ml of milk.Results: Both visual and auditory reaction time were significantly reduced (p<0.001) after intake of caffeineintake. The ability of the subject to appreciate the flickering light stimuli to be steady (critical flicker fusionfrequency) was significantly improved 15% after caffeine intake.Conclusion: Decrease in visual and auditory reaction and increase in critical flicker fusion frequency valuesindicate caffeine increases alertness thereby it may enhances performance efficiency in reasoning, planning,judgment, organizing, concept formation, and problem solving.
Litigation Following Total Hip Arthroplasty
Authors: Aneesh Dave  , Timothy Matthews  , Sanjeev Gupta
Published: September 2021

Background: Total hip arthroplasty (THA) is commonly performed procedure internationally, and patientsmay expect an excellent prognosis. Risks associated with the procedure may lead to patient dissatisfactionand litigation. International data suggests orthopaedic surgery is particularly prone to high litigation rates,third to only obstetrics and general surgery in this regard. In Australia, there is currently no body whichaccurately collates litigation data following surgery.Methods: We performed a systematic search of several Australian legal databases to find cases of litigationfollowing THA, and supplemented this with data provided by the Health Care Complaints Commission,National Joint Replacement Registry and medical indemnity insurers. We also performed a review of thecurrent literature in the field.Conclusions: 11 cases were found and analysed. 28% of cases were successfully litigated. Approximately1/3 of litigation was for leg length discrepancy. Other causes for litigation included infection, nerve injuryand dislocation. Remuneration following successful litigation varied between $25, 000 and $265, 000,corrected for inflation. The Australian data is in keeping with that of similar studies from USA and UK. Thedissemination and accessibility of this data is important for surgeons in improving the informed consentprocess for their patients.
In COVID-19, Unmet Needs of Nursing Students Participating in Limited Clinical Practice
Authors: Gie-Ok Noh
Published: September 2021

Background: This study was conducted to identify unmet needs through qualitative research on studentswho have experienced clinical practice and alternative practice that are suddenly limited to COVID-19situations.Method: Qualitative research using focus group interviews involved five junior students with untact orlimited clinical practice experience.Finding: The unmet needs of nursing students were analyzed as four categories based on “lack of variousmedia and visual materials” and “need to strengthen self-directed learning capabilities.”Conclusion: The results of this study suggested that nursing students who experienced untact or limitedclinical practice experience are demanding education that utilizes various media and enhances self-directedlearning, despite suffering from a lack of direct field experience and burden on tasks. Therefore, educationprograms should be developed to meet these needs.
Differences in Body Esteem and Sexual Assertiveness between Male and Female College Students
Authors: Hyun Ju Chae  , Kwang Ok Lee
Published: September 2021

The present study was conducted to identify the differences in body esteem and sexual assertiveness betweenmale and female college students. A total of 288 students (156 males and 132 females) from a universityin Chungnam, South Korea, participated in this study. A self-administered questionnaire survey with thestudy participants was conducted from December 1 to 14, 2018. The data obtained were analyzed usingdescriptive statistics, c2 test, analysis of covariance, t test, one-way analysis of variance (Scheffé test forpost hoc analysis), and linear regression with the IBM SPSS 20.0 program. Body esteem among the malestudents was higher than that among the female students, whereas sexual assertiveness among the femalestudents was higher than that among the male students. Body esteem differed according to body imageperception in the male students and according to body image perception as well as the number of romanticrelationships in the female students. Sexual assertiveness differed according to grade level and body imageperception in the male students only. In all the study participants, the higher the body esteem, the higher thesexual assertiveness. These results indicate that (1) interventions that increase the body esteem of femalestudents should be provided and (2) interventions that increase sexual assertiveness should factor in bodyesteem. Additionally, developmental interventions for body esteem and sexual assertiveness should considerbody image perception.
Comparison of Nurses’ Image in Korean Online Newspaper Articles before and after COVID-19: A Text Mining Analysis
Authors: Jeongmin Ha  , Dahye Park
Published: September 2021

Background/Objectives: This study investigated nurse-related keywords which were presented togetherwith nurse on phrase, clauses or sentence of documents or conversations in the Korea online newspaperarticles.Methods/Statistical analysis: Text mining, which is a common method of analysis for large datasets, wasused to analyze the changes in nurses’ image before and after COVID-19. A total of the linking wordswith nurse were calculated by the number of presentation on online newspaper article in Naver before andafter COVID-19. In order to identify the meaning of the words, clustering of the collected linking wordsby categories was analysed and the characteristics of each cluster were classified. Over 5,000 articles wereidentified as targets for a keyword analysis.Findings: The most frequently presenting words were hospital, medical and patient. Before COVID-19, thewords related to ‘workplace bullying’ were highly presented and after COVID-19, the words related to ‘care’were highly presented.Improvements/Applications: With analyzing the trends of changes and characteristics of words byCOVID-19 and clusters, we attempted to investigate the image of nurse that the public think and feel aboutnurse.
Resilience, Social Support, and Meaning in Life among Koreans During Midlife
Authors: Jeong-Sook Lee
Published: September 2021

Background: Toinvestigatethe associationsbetweenresilience, social support, and meaning in lifeduringmidlife and the factors related to meaning in life.Methods:In this cross-sectionalstudy conducted from May 22 to June 21, 2019, 159 South Koreans aged40–64years were surveyed about resilience, social support, meaning in life, and personal characteristics.Descriptive statistics, t-tests, analysis of variance, bivariate Pearson’s correlations, and multiple regressionanalyses were performed.Conclusion: The difference in resilience according to general characteristics showed significant differencesin age, educational attainment, religious affiliation, and health status.Differencesin social support weresignificantly correlated to gender, social class, and health status. Meaning in life varied significantly accordingto differences in religious affiliation, social class, and health status. Resilience, social support, and meaningin life were significantly correlated. In the multiple regression model, resilience, social support, and selfratedhealth statussignificantly influencedmeaning in life. Strengthening resilience andsocial supportduringmidlife mightincrease meaning in life, in turn,positively influencing thequality of life inold age.
The Effect of NelumboNucifera seeds and Hyphaene Thebaica on Induced Animal’s Hyperlipidemia and Hypertension
Authors: Marwa F. Elmahdy  , Adris M.A
Published: September 2021

The life style of the people by large has been adversely affected due to manifold reasons which includesindustrialization and eventually making obesity as a very fast growing epidemic worldwide. Consequenceof overweight, results in chronic diseases like cardiovascular issues, diabetes, and cancer. Nearly everyobese person is found to be hyperlipidemia, which indicates a condition of having high levels of cholesterol,cholesterol esters, triglycerides, low-density lipoprotein and depleted levels of high-density lipoprotein. Thehigh frequency of side effects implications of the drugs available in the market has raised a dire need ofdiscovering and developing a new novel drug. The studies show that the plants have proven to be an uprightsource of natural as well as multifunctional molecules. The natural molecules flavonoids along with othercomponents have been reported for multi-functionality. HyphaeneThebaica and NelumboNucifera havedirect lowering effect on blood lipids and hypertension. This review explains the effect of HyphaeneThebaica(Doum) and NelumboNucifera (Lotus seeds) on blood lipids and hypertension. Lipid profile will be evaluatedby estimation of Cholesterol count , Triglycerides , High and low density lipoprotein while hypertensionwill be evaluated by measuring Aginotensin converting enzyme ( ACE) in serum and tissue extraction.Herbal medicine is the new good treatment for many chronic diseases to get ride from side effects of anticholestremicand anti-hypertension drugs.
Nursing Students Perception of E-learning during COVID-19 Pandemic; A Literature Review
Authors: Mohammad R. AlOsta  , Inaam A. Khalaf
Published: September 2021

Background: E-learning has expanded recently in response to the social distance measures duringCOVID-19 pandemic. A part of the learning process is evaluating its effectiveness and impact on learners.Aim: to examine nursing students’ perceptions of e-learning during COVID-19 pandemic.Methods: A literature search to identify publications on perceptions of e-learning was conducted via threedatabases.Conclusion: Sixty five articles were included and reviewed. The articles addressed the following: (1)benefits of e-learning, (2) drawbacks and challenges (3) Students’ interaction, (4) e-learning environment(5) students’ engagement and satisfaction, (6) e-learning during COVID-19 pandemic, and (7) Clinicaltraining during COVID-19 pandemic. Shifting to E-learning during the COVID-19 pandemic has manybenefits that positively impact student health status and learning outcome, although it has several drawbacksand barriers that can affect the learning process quality. Finally, implementing e-learning is not an easytask; higher education institutions should consider several factors to provide the students with an efficientlearning process
Synthesis of O6-alkylated preQ1 derivatives
Authors: Flemmich Laurin , Moreno Sarah , Micura Ronald
Published: September 2021

A naturally occurring riboswitch can utilize 7-aminomethyl-O6-methyl-7-deazaguanine (m6preQ1) as cofactor for methyl group transfer resulting in cytosine methylation. This recently discovered riboswitch-ribozyme activity opens new avenues for the development of RNA labeling tools based on tailored O6-alkylated preQ1 derivatives. Here, we report a robust synthesis for this class of pyrrolo[2,3-d]pyrimidines starting from readily accessible N2-pivaloyl-protected 6-chloro-7-cyano-7-deazaguanine. Substitution of the 6-chloro atom with the alcoholate of interest proceeds straightforward. The transformation of the 7-cyano substituent into the required aminomethyl group turned out to be challenging and was solved by a hydration reaction sequence on a well-soluble dimethoxytritylated precursor via in situ oxime formation. The synthetic path now provides a solid foundation to access O6-alkylated 7-aminomethyl-7-deazaguanines for the development of RNA labeling tools based on the preQ1 class-I riboswitch scaffold.
PROSPECTIVE STRUCTURE AND FUNCTIONING OF THE CENTER FOR UNMANNED AIRCRAFT SYSTEMS OF EMERCOM OF RUSSIA
Authors: Исавнина Инесса Николаевна , Осипов Юрий Николаевич , Ершов Владимир Иванович , Каменских Надежда Германовна
Published: September 2021

Развитие системы беспилотной авиации, независимо от ее предназначения и структурной принадлежности, предполагает согласованные усилия заинтересованных лиц (руководства, ученых и конструкторов, специалистов испытательных комплексов, преподавателей, инструкторов теоретического и практического обучения операторов управления летательными аппаратами и их полезными нагрузками) по совершенствованию технических характеристик и функционала беспилотных воздушных судов, а также по формированию соответствующих компетенций у персонала эксплуатирующих подразделений. Очевидным является тот факт, что все перечисленные мероприятия наиболее полно могут быть реализованы в рамках функционирования специальных центров развития беспилотных авиационных систем государственного или ведомственного уровня.

The development of unmanned aircraft system, regardless of its purpose and structural affiliation, involves the concerted efforts of stakeholders (management, scientists and designers, specialists of test complexes, tutors, as well as theoretical and practical instructors for operators of aircraft and their payloads control) to improve the technical characteristics and functionality of unmanned aircraft, as well as to create appropriate competencies among the personnel of operating units. It is obvious that all these measures can be fully implemented within the framework of special centers for unmanned aircraft systems of state or departmental level.
METHOD FOR ASSESSING THE IMPACT OF FIRE ON BUILDING STRUCTURES WHEN JUSTIFYING SEPARATION DISTANCES OF LESS THAN 6 METERS
Authors: Леончук Петр Алексеевич , Иващук Роман Анатольевич , Фомин Максим Валерьевич , Рукавишников Максим Михайлович
Published: September 2021

Рассматриваются особенности нормативного регулирования противопожарных расстояний в части расчетного обоснования их величин. Аргументируется необходимость усовершенствования расчетных методов, закрепленных в СП 4.13130.2013. Осуществляется постановка задачи и приводятся пути ее решения для определения допустимости сокращения противопожарного расстояния до менее чем 6 м. Дается краткий обзор возможностей моделирующих программ, сделан вывод о необходимости решения поставленной задачи как с использованием численных методов, так и путем решения дифференциального уравнения теплопроводности. Приведен возможный алгоритм обоснования противопожарного расстояния на основе полученных зависимостей. Названы инструментальные средства, с помощью которых может быть решена задача обоснования противопожарных расстояний.

There are considered the features of normative regulation of separation distances in terms of estimated justification of their values. The necessity of improving the calculation methods mentioned in SP 4.13130.2013 is justified. There is formulated the problem as well as the ways of its solution concerning acceptability of reduction the separation distance to less than 6 m. A brief overview of the capabilities of modeling programs is given. There is concluded the necessity to solve the problem using both numerical methods and by solving the differential equation of thermal conductivity. The possible algorithm for justifying separation distance on the base of the obtained dependencies is presented. There are specified tools for solving the problem of justification of separation distances.
SUPERAÇÃO DA DORMÊNCIA DE SEMENTES DE CEDRO ROSADO (ACROCARPUS FRAXINIFOLIUS WIGHT ET. ARN.)
Authors: Silva Flavio Pereira , Oliveira Robson José de , Sant'anna Giovani Levi , Santos Paula Barbosa dos
Published: September 2021

O cedro rosado é uma espécie florestal tropical, pioneira e de rápido crescimento, exigente em água, intolerante a déficit hídrico acentuado e geadas fortes, porém tolera geadas leves. A sua madeira é bastante atraente, possui excelentes propriedades tecnológicas, grande versatilidade, alto valor comercial, podendo ser empregada na construção de casas, produção de painéis aglomerados e usada em sistemas agroflorestais. Sua principal forma de propagação é via seminal, porém, suas sementes apresentam dormência do tipo tegumentar, a qual limita a produção homogêneas e satisfatória de mudas. Mesmo sob condições ótimas, as sementes do cedro rosado apresentam germinação desuniforme e em baixas percentagens, requerendo o desenvolvimento de tecnologias que proporcione uniformidade e melhores taxas de germinação. Este trabalho teve como objetivo desenvolver metodologias eficientes e de baixo custo, para superação da dormência das sementes de cedro rosado. A imersão prévia das sementes da espécie em ácido sulfúrico 90% PA, durante 20 e 30 minutos, seguido de uma lavagem em água corrente durante 30 segundos foi o método mais eficaz para superação da dormência das sementes de cedro rosado.
Immunosuppression in transplant of vascularized composite allografts
Authors:   Clinica de Chirurgie Plastică, Estetică şi Microchirurgie Reconstructivă, Spitalul Clinic de Urgenţă, Bucureşti, GROSU-BULARDA Andreea , VERMEŞAN Oana ,   Clinica de Chirurgie Plastică, Estetică şi Microchirurgie Reconstructivă, Spitalul Clinic de Urgenţă, Bucureşti, LĂZĂRESCU Luana ,   Clinica de Chirurgie Plastică, Estetică şi Microchirurgie Reconstructivă, Spitalul Clinic de Urgenţă, Bucureşti, LASCĂR Ioan ,   Clinica de Chirurgie Plastică, Estetică şi Microchirurgie Reconstructivă, Spitalul Clinic de Urgenţă, Bucureşti
Published: September 2021

Since 1998, when the first successful hand transplant was performed in France, at Lyon, an unpredicted development of reconstructive transplant surgery (transplant of VCA: vascularized composite allografts) occurred. Those procedures represents the only option for patients having extensive, complex tissue defects, involving multiple anatomical layers, impossible to approach using conventional reconstructive techniques. More than two hundred VCA procedures were reported worldwide, including: upper and lower limbs, face, larynx, trachea, abdominal wall, penis, uterus, knee allotransplant. Important aspects arise in the study of immunological mechanisms of acceptance and rejection of the allograft, the mode of action of immunosuppressive agents and protocols currently used in transplant programs for vascularized composite allografts. Immunosuppressive regimens that are used for solid organ transplantation (kidney, heart) are also effective for VCA transplants with good results regarding survival and functionality of the allografts. Current goal is the minimization of immunosuppression, composite tissue allotransplantation procedures being addressed for functional recovery (are not life-saving interventions like solid organ transplants). The ideal situation, which would allow a large scale utilization of VCA procedures, is the possibility of induction the donor-specific tolerance, allowing allograft acceptance without the need of immunosuppressive therapy. Currently this circumstance is difficult to achieve in clinical practice, resulting in large transplant centers ongoing research focusing on immunological difficult aspects.
Current status and novel directions in triple negative breast cancer patients. Risk factors. Role of the platinum-based chemotherapy
Authors:   “Bucur” Maternity, Bucharest, Romania, IONESCU Olivia , BALESCU Irina ,   “Ponderas” Hospital, Bucharest, Romania, BACALBASA Nicolae ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: September 2021

Rationale. Breast cancer (BC) has been recognized to be the most common type of cancer in women all over the world. One of the most aggressive subtype of BC is the triple negative breast cancer (TNBC) which is defined by the absence of estrogen receptor (ER) and progesterone receptor (PR) as well as the lack of overexpression of the human epidermal growth factor 2 (HER 2). Aim. As the estrogen and progesterone receptors as well as the expression of HER2 are lacking, a targeted therapy with anti-hormone agents and anti-HER2 cannot be utilized, the therapeutic possibilities for TNBC women are limited. The aim of this review is to present the current scientific data as well as the latest research in TNBC with focus on the risk factors as well as the current role of platinum-based chemotherapeutic agents and their future implications in TNBC treatment. Method. Information about the risk factors associated to TNBC as well as the chemotherapeutic regimens was searched through Pubmed and Medline using controlled vocabulary (e.g. breast cancer) and key words (e.g. neoadjuvant, triple negative, platinum). Systematic reviews, randomized and controlled clinical trials were analyzed. No restrictions regarding date or language were used. Conclusions. TNBC is a complex and heterogeneous disease, divided into many subtypes and with an aggressive evolution. Premenopausal women and African American women are far more likely to develop TNBC. More research is required in order to confirm the association between obesity, BMI, parity, use of oral contraceptives, alcohol and cigarette smoking and TNBC. Randomized clinical trials presented at the San Antonio Symposium suggest that platinum chemotherapy play an important role in the treatment of TNBC, especially early stage TNBC. Tumor-based measures of genomic instability will help to clarify the optimal use and activity of platinum in TNBC. However, it is clear than more epidemiological studies as well as the discovery of novel therapeutic possibilities are mandatory in order to unravel the complexity of this BC subtype, hence offering a chance to women diagnosed with TNBC.
Therapeutic approach and recovery options in traumatic caused intratemporal facial paralysis of children
Authors:   Spitalul Clinic de Urgenţă pentru Copii „Maria Sklodowska Curie“, Bucureşti Universitatea de Medicină și Farmacie „Carol Davila“ București, EPURE Veronica , GHEORGHE D.C. ,   Spitalul Clinic de Urgenţă pentru Copii „Maria Sklodowska Curie“, Bucureşti Universitatea de Medicină și Farmacie „Carol Davila“ București
Published: September 2021

TFacial nerve paralysis is one of the most feared complications of otologic surgery; the surgeon must always be prepared to recognize and solve such lesions if they occur. The authors present 2 clinical cases of intratemporal lesions of the facial nerve; in one of these we performed early neurografting of the facial nerve, in the second one we performed delayed decompression of the nerve. Facial nerve paralysis with early onset after otologic surgery needs timely exploration (via ENoG) and repair – this is always an emergency, the earlier the exploration the better the outcome; there are a variety of surgical methods for facial nerve repair, according to the type of lesion and its duration. Postoperatively the patient should be carefully monitored both clinically and by electromiography. Generally, posttraumatic facial nerve paralysis evolves better in children, compared to adult age.
Obstructive sleep apnea syndrome: is it different in women?
Authors:   Universitatea de Medicină și Farmacie „Carol Davila“, București, DIACONU Camelia C. ,   Spitalul Clinic de Urgență Floreasca, Clinica de Medicină Internă, București
Published: September 2021

Traditionally, obstructive sleep apnea syndrome (OSAS) was regarded by the medical community as a men’s disease. Current data shows indeed that the prevalence of OSAS is higher among men than women. However, in postmenopausal women the prevalence of OSAS is high. Differences between men and women in the prevalence of OSAS drop as age increases, mainly as a result of a marked increase in the prevalence and severity of respiratory sleep disorders in women after menopause. There are some differences regarding the clinical manifestations of OSAS in women and men. Also, it seems that women with moderate OSAS are more susceptible to cardiovascular consequences of OSAS compared with men, having a higher degree of endothelial dysfunction. Gender differences in the response to different therapeutic strategies for OSAS are still not known with certainty.
Diabetes education in romanian patients – a review of the national education projects and studies
Authors:   “Carol Davila” University of Medicine and Pharmacy, Bucharest, MITRACHE Marilena ,   Diabetes Department, Municipal Hospital, Ploiesti, STOICA Roxana Adriana ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest, IONESCU-TIRGOVISTE Constantin ,   “Carol Davila” University of Medicine and Pharmacy, Bucharest,   “N.C. Paulescu” National Institute of Diabetes, Nutrition and Metabolic Diseases, Bucharest
Published: September 2021

Prevention of diabetes mellitus is done by increasing medical knowledge about a healthy lifestyle, early identification and reduction of risk factors. The present study is a review of national projects and studies of medical education, appreciates the involvement of experts, authorities and the media in informing the public on diabetes and shows the impact on the population. Although efforts are made to increase the level of medical education, patient compliance with diabetes remains low on lifestyle changes, compliance with treatment, and regular medical visits.
Beetroot and carrot juice increase the risk of thyroid nodules and hypothyroidism in breast cancer patients
Authors:   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania, ARTENE Diana Viorela , BORDEA Cristian I. ,   „Prof. Dr. Al. Trestioreanu“ Institute of Oncology, Bucharest, Romania, CROITORU Mircea D. ,   University of Medicine and Pharmacy, Targu Mures, Romania, BLIDARU Alexandru ,   „Carol Davila“ University of Medicine and Pharmacy, Bucharest, Romania,   „Prof. Dr. Al. Trestioreanu“ Institute of Oncology, Bucharest, Romania
Published: September 2021

After diagnosis, many breast cancer patients start consuming high quantities of beetroot and carrot juice, in the hope of improving the outcome of their treatment. However, these foods are very high in nitrate, which can competitively inhibit the uptake of iodine by the thyroid, potentially leading to hypothyroidism or thyroid nodules. We applied a nitrate and iodine food frequency questionnare (asking about dairy, fish, seafood and iodized salt for iodine intake and spinach, carrots, beetroot, lettuce and arugula for nitrate intake) to 353 ER+/PR±/HER2-luminal A and B breast cancer patients during antiestrogenic treatment. We excluded patients with a thyroid disease diagnosis prior to the cancer diagnosis, smokers, ex-smokers and those with renal disease or bipolar disorder. The only correlations found between dietary intake of iodine and nitrate and the incidence of de novo thyroid nodules were: decreased risk for a daily intake of minimum 250ml dairy; and increased risk for daily intakes of over 200g spinach, 250g carrots or 250g beetroot. The correlations between dietary intake of nitrate and the incidence of de novo hypothyroidism were: decreased risk for a daily intake of iodized salt 2.5g and minimum of 100g fish or 250ml dairy; and increased risk for daily intakes of over 250g carrots or 250g beetroot. The results of this study support the hypothesis that the increased intake of nitrate-rich foods – particularly beetroot and carrot juice – is a risk factor for de novo hypothyroidism or thyroid nodules, after a breast cancer diagnosis.
The utility of tracheal stents in Pediatrics
Authors:   Spitalul Clinic de Urgenţă pentru Copii „G. Alexandrescu“, Bucureşti, ZAMFIR-CHIRU-ANTON A. , VLĂSCEANU V. ,   Spitalul Clinic de Urgenţă pentru Copii „G. Alexandrescu“, Bucureşti, STANCIU A.E. ,   Institutul Oncologic Bucureşti, GHEORGHE D.C. ,   Spitalul Clinic de Urgenţă pentru Copii „M.S. Curie“, UMF „Carol Davila“, Bucureşti
Published: September 2021

Tracheo-bronchial malformations in small children need urgent therapeutical approach, usually in lack of other medical options. The authors discuss the availability and medical efficiency of tracheo-bronchial stenting in children with tracheo-bronchomalacia or benign respiratory stenosis of the upper airways. The advantages and risks associated with existing devices are presented. Each of the available stents can produce serious complications and are difficult to manage in long term surveillance. The nitinol stents and the silicon types seem the most suitable for tracheal anatomy in small children. In the end, the decision for stenting or indicate surgery for tracheal malformations needs a careful multidisciplinary team approach.
MELATONIN AND MONOAMINERGIC SYSTEM – BEHAVIOURAL ASPECTS
Authors:   Department of Functional Sciences, Discipline of Physiology and Fundamental Neuroscience,  “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Voiculescu S.E. , Rosca A. ,   Department of Functional Sciences, Discipline of Physiology and Fundamental Neuroscience,  “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania,   “Victor Babes” National Institute of Research-Development in the Pathology Domain, Bucharest, Romania, Zahiu C.M.D. ,   Department of Functional Sciences, Discipline of Physiology and Fundamental Neuroscience,  “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, Badiu C. ,   Department of Endocrinology, “Carol Davila” University of Medicine and Pharmacy,  “C.I. Parhon” National Institute of Endocrinology, Bucharest, Romania, Zagrean A.M. ,   Department of Functional Sciences, Discipline of Physiology and Fundamental Neuroscience,  “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
Published: September 2021

Melatonin, the hormone synthesized mainly by the pineal gland, is a key member of the complex monoaminergic signaling system, and a circadian regulator with pleiotropic functions. This ubiquitary lipophilic and hydrophilic molecule acts both at cellular and subcellular level, exerting anti-inflammatory, anti-oxidative and anti-apoptotic activities, extremely important in the nervous system, given its high vulnerability to oxidative injury. Melatonin deprivation and the consecutive chronodisruption are associated with multiple behavioural abnormalities, psychiatric disorders and neurodegenerative diseases. The present review summarizes the available information concerning the link between melatonin, monoaminergic neurotransmission and the pathophysiological bases of these conditions.
MANAGEMENT OF THE PATIENT WITH ADVANCED AMYOTROPHIC LATERAL SCLEROSIS: THE CAREGIVER’S OPINION
Authors:   Respiratory Diseases Unit and ALS Centre, Hospital of Sestri Levante, Italy, Rivara Maria , Barlascini Cornelius ,   Hygiene and Health Medicine Unit, Hospital of Sestri Levante, Italy, Banfi Paolo ,   Don Gnocchi Foundation and Neuromuscular Diseases Centre, IRCSS, Milan, Nicolini Antonello ,   Respiratory Diseases Unit and ALS Centre, Hospital of Sestri Levante, Italy, Grecchi Bruna ,   Physical Medicine and Rehabilitation Unit, ASL 4 Chiavarese, Italy
Published: September 2021

Objectives. The possibility of prolonging and augmenting the quality of life of respiratory patients in end-stage disease and in particular neuromuscular disease patients depends on an increased level of care. Amyotrophic lateral sclerosis (ALS) is a neurological disease characterized by a fast progressive impairment of respiratory function which leads to mechanical ventilation and high burden of care. A specifically designed questionnaire was administered to caregivers to analyze the level of care provided to these patients in our districts. Patients and methods. The study population consisted of 70 patients (44 males and 26 females). Of the 70 patients, 46 were being treated with non-invasive ventilation and 24 with invasive mechanical ventilation. The questionnaire was divided in two parts: questions 1 to 13 investigated life conditions and 14 to 22 the quality of care provided. Results. The patients studied present a heavy burden of care and this is in relation to the quantity of respiratory aids prescribed. The symptom which created statistically significant problems for care was breathlessness, as is often reported in the literature. The presence of homecare tended to create conditions of greater serenity for the caregivers. Conclusions. This study shows that the burden of care in end-stage ALS patients is very onerous, and it can help to point out problems not sufficiently contemplated in healthcare planning.
PROFILE IN GANGLIOSIDE ANTIBODIES IN BENIGN PROSTATIC HYPERPLASIA
Authors:   Department Dermatology, “Victor Babes” Clinical Hospital of Tropical and Infectious Diseases, Bucharest, Romania, Nicolae Ilinca , Ene Corina-Daniela ,   Nephrology Hospital “Dr. Carol Davila”, Bucharest, Romania, Petrescu Mirela ,   Department Dermatology, “Victor Babes” Clinical Hospital of Tropical and Infectious Diseases, Bucharest, Romania, Georgescu Simona Roxana ,   Department Dermatology, “Victor Babes” Clinical Hospital of Tropical and Infectious Diseases, Bucharest, Romania
Published: September 2021

Molecular pathology of benign prostatic hyperplasia is multifactorial and involves endocrine, biochemical, immunological interactions. The mechanisms involved in the onset and progression of benign prostatic hyperplasia are: infections, older than 50 years, imbalances in hormones and neurotransmitters, inflammation, oxidative stress. It is estimated that an infectious etiology can be a cause of wrong immune response directed at the prostate. Inflammatory neuropathies often occur after infections with various microorganisms. It is also known, that the presence of microorganisms is heterogeneous in patients with benign prostatic hyperplasia. In this paper we documented the antibody profile of anti-GM1, -GM2, -GM3, -GD1a, -GD1b, -GT1b, -GQ1b IgG and IgM type in 30 patients with benign prostatic hyperplasia and in 30 controls. The results showed an increasing anti-GD1a and anti-GQ1b titer in patients with benign prostatic hyperplasia compared to control. The authors suggest that a careful monitoring of the patients developing an endogenous anti-gangliosidic immune response is required in order to assess these antibodies as potential risk factors for neuropathy in patients with benign prostatic hyperplasia.
Liberating Pathologization? : The Historical Background of the 1961 Decriminalization of Homosexuality in Hungary
Authors: Takács Judit , P. Tóth Tamás
Published: September 2021

Analyzing the principles, considerations, and official explanations underpinning the (de)criminalization of sexual relations between same-sex partners can highlight that around the mid-twentieth century medicalizing references were used in legal and societal judgments on same-sex intimacy in Hungary (and elsewhere). In this study, we want to illustrate the medicalization process of social issues that otherwise seem difficult to “solve” (i.e., these issues, in this case, were put within a psycho-medical ambit) by focusing on a twentieth-century historical example from Hungary. The background of the decriminalization of consensual sexual acts between adult men in the 1961 Hungarian Penal Code will be explored in detail using previously unknown original archival material from 1958. This article will introduce the changes proposed by the Neurology Committee of the Health Science Council (HSC; Egészségügyi Tudományos Tanács) in 1958 leading to the HSC’s unanimous support for a proposal to decriminalize “unnatural fornication” between consenting adults and to the actual decriminalization of homosexuality (i.e., decriminalization of consensual sexual acts between adult men) in 1961. The empirical foundation of the present study includes archival records from the National Archives of Hungary and other primary sources.
Coronary Artery Disease and its Psychosocial Risk Factors: A Narrative Review
Authors: Fatrous Tarek
Published: September 2021

Objective: Whenever the subject of coronary artery disease (CAD) and myocardial infarctions is discussed, the focus is usually shifted towards biological factors such as smoking, diabetes, or obesity; consequently, the management aims at addressing these factors. This paper approaches the subject from a psychosocial perspective and highlights the importance of these risk factors and their inclusion in CAD screening.
Background: CAD is one of the most common diseases worldwide and also one of the leading causes of death in multiple countries. Although we have a proper understanding of its pathogenesis and risk factors, we sometimes tend to overlook the psychological factors that affect the patient both pre- and post-diagnosis. The purpose of this paper is to present these underestimated factors and convey their importance.
Methods: To accomplish this, an extensive review of the literature was done using PubMed and Google Scholar, and articles were chosen based on the specified keywords. The references of these articles were also screened to identify more related studies and clinical trials.
Discussion: This paper is composed of multiple subsections that go over the epidemiology of the disease as well as its pathogenesis and known biological risk factors, before delving into the psychosocial aspects associated with CAD including the effects of depression, anxiety, social support, and sex differences on a patient’s prognosis.
Conclusion: CAD is a disease for which the management is through multifactorial interventions. Although the pathogenesis is well understood, there is a clear gap when it comes to appreciating the patients’ mental health when living with this diagnosis. Additionally, it has been shown that there is an increase in morbidity and mortality in the patients struggling on a psychosocial level, thus these factors should be included in the screening process.