bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigator, Prosecutor, Judge  and Now Plaintiff? The Leviathanian Role of the European Commission in the Light of Fundamental Rights
Authors: Palzer Christoph , Hauger Nils F.W.
Published: April 2022

Already holding a very prominent position in competition law, in 2008 the Commission also stepped into the arena of private enforcement. The action for damages, however, was brought against the members of a cartel, which the Commission itself had imposed fines against, beforehand. That raised the question of conformity with the defendants' right to a fair trial. Notwithstanding that the European Court of Justice ('ECJ') rejected the defendants' doubts in its judgment of 6 November 2012, this ruling clearly focusses the attention on the concentration of powers in hand of the Commission. It therefore shall serve as a starting point for dwelling on the adjudicatory role of the Commission or the question whether fundamental rights require competition fines to be imposed by the Courts, respectively. In fact, much of the criticism of the current system - though there would certainly be much to be said about issues of due process - appears to stand and fall with the answer to that question.
Public and Private Enforcement of Competition Law: A Differentiated Approach
Authors: Hüschelrath Kai
Published: April 2022

We investigate the relationship between public and private enforcers introducing a more differentiated approach. In contrast to the existing literature, we take into account that the costs and benefits of detection and prosecution and thus, the usefulness of each enforcement mode may change with a variation of the type of anticompetitive conduct. We define a set of parameters that determine the costs and benefits of both types to enforce the antitrust laws and discuss implications for European competition law and policy.
The Qihoo/Tencent Dispute in the Instant Messaging Market: The First Milestone in the Chinese Competition Law Enforcement?
Authors: Jiang Tiancheng
Published: April 2022

Qihoo/Tencent is the most high-profile and complicated anti-monopoly lawsuit before the Chinese Court since the enactment of the Chinese Anti-Monopoly Law in 2008. Qihoo complained to the court, alleging that Tencent had abused its dominant position by firstly leveraging its market power from the market for instant messaging software products onto the market for internet security software products by forcing its users to uninstall the plaintiff's products and secondly abusively tying two of its software products. The unique pricing and profit mode in the IM market gives rise to the difficulty in determining the scope of the relevant market. The features of the dynamically competitive industries have to be taken into account in evaluating the market power of the defendant. This article investigates the Chinese Court's most recent analytical approaches in defining the relevant market, evaluating dominance in a fast-growing sector particularly after the coming into force of the first AML judicial interpretation, and compares the approaches with the techniques employed in the practice of the European Commission (particularly the Microsoft/Skype case) and the case law of European Court of Justice.
An Effects-Based Approach to Article 102: A Response to Wouter Wils
Authors: Rey Patrick
Published: April 2022

In his defence of the General Court's Intel judgment as 'effects-based' and 'economically sound' Wouter Wils has articulated an interpretation of Article 102 which rejects a case-by-case approach as inconsistent with the European Treaties and instead favours the uniform application of clear a priori legal rules that are easily administrable and assign the risks of non-compliance to dominant firms. Wils argues that this approach is best designed to protect the discovery value of competition. Wils' article identifies many of the key issues concerning how competition law, and Article 102 in particular, should be applied. In this article the authors examine Wils' analysis. They first address whether the European Treaties preclude a case-by-case approach under Article 102 and conclude that they do not. They then note that, even if early regulatory intervention has the virtues of predictability and ease of administration, it fails to take into account the effects of both the conduct it seeks to regulate and the effects of such regulation. As a result, they conclude that the goal of protecting competition is best served by intervention only when there is a risk to competition based on the most likely assessment of the effects of the conduct concerned.
Reforming the Treatment of Minority Shareholdings in the EU: Making the Problem Worse Instead of Better?
Authors: Bas Kadir
Published: April 2022

This article considers the treatment of non-controlling shareholdings in EU competition law, which has received increased attention following the Ryainair/Aer Lingus case. The Commission perceived this case to illustrate the existence of an enforcement gap and put forward possible solutions in its recent White Paper. Irrespective of whether there is actually a loophole as pronounced, these solutions generally focus on the future inclusion of non-controlling shareholdings in the Merger Regulation. However, they are possibly inconsistent with the rules of EU competition law governing other operations, especially joint ventures. Therefore, such a reform may lead to some inconsistencies and uncertainties and thereby further complicate the current situation in the EU, instead of improving it. This article thus argues that under the current framework of EU competition law, more active use of the current competition tools, particularly Article 101 TFEU, is a better way to solve the under-enforcement problem regarding non-controlling shareholdings.
Identifying Geographic or Customer-Based Collusion
Authors: Proctor Adrian J.
Published: April 2022

Several articles have considered procedures for identifying markets susceptible to coordination. When a checklist of factors is considered, firms are usually assumed to be coordinating based on price. In this article, this approach is adapted to accommodate markets that may be coordinating on other focal points based on geographic or customer allocations. Some of the check-list features are still valid, but others need to be seen in a new light. New approaches for identifying tacit collusion in these markets are outlined. The example of the recent UK market investigation into cement is discussed as well as some other literature.
Administrative and Judicial Discretion in Setting Fines
Authors: Solek Lukas
Published: April 2022

Article 23(2) of Regulation 1/2003 accords the European Commission a broad discretion in fining undertakings for their anti-competitive behaviour. Nevertheless, the European Commission still occasionally exceeds its broad discretion in order to reach its fining policy objective of a ‘sufficiently deterrent effect’. This overstepping arises particularly in the context of the personal scope of EU competition law, namely in defining the undertaking. Notwithstanding its broad discretionary powers to set fines, the European Commission is nevertheless bound by strict rules in establishing parental liability for the purposes of defining an undertaking. However, these rules are often and unjustifiably disregarded in situations where the European Commission is looking to increase the deterrent effect of a fine. Although achieving a ‘sufficiently deterrent effect’ is key to the European Commission’s fining policy objectives, it is hard to argue that this can or should be pursued ultra vires, in apparent disregard of the established rules. By way of example, the European Commission will include or exclude intra-group sales made by undertakings without establishing whether the relevant parent company and subsidiary form a single undertaking and reflect the economic importance of the infringement and the relative weight of the parent company participating in the infringement. Likewise, the European Commission will increase fines imposed on a parent company based on recidivism, even though it is only its subsidiary which has committed and been fined for the past infringement. Similarly, the European Commission will apply a single 10% ceiling of the group’s turnover to cap the fine for the cartel participant for a violation occurring prior to its acquisition by the group.
Comparing Microsoft and Google: The Concept of Exclusionary Abuse
Authors: Temple Lang John
Published: April 2022

Comparison of the Microsoft and Google cases reveals a number of differences. Microsoft involved two recognized exclusionary abuses, tying and failure by a monopoly to disclose information necessary for interoperability, as in the Decca case.1 Google has what appears to be high market shares (depending on how the market is defined) but it is not a monopoly, and therefore cannot be an essential facility. On any traditional interpretation of Article 102, Google is not committing an abuse. But three novel theories of harm have been suggested by companies complaining against Google: Google should list its competitors’ websites, it should give them all the benefits it gives to its associated companies, and it should be obliged to make any improvements suggested by the Commission. However, although it is an abuse to create an obstacle for competitors, a dominant company without an essential facility never has an obligation to help them. If the Commission used Article 102(b) as the definition of exclusionary abuse, as the Court did in GlaxoSmithKline,2 it would be clear that none of these theories describe exclusionary conduct. If there is no abuse, there cannot be a remedy.
Pharmaceutical Mergers and Their Effect on Access and Efficiency: A Case of Emerging Markets
Authors: Kathuria Vikas
Published: April 2022

Pharmaceutical M&As in emerging markets may jeopardize cheap access to generics. This may be a motivation for policy makers to use competition law as a tool to deter cross-border M&As. Additionally, while M&As in the pharmaceutical sector may give rise to certain efficiencies, it is not clear how efficiencies will be treated in the peculiar socio-economic context of emerging markets. This article develops a theoretical framework that argues that the application of competition law is guided by sector-specific socio-economic realities and institutional realities of the jurisdiction. Thereafter, it employs this framework to analyze the issues of access to generics and efficiencies of production.
Private Enforcement of EU Antitrust Law and Its Relationship with Public Enforcement: Past, Present and Future
Authors: Wils Wouter P. J.
Published: April 2022

This article provides a short history of private enforcement of EU antitrust law and its relationship with public enforcement, from the 1957 EEC Treaty over Regulation 17 and Regulation 1/2003 until Directive 2014/104 and the current outlook.
Level Discrimination and FRAND Commitments Under EU Competition Law
Authors: Nazzini Renato
Published: April 2022

Standards are of fundamental importance in our economy and competition law has an important role to play in ensuring that standard setting procedures are not distorted so as to result in negative effects on technological progress and social welfare. This article examines the practice of level discrimination, which occurs when the holder of a standard essential patent (SEP), having made a commitment to license the SEP on fair, reasonable and non-discriminatory (FRAND) terms, decides to license only undertakings at a given level of the supply chain, typically, the end-product manufacturers, rather than the component manufacturers. Level discrimination is significant in practice and raises novel questions in the interpretation and application of Article 102. This article examines the economic and policy arguments for and against level discrimination and discusses whether the practice may amount to an abuse of a dominant position under Article 102 TFEU, distinguishing the position of practising and non-practising entities.
Fining Foreign Effects: A New Frontier of Extraterritorial Cartel Enforcement in Europe?
Authors: Huizing Pieter J.F.
Published: April 2022

Regulation 1/2003 does not explicitly address the question whether national competition authorities (NCAs) have the power to prosecute and sanction infringements of Article 101 TFEU beyond their own national borders. This has allowed wide differences to exist between NCAs in respect of the territorial scope of their fines imposed under Article 101. A legal assessment reveals that there is much uncertainty as to the legality of NCAs taking into account foreign effects in sanctioning cross-border cartels. Many of the legal arguments used to either support or object to the right for NCAs to do so are unsatisfactory, at least in the context of the current legal framework. As such a right can significantly enhance the effectiveness of decentralized enforcement of Article 101, it may well be desirable to further explore this new frontier of extraterritorial cartel enforcement within the Union. However, it is submitted that this will require legislative action, so that legal certainty can be provided in accordance with the common views of Member States. Either as part of the new ECN Directive or through an amendment of the Regulation, the necessary procedural rules and safeguards can be put in place to give NCAs the right to fine foreign effects in a way that ensures effective enforcement and proportionate sanctioning while still allowing for sufficient prosecutorial discretion at the national level.
Market Definition for Multi-Sided Platforms: A Legal Reappraisal
Authors: Holzweber Stefan
Published: April 2022

It is frequently assumed that the outcome of today’s most discussed competition law cases hinges on market definition. In the context of multi-sided platforms, delimiting the relevant product market is a particularly delicate and complex task. Thus, this article seeks to analyse, from both an economic and a legal perspective, how relevant product markets for multi-sided platforms are properly defined under European competition law. Multi-sided platforms act as intermediaries which enable distinct groups of customers (also called platform-sides) to interact with each other. Multi-sided platforms have the possibility to set different prices for each group of customers, therefore econometric tools such as the small-but-significant-non-transitory increase-in-price test (SSNIP-test) must be applied with caution. It is argued that multi-sidedness can be considered a question of degree, therefore, for the purpose of market definition, it is necessary to distinguish different types of multi-sided platforms. The stronger the indirect network effects involved, the more the market definition deviates from traditional approaches. Indeed, the established legal framework allows a sound categorization of various forms of multi-sided platforms. In the context of multi-sided platforms, markets are regularly closely interrelated, therefore, the competitive assessment would be incomplete without an intermarket-analysis.
The Scope of the Special Responsibility upon Vertically Integrated Dominant Firms after the Google Shopping Case: Is There a Duty to Treat Rivals Equally and Refrain from Favouring Own Rel
Authors: Valdivia Eduardo Aguilera
Published: April 2022

The Google Shopping case has brought into discussion the existence of a general duty upon vertically integrated dominant firms not to discriminate competitors in neighbouring markets and to treat them in the same way as own related business. Such general duty is nonsensical from an economic perspective and finds no support in the case law. A case-by-case analysis should therefore be applied. The case law has established that pure discrimination of competitors by a vertically integrated undertaking could amount to a discriminatory abuse of Article 102(c) TFEU instead of an exclusionary abuse of Article 102(b) TFEU. This seems to be the position taken by the Commission in the Google Shopping case. Exclusionary abuse framework, including refusal to deal principles, are not applicable to cases of ‘self-preferencing’. Exclusion of competitors is not the only plausible theory of harm, which does not imply lowering the legal standard to find an anticompetitive infringement. Although there is not a duty of equal treatment as a rule of thumb, there are strong reasons to suspect that the Commission pretends to establish the principle of ‘search neutrality’ in online services.
Antitrust Scrutiny of Excessive Prices in the Pharmaceutical Sector: A Comparative Study of the Italian and UK Experiences
Authors: Colangelo Margherita , Desogus Claudia
Published: April 2022

Excessive pricing has generally been seen as a problem to be addressed through sector-specific regulation rather than through antitrust intervention. Literature on the issue is divided between scholars calling for an interventionist approach and those supporting a non-interventionist approach on the basis of conflicting rationales. However, recent cases have called attention to the imposition of excessive prices in the pharmaceutical sector. The Aspen and the Flynn cases, in particular, constitute emblematic examples of such practice in the field of off-patent drugs. The analysis of the investigations conducted by national competition authorities in these cases provides some important insights into the controversial issues of ascertaining when antitrust intervention can be considered justified and of determining which methodology may be properly adopted in order to assess whether a drug price is unfairly high.
Achieving Competitive Neutrality Step-By-Step
Authors: Albers Michael
Published: April 2022

States are not only rule makers, they also are purchasers and often also suppliers of goods and services. However, the state is not a purchaser or supplier like any other. It may enjoy competitive advantages other market participants do not have. The concept of competitive neutrality addresses the problem of distortions of competition caused by state activity on markets. This article lists thirteen consecutive steps, which are clustered in three distinct groups, to improve the conditions of competition on markets where private enterprises are active as purchasers or suppliers next to the state.They reach from creating more awareness of competition-distorting state measures and the prevention of new distortions to the removal of distortions.
Collective Certification in UK Competition Law: Commonality, Costs and Funding
Authors: Veljanovski Cento
Published: April 2022

The UK introduced a new regime for opt-out ‘class’ or collective actions in 2015. These require certification before they proceed to trial to establish whether the members of the class have sufficient ‘common interest’. The certification of the first two collective actions – Gibson v. Pride Mobility Products and Merricks v. Mastercard – were dismissed by the Competition Appeal Tribunal (CAT). Here a critical assessment of the UK’s emerging collective certification process is undertaken focusing on the determination of common issues, pass on, distribution of damages, costs and funding. It is argued that the CAT has applied the test for certification too strictly and not in accordance with the case law surrounding the ‘Canadian model’ on which the UK certification procedure is based; and incorrectly treated the award of aggregate damages as the summation of individual damages. The way the CAT has handled these two factors threatens to undermine the purpose and effectiveness of the UK’s new collective action regime.
Independence of Competition Authorities: The Example of the EU and Its Member States
Authors: Wils Wouter P. J.
Published: April 2022

At the end of 2018, the European Parliament and Council adopted Directive (EU) 2019/1, often referred to as the ‘ECN Directive’, which, among other things, contains provisions ensuring the independence of the competition authorities of the EU Member States (national competition authorities or NCAs), which are, together with the European Commission, responsible for the enforcement of the EU antitrust rules laid down in Articles 101 and 102 TFEU. In early 2019, the European Commission visibly showed its own independence by prohibiting Siemens’ takeover of Alstom’s rail transport business, a proposed merger publicly backed by the German and French governments. This article gives an overview of the independence guarantees in EU law and discusses more in general the notion of independence of competition authorities and its rationale.
Proportionality of Fines in the Context of Global Cartel Enforcement
Authors: Huizing Pieter J.F.
Published: April 2022

This article assesses the fundamental elements of national and international cartel sanctioning practices from a proportionality perspective under both retributive and consequentialist theories on punishment. It finds that the current framework of setting fines for international cartels fails to ensure proportionate overall punishment. This is due to two types of shortcomings. First, the amplification at an international level of the failure of national sanctioning methodologies to fully observe retributive or consequentialist proportionality principles. Second, the absence at an international level of an appropriate maximum limit on the level of punishment or any consideration of the overall proportionality of the overall punishment. Overcoming these shortcomings calls for not only the coordination of sanctions between authorities pursuing the same cartel, but also a serious reconsideration of the fundamental elements of national cartel fining methodologies. At the least, achieving overall proportionate punishment requires authorities to start considering the retributive and consequentialist objectives already achieved by fines imposed elsewhere for the same overall cartel conduct.
The Challenge of Sanctioning Unfair Royalty Rate by the SEP Holder: ‘When’, ‘How’ and ‘What’
Authors: Botta Marco
Published: April 2022

The holder of a Standard Essential Patent (SEP) is usually required to license its patent to any licensee on the basis of Fair and Reasonable and Non-Discriminatory (FRAND) terms. In their recent judgments in Unwired Planet and Sisvel v. Haier, the UK Supreme Court and the German Bundesgerichtshof ruled that a ‘range’, rather than a ‘single’ royalty rate, may be considered compatible with the FRAND commitment. On the other hand, a royalty rate ‘beyond the outer boundary of the range’ would not be FRAND. In addition, an ‘unfair’ royalty rate might also be regarded as an abuse of dominant position by the SEP holder, in breach of Article 102(a) Treaty of the Functioning of the European Union (TFEU).

The paper analyses whether and under what circumstances Article 102(a) TFEU could be relied on by a competition authority in Europe to sanction a case of ‘unfair’ royalty rate requested by the SEP holder to its licensees. In particular, the paper assesses ‘when’ competition policy should sanction an unfair royalty rate requested by the SEP holder, ‘how’ a competition agency should analyse the case in accordance with the case law of the EU Court of Justice concerning Article 102(a) TFEU and, eventually, ‘what’ remedies the competition authority could adopt.

Standard Essential Patent; royalty rate; Fair, Reasonable and Non-Discriminatory terms; unfair pricing; Article 102(a) TFEU; EU Court of Justice; United Brands test; benchmarking methods; efficiency defence; competition law remedies
Can Competition Protect Privacy? An Analysis Based on the German Facebook Case
Authors: Lypalo Dzhuliia
Published: April 2022

The increasing collection of personal data by online platforms causes concerns among regulators and consumers. Due to privacy-related market failures in multi-sided markets, the question of possible remedies arises. This article aims to determine if a contribution of competition law is needed to enhance data protection rules. The first part will discuss the possible types of datarelated abuses of dominance in the context of the pioneering attempt of the German competition authority. The second part will analyse the drawbacks of the German Facebook case and possibilities to reconcile it with EU competition law. In addition, the article will analyse other ways to tackle privacy issues, including the proposal for a Digital Markets Act (DMA). It is suggested that an intervention of competition law in data protection matters is unnecessary. We argue that it may prevent the emergence of innovative products and services, ultimately harm consumer welfare and competition, as well as put an undue burden on dominant undertakings. It is submitted that a coherent regulation allowing for legal certainty could serve the objective of consumer welfare while preserving the interests of undertakings.

Article 102 TFEU, data protection law, personal data, privacy, GDPR, exploitative abuse, unfair trading conditions, German competition law, Digital Markets Act, exclusionary abuse, Facebook case
Shaping the New Modality of the Digital Markets: The Impact of the DSA/DMA Proposals on Inter-Platform Competition
Authors: Andriychuk Oles
Published: April 2022

An unprecedented recalibration of the rules regulating the functioning of competition in the digital markets has catalysed diverse reactions among the main stakeholders. The proposed approach to regulating gatekeepers will have a paradigmatic impact on European consumers, businesses and public institutions. It will have equally significant implications for the theoretical foundations of competition law, economics and policy. While formally the Digital Markets Act (DMA) is complementing, not substituting, existing provisions of competition de lege lata, such a substantial extension of the rationale and instruments of competition policy is likely to have significant implications also for the application of ex-post rules. The entire apparatus of competition law will be extended by the new modality. Out of the wide spectrum of changes introduced by the DMA/DSA proposal, this article identifies and analyses one of the central – though not so commonly discussed – elements of the transformation. It asks a normative question about what kind of competition in the digital markets the European Union should seek to establish, and a methodological question about procedural and substantive legal mechanisms used for shaping such a new format.

digital competition law, polycentric and dialectical approach to antitrust, competition law and the digital economy, goals of competition law, ex-ante and ex-post competition policy, Digital Markets Act – DMA, inter-platform competition, ecosystem competition, Digital Services Act – DSA.
Construyendo bloques la promiscuidad política online en tiempos de polarización en España
Authors: Garmendia Madariaga Amuitz , Lorenzo Rodríguez Javier , Riera Pedro
Published: April 2022

Los excepcionales niveles de polarización política, fragmentación del sistema de partidos y volatilidad electoral que experimenta España en la actualidad recomiendan analizar los orígenes de estos patrones. Empleamos una combinación única de datos de encuestas a nivel individual y de actividad en Twitter pertenecientes a una muestra de usuarios de la Aplicación de Asesoramiento al Voto que lanzamos durante la campaña de las elecciones generales españolas de 2015 para investigar los determinantes ideológicos de la construcción de redes online de los individuos. Nuestros resultados demuestran que, entre los individuos que siguen los perfiles de los partidos/candidatos online, la promiscuidad política es el comportamiento más común, aunque este comportamiento depende en gran medida de las actitudes políticas de los usuarios online y offline entendidas en un sentido amplio.
A FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN DIARE DI UNIT STROKE RSUP DR. KARIADI
Authors: Hilmansyah Taufik
Published: April 2022

Abstrak

Latar belakang: Diare disebabkan oleh multifaktorial dan beberapa faktor diketahui berhubungan dengan diare selama pasien dirawat yaitu usia lanjut, lama rawat inap, kejadian infeksi, penggunaan antibiotik, dan status gizi malnutrisi. Di RSUP Dr. Kariadi Semarang belum pernah dilakukan penelitian faktor yang berhubungan dengan diare. Tujuan: Menghitung besar risiko usia lanjut, lama rawat inap, kejadian infeksi, penggunaan antibiotik, formula nutrisi enteral non pabrikasi, dan status gizi malnutrisi dengan kejadian diare. Metoda: Jenis penelitian case control dengan mengambil data restrospektif pasien stroke yang memenuhi kriteria inklusi dan eksklusi selama Januari – April 2020. Dilakukan pemeriksaan data berdasarkan variabel bebas, dilakukan pencatatan dan dianalisis hubungan dengan menggunakan uji statistik Chi Square. Hasil: Sebanyak 40 subyek penelitian yang di rawat di unit stroke RSUP Dr Kariadi mayoritas diagnosis stroke non hemoragik (55%) dan laki-laki (60%). Mayoritas subyek usia non geriatri yaitu kurang dari 60 tahun. Hasil penelitian menunjukkan adanya hubungan yang signifikan pada faktor usia lanjut, lama rawat inap dan penggunaan antibiotik terhadap diare. Usia lanjut subyek (p = 0,043) dengan risiko 10 kali lipat. Lama rawat inap > 5 hari (p = 0,031) dengan risiko 11,56 kali lipat. Penggunaan antibiotik dengan risiko 13,5 kali lipat. Sedangkan variabel lain tidak signifikan. Simpulan: Terdapat hubungan usia lanjut, lama rawat inap >5 hari dan penggunaan antibiotik terhadap kejadian diare pada pasien stroke yang di rawat di unit stroke RSUP Dr Kariadi

Kata kunci: diare, unit stroke, geriatri, antibiotik, lama rawat inap
Calidad asistencial de la psicología clínica en el Servicio Andaluz de Salud evaluada por los facultativos
Authors: Benítez Ortega José Luis , Venceslá Martínez José Fernando , López Pérez-Díaz Ángel G. , Rodríguez Gómez Alfredo , Gómez Gómez Verónica , Martínez Cervantes Rafael J. , Romero Gamero Rafael , Vázquez Morejón Antonio José
Published: April 2022

Objective: Evaluation of healthcare quality of clinical psychology services in the Andalusian Health Service (SAS) from the perspective of the facultative.
Method: Descriptive research. For data collection, a 39-item questionnaire was developed that assesses various dimensions of quality (prevention, accessibility, suitability of evaluation and treatment interventions, safety, and care coordination). A sample of 83 clinical psychologists responded to the questionnaire, representing 32.17% of the reference population, 258 facultative who, at the time of data collection make up the SAS staff.
Results: The current quality of care of clinical psychology services in the SAS, based on a ratio of 3.05 clinical psychologists per 100,000 inhabitants, is deficient, especially in the dimensions of prevention, intensity of treatment interventions, and safety, and worrisome in the 2nd level of care.
Conclusions: It is urgent to increase the ratio of clinical psychologists/100,000 inhabitants to reduce the risk posed for users by the deficient intensity with which psychological treatments are currently practiced. It is necessary to establish standards for the workload of clinical psychologists in order to offer
Clinical and dermatoscopical aspects of pigmented basal cell carcinoma – Case series and literature review
Authors:   “Dr. Carol Davila” Emergency University Central Military  Hospital, Bucharest, Romania, Tilea Anton M. , Trifu Viorel ,   “Dr. Carol Davila” Emergency University Central Military  Hospital, Bucharest, Romania, Dima Bogdan ,   Elias Emergency University Hospital, Bucharest, Romania, Badea Mihai A. ,   Târgu-Mureș County Hospital, Targu-Mures, Romania, Costache Raluca S. ,   Central Military  Hospital, Bucharest, Romania, Costache Daniel O. ,   “Dr. Carol Davila” Emergency University Central Military  Hospital, Bucharest, Romania, Tiplica George S. ,   Colentina Clinical Hospital, Bucharest, Romania; “Carol Davila”  University of Medicine and Pharmacy Bucharest
Published: April 2022

The diagnosis of pigmented basal cell carcinoma can bring significant distress to patients and physicians alike. However, astute clinicians that can employ correctly the clinical and dermatoscopical clues can reach a correct preoperative diagnosis, and as such can avoid unnecessary worry for the patient, additional work-up, or overtreatment. We present a case series of pigmented basal cell carcinomas and a comparative case with pigmented cutaneous melanoma, together with a literature review, that will highlight these aspects of the management of pigmented tumours of the skin.
Diagnostic challenges in gastrointestinal infections
Authors:   Department of Psycho-Neuroscience and Recovery, Faculty of  Medicine and Pharmacy, University of Oradea, Oradea, Negrut Nicoleta , Khan Shamin A. ,   Faculty of Medicine and Pharmacy, University of Oradea,  Oradea, Bungau Simona ,   Department of Pharmacy, Faculty of Medicine and Pharmacy,  University of Oradea, Oradea, Zaha Dana C. ,   Department of Preclinical Disciplines, Faculty of Medicine and  Pharmacy, University of Oradea, Oradea, Corb Anca A.R. ,   Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Bratu Ovidiu ,   Clinical Department 3, University of Medicine and Pharmacy  “Carol Davila”, Bucharest 050474, Romania, Diaconu Camelia C. ,   Department 5, “Carol Davila” University of Medicine and  Pharmacy, Internal Medicine Clinic, Clinical Emergency Hospital  of Bucharest,Bucharest, Romania, Ionita-Radu Florentina ,   Department of Gastroenterology, University Emergency Central  Military Hospital, Bucharest, Romania
Published: April 2022

Gastrointestinal infections are among the most common infectious diseases found all over the world, varying depending on the etiological agent. Symptoms usually include diarrhea, vomiting, and abdominal pain. Water and electrolyte imbalance is the main consequence of gastrointestinal infections. Most of them are cured or self-limited in few days, but at the same time, for a specific population such as immunocompromised, elderly patients or new-borns, these infections are potentially severe. In this context, it is very important to identify the etiological agents of acute diarrhea for the appropriate treatment and infection control measures. While routine laboratory diagnosis of parasitic diarrhea still depends largely on microscopic examination of fecal samples, immunological and molecular methods are becoming increasingly commercially available and, in well-resourced settings, will ultimately displace traditional methods. The present paper presents some of the most common and well-known pathologies of this type, being a brief presentation of the variety of gastrointestinal diseases, each with characteristic clinical manifestations and diagnosis.
Overview of bilirubin as criterion for higher military education admission
Authors:   ", Oniciuc Viorel M. ,   Stefan cel Mare",   ",   National Military College, Campulung  Moldovenesc, Romania
Published: April 2022

This article was written because of the necessity of clarifying the recent biomedical selection criterion for the medical exam of the students who are applying for higher military education. In order to screen for or monitor liver disorders or hemolytic anemia the bilirubin is measured. The increased values of the bilirubin can be caused by multiple factors and they are presented in the following chapters.
Elastofibroma – an uncommon cause of upper limbs pain
Authors: Dumitrescu Natalia , Sandu Bianca , Dumitrescu Silviu V.
Published: April 2022

A female patient age 65 came to our clinic forcontinuous pain of the upper limbs (left more than right), increased when moving the scapulae. Patient declared that in the past few months the dorsal decubit became gradually painful and she cannot achive a good sleep. One year ago patient was diagnosed with bilateral suprascapular lipoma and a surgical removal was proposed. At the visual examination, we found two well-circumscribed suprascapular tumor mobile with arms movements. At palpation, we noticed that each scapula was pushed from below from an underlying tumor with a very firm consistency. A CT scan of torax was performed and revealed two subscapular unencapsulated, soft tissue masses with skeletal muscle attenuation interspersed with strands of fat attenuation. The patient was directed to thoracic surgery and the tumors were removed. The histological findings were consistent with the diagnosis of elastofibroma [3]. The recovery period was long, allmost two months passed before complete healing. The long period needed for healing, usually burdened with local complications and the fact that the tumor is benign makes the surgery not recommendable for the patients with 112 no discomfort or impared arms movement.
Crossed renal ectopia
Authors:   “Ovidius” University of Medicine and Pharmacy, Constanţa, Bordei P. , Bulbuc I. ,   “Ovidius” University of Medicine and Pharmacy, Constanţa, Rusali A. C. ,   “Ovidius” University of Medicine and Pharmacy, Constanţa, Jecan  , Jecan C.R. ,   ‘’Agripa Ionescu’’ Hospital, Bucharest  ‘’Carol Davila’’ University of Medicine and Pharmacy Bucharest, Ardeleanu V. ,   “Ovidius” University of Medicine and Pharmacy, Constanţa Arestetic Clinic Galati   “Dunarea de Jos’’ University from Galati  General Hospital CFR Galati
Published: April 2022

The case of 73 years - old male patient with inferior crossed renal ectopia diagnosed upon imaging workup using a GE LightSpeed 16 Slice CT, with urothelial carcinoma, at the level of the left kidney, nephrolithiasis and thrombosed aneurysm at the level of the origin of right common iliac artery. The upper lobe of the right kidney fused with the lower lobe of the left kidney, on the left side of the midline. There were 6 renal arteries (4 on the left and 2 on the right) originating from the left side of the abdominal aorta, at the level of the termination of the abdominal aorta, the left common iliac artery and the right internal iliac artery. The patient presented with 6 renal veins (3 on the left and 3 on the right) that drained anteriorly on the left side of the inferior vena cava into the left common iliac vein and into the right internal iliac vein.
The role of career anchors in human resource strategy (Case study: Students of Management Faculty of Yadegar-e-Imam Khomeini (RAH) Shahre Rey Branch, Islamic Azad University)
Authors:   Faculty of Accounting and Management, Yadegar-e-Imam  Khomeini (RAH) Shahre Rey Branch, Islamic Azad University,  Tehran, Iran, Peidaie Mir , Belal Mohammad ,   Faculty of Accounting and Management, Yadegar-e-Imam  Khomeini (RAH) Shahre Rey Branch, Islamic Azad University,  Tehran, Iran
Published: April 2022

Maintenance of efficient, highly specialized, and valuable forces in the present age is one of the most important concerns of organizations, especially organizations with advanced technologies. The importance of human resources planning and management in these organizations has greatly increased, and in the various areas of human resource management, the approach to occupational anchor planning has been very much considered. The purpose of this study was to investigate the role of the job path anchors in human resource strategy among the target community. Participants were selected randomly from among 3500 students at the Faculty of Management of Yadegar-e-Imam Khomeini (RAH) Shahre Rey Branch, Islamic Azad University in Tehran Province, Iran. The sample size was 346 by the Cochran method and the questionnaire was collected by electronic means. At the time of the study, 346 questionnaires were completed and the analysis was performed based on 346 questionnaires. To collect data, standard job anchor questionnaires, and Human Resources Strategic HR Questionnaire was used. The study population included 346 people, of whom 203 were male and 143 were female. The age of the people below the age of 20 was 38, from 20 to 25 years old, 94, between the ages of 26 and 30, 60, people aged 31 to 35, and 76 people over the age of 35 years. The reliability of the work anchors was 91% and the human resources strategy questionnaire was 80%. Investigations have shown that, on the anchors of the career path, the factors of creativity - entrepreneurship, autonomy-independence, pure challenges and public management with a committed strategy and public management, creativity-entrepreneurship, security-stability in the strategy of contracting businesses and creativity - entrepreneurship, Pure challenges, security with secondary jobs, and creativityentrepreneurship, public management, pure challenges in parenting jobs. According to the results of this study, it seems that the emphasis on reducing organizational structures, empowerment, and participatory decision making can determine the necessary grounds for determining the type of human resources strategy in an organization.
Overview of telemedicine use aspects in natural and technical disaster and combat situation
Authors:   Trauma Research Center, Baqiyatallah University of Medical  Sciences, Tehran, Iran, Rasouli Hamid , Kondor Karim ,   Marine Medicine Research Center, Baqiyatallah University of  Medical Sciences, Tehran, Iran, Ahmadpour Fathollah ,   Trauma Research Center, Baqiyatallah University of Medical  Sciences, Tehran, Iran, Nobakht Mohammad ,   Marine Medicine Research Center, Baqiyatallah University of  Medical Sciences, Tehran, Iran, Esfahani Ali ,   Marine Medicine Research Center, Baqiyatallah University of  Medical Sciences, Tehran, Iran, Farajzadeh Mohsen ,   Marine Medicine Research Center, Baqiyatallah University of  Medical Sciences, Tehran, Iran
Published: April 2022

Preparation and hospital development estimated an essential part of the policies and strategic purposes of healthcare in each government. Today, applications of management to reduce the burden of natural and technical disasters appear are very necessary. Objectives: The study aimed to review the major relevant articles in the case of the application of telemedicine for trauma injuries in disaster and military situations. Methods: Original clinical trials investigating the effects of telemedicine on trauma injuries published before April 2018 were aggregated, and used in this study. We search the scientific sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI, and Scopus. The keywords that applied to identify these articles combined: Telemedicine, Mobile Health, Health, Mobile, mHealth, Telehealth, eHealth, Trauma, War, military, medicine, Wounds and Injuries, injuries. Results: The text of the articles and abstracts were examined from various aspects, the 21 articles were evaluated for quality, and then 10 papers entered in a systematic review. We found that the use of telemedicine in trauma injury, rural and the military is very helpful for high-quality trauma care; also the telemedicine and telephone consultations can be were demonstrated reducing the risk of physician-related medicine mistakes. The economic evaluation of telemedicine was demonstrated cost-saving and cost-effective of telemedicine consultations. We also realized the importance and practicable of telemedicine for improving rural trauma care. Conclusions: Ultimately, the telemedicine can help patients and health government organizations economically, the telemedicine consultations due to cost-saving and cost-effective. Further studies to evaluate the running of telemedicine need to abating the practical and high-efficiency method, that can be done everywhere and it's free from mistakes and defects.
Effect of pharmacist’s patient education on patient compliance in the southeast of Iran: A quasi-experimental study
Authors:   Laboratory Research Center of Food & Drug Control, IRFDA,  MOHME, Tehran, Iran, Izadpanah Fatemeh , Rigi Dariush ,   Student research committee Zabol University of Medical  Sciences, Zabol, Iran, Afshari Mahdi ,   Department of Community Medicine, School of Medicine, Zabol  University of Medical Sciences, Zabol, Iran, Moradi Mandana ,   Clinical Pharmacy Department, Faculty of Pharmacy, Zabol  University of Medical Sciences, Zabol, Iran
Published: April 2022

As an essential part of the treatment chain and also the link between physicians and patients, pharmacists play a major role in optimizing drug administration. Compliance with a therapeutic regimen is necessary for therapeutic success, while non-adherence can lead to disease progression and eventually treatment failure. This study aimed to evaluate the impact of pharmacist’s patient education on different parameters of patient compliance. Results: The results showed the patients receiving the intervention compared to the control group, were significantly more adherence to the correct drug use dose (p = 0.016), time of use (p = 0.018), treatment duration (p =0.001), and frequency (p = 0.049). Conclusions: This study indicates that detailed patient counseling at pharmacies can positively influence different parameters of patients’ adherence.
Medical causes and diseases leading to early permanent disqualification in IRIAF pilots based on their service categories
Authors:   Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran, Darvishi Mohammad , Shahali Hamze ,   Aerospace and Sub-Aquatic Medical Faculty, Aja University of Medical Sciences, Tehran, Iran
Published: April 2022

Background and Aim: Efficient manpower is the most important capital and studies have shown the relationship between health and performance.Understanding the factors leading to disability has preventive importance.Our aim is determine the causes and diseases leading to early permanent medical disqualification of the Islamic Republic of Iran Air Force pilots based on their service categories. Methods: This is a descriptive, cross-sectional, retrospective study with target population of the Islamic Republic of Iran Air Force pilots with early and permanent medical disqualification from 1986 to 2016. Results: Out of 508 cases of early medical discharges, 239 items were considered medical disqualification, 17 war captives, 34 service exchange and the remaining 218 was for on service killed or missed persons.The main medical causes were neurosurgery, cardiovascular and psychiatric, while common diseases include lumbar discopathy, myocardial infarction and cardiac arrhythmia.The lost service years was 3233 person year and the average was 12.63 person year per individual. Conclusions: Based on the previous similar studies, it was expected that the common cause include neurosurgery, cardivascular and psychiatric with more prevalence in fighter, transportation, and helicopter service categories.At the end, we found that our results were in line with initial expectations.
The effect of multimedia training on social function of burn patients in Shahid Motahhari Hospital, Tehran: A clinical trial study
Authors:   Department of Nursing, Orumieh Branch, Islamic Azad University, Orumieh, Iran, Bekmaz Karvan , Hashemzadeh Somayeh ,   Department of Nursing, Ali Abad Katoul Branch, Islamic Azad University, Ali Abad Katoul, Iran, Okhli Hadiseh ,   Department of Nursing, Ali Abad Katoul Branch, Islamic Azad University, Ali Abad Katoul, Iran, Ardebili Fatemeh M. ,   Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran, Khanmohammadi Samira ,   Department of Nursing, Ali Abad Katoul Branch, Islamic Azad University, Ali Abad Katoul, Iran, Mamashli Leila ,   Department of Nursing, Gonbad Kavoos Branch, Islamic Azad University, Gonbad Kavoos, Iran
Published: April 2022

Introduction: Burn is a tissue injury and affects social functioning and relationships. Complications of burns lead to disruption of social relationships and consequently social dysfunction. Objective: Aim of this study was to determine the effect of multimedia training on social functioning of burn patients in Shahid Motahhari hospital in Tehran. Methods: This clinical trial study was performed on 100 burned patients. The intervention group received a multi-media self-care discharge training on a CD in addition to the common education. Social function of quality of life was examined in both groups before intervention, 3 months and 6 months after intervention. Conclusion: Results showed that before intervention the mean score of social function of quality of life in intervention and control group was 1/55± 0/46, 1/92± 0/6 respectively which was statistically significant (p <0.001). Mean and standard deviation of social function of quality of life in the intervention and control groups three and six months after intervention were ... respectively which was statistically significant (...).