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Creutzfeldt-Jakob disease (CJD) is a rare condition. In this study we describe the diagnosis of the disease in a 73-year old female, presenting dementia. Diagnostic tests unveiled characteristic features of CJD. The diagnosis of CJD was confirmed. It is important to always take into consideration the diagnosis of CJD in the diagnostic process of dementia. Purpose: The aim of this scientific paper is to present symptoms and diagnostic methods of Creutzfeldt-Jakob disease on the basis of a clinical case. Review Methods: We conducted our study as a literature review based on information gathered from PubMed, Embase, GoogleScholar using combinations of the following. As a part of study, we also present a case description from our materials from clinical practice.

Nordic Walking (NW) is a widely practiced sport that was originally intended as a way for cross-country skiers to get a year-round workout. However, it quickly proved to be easy, enjoyable and undemanding, which led populations around the world to train NW. Today, the sport is used as rehabilitation in most medical specialties, as it is considered to be safe, not creating barriers, inexpensive and has no side effects. This article presents a literature review on the effects of NW on patients' mental and physical health.

Migraine is a chronic condition that manifests itself periodically. It is characterized by recurrent, severe, often hemiplegic, throbbing headaches accompanied by autonomic symptoms in the form of nausea, vomiting, hypersensitivity to noise and light. For many years, triptans have been the gold standard in the treatment of migraine, acting by constricting blood vessels and inhibiting the release of neuropeptides. However, their efficacy is not satisfactory for all patients, especially those with cardiovascular disease. In response to the need for effective and safe therapies, gepants, a new class of drugs that block the calcitonin gene-related peptide (CGRP) receptor, have emerged. Rimegepant, one of the newest representatives of gepant, has been approved for the treatment of migraine both in the acute attack phase and prophylactically. Clinical trials have shown its effectiveness in reducing the number of days with migraine and alleviating associated symptoms. Rimegepant also has a favorable safety profile, making it a promising therapeutic option for migraine patients. This article aims to discuss in detail rimegepant as a new treatment option for migraine, including its mechanism of action, efficacy, safety profile, clinical trial and outlines the benefits of introducing this drug into standard clinical practice.

Atopic dermatitis (AD) is a chronic, recurrent dermatosis that affects an increasing percentage of the population. It usually affects children and resolves spontaneously, however, symptoms can persist into adulthood and even appear de novo later in life. The skin lesions that appear in this disease significantly reduce patients quality of life. Visual skin symptoms are exacerbated during stress, and pruritus leads to sleep problems. The effect of an inadequately controlled disease can even be a reduction in social activities and a reluctance to leave the house. The basis of treatment is skin care using emollients and avoiding triggers and aggravating factors. In the next stage, the doctor may prescribe topical or systemic treatment for the patient, depending on the severity of the disease. Such measures may not be enough, so more and more new drugs are being registered for the treatment of atopic dermatitis. One of them is upadacitinib, which appears to be extremely effective compared to other medications used to treat moderate to severe ad. It is a selective JAK inhibitor that reduces the inflammatory response by inhibiting migration, proliferation and cytokine secretion by granulocytes. It brings rapid and sustained effects in reducing skin lesions and reducing one of the most bothersome symptoms, pruritus.It may serve as a good alternative to the existing methods for treating moderate to severe atopic dermatitis The purpose of our study is to describe this new drug, its mechanism of action and discuss its possible benefits versus side effects.

Introduction: Ozempic (semaglutide) is a long-acting GLP-1 receptor agonist widely used to treat type II diabetes and obesity. Its mechanism of action includes stimulation of insulin secretion, inhibition of glucagon secretion, and delaying gastric emptying, which leads to lower blood glucose levels and body weight reduction. Despite its therapeutic benefits, the use of Ozempic may cause side effects that affect patients' quality of life and their ability to continue treatment. This article aims to comprehensively analyze side effects associated with using Ozempic to provide a detailed understanding of their development mechanisms and their impact on patient's daily functioning.Material and Methods of Research: The literature was collected through searches in the PubMed and Google Scholar databases and references from the initially retrieved articles. Results: The literature review indicates various potential side effects of liraglutide, including gastrointestinal upset, pancreatitis, and the 'Ozempic face' phenomenon. This phenomenon, characterized by a skeletal facial appearance with deepened wrinkles, may result from the drug's impact on body composition and fat distribution, leading to a loss of subcutaneous fat in the face and a more pronounced appearance of underlying facial structures.Conclusion: Clinical studies highlight the need for continuous patient monitoring by healthcare providers to ensure the safe and effective use of Ozempic. Further education on a healthy lifestyle, diet, and physical activity is necessary to maintain the effects of drug therapy and prevent weight gain after treatment. Additional research on the long-term safety of GLP-1 is also crucial. Physicians should be aware of the potential risks and side effects associated with the use of Ozempic and should educate their patients to enable them to make informed decisions about their treatment.

In recent years, the popularity of drugs which were firstly introduced as treatment for diabetes type 2 has surged, because of their’s significant effect of managing the body weight especially for patients that suffer for diabetes type 2. Tirzepatide is a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 (GLP-1) receptor agonist. Semaglutide is a glucagon-like-peptide 1 receptor agonist. The aim of our study is to present reliable and up-to-date knowledge of effects that both drugs provide and their beneficial effects on health.

Introduction: Over the years the participation of women in sports and physical activities has significantly increased. The rise in the number of female athletes has brought to attention the health issues specific to this population. The Female Athlete Triad is a syndrome in which the affected woman presents the combination of three intertwined conditions such as (1) low energy availability, (2) menstrual dysfunction, and (3) low bone mineral density. The crucial factor in the pathophysiology is energy imbalance, which leads to impairment of the reproductive and skeletal system, eventually having a very harmful effect on the whole organism and leading to appalling short-term and long-term consequences. It affects women of all ages and from every sports discipline, but most at risk are those in adolescence involved in sports that prioritize leanness and endurance. Purpose: The objective of this article is to review the current state of knowledge about the Female Athlete Triad, spreading awareness of this syndrome, which is still very low in society, and highlighting the importance of early identification and multidisciplinary treatment to prevent serious complications. Materials and methods: The review was based on a comprehensive analysis of the available literature sourced from PubMed, Google Scholar, and other scientific articles, which was searched by using listed keywords and analysed for topic relevance and knowledge currency.

Injuries in combat sports can happen to any athlete, regardless of gender, age, training experience or whether he or she is an amateur or a professional. The range of injuries varies from superficial, short-term damage to severe injuries with serious consequences, including death. There are many types of combat sports, each with different rules and specific injuries. Amongst various divisions of combat sports, one of the basic ones is the division into ground and stand-up sports. In the following work, using the available literature, we wanted to present the specifications of several of the most popular combat sports and compare their most common locations of injuries, types of injuries and mechanisms of their formation, paying attention to which of these categories a given sport belongs to. We also discuss differences in the rate of injury for different age, genders, prevalence of injuries during situations of practice and competition. In the end, it is presented what are the possible long-term complications of injuries in combat sports and which actions such as protective gear, bans on certain techniques or behavioural changes might reduce the injury rate to protect the athletes health, well-being and decrease the economic burden on healthcare systems.

Schizophrenia is a chronic mental disorder characterized by severe cognitive and behavioral impairments. It often coexists with multiple and complex anxiety symptoms that exacerbate the clinical challenges associated with schizophrenia. This case report presents the history of a 32-year-old woman with a final diagnosis of both paranoid schizophrenia and mixed anxiety disorders. The patient presented with persistent auditory pseudohallucinations, severe anxiety together with occasional panic attacks, which were treated with a variety of antipsychotics. Treatment adjustments were necessitated by the emergence of side effects, including neutropenia, motor disturbances and the observation of major anxiety symptoms, including panic disorder. Ultimately, the successful use of quetiapine in monotherapy was achieved. This case study emphasizes the need for comprehensive treatment strategies to address the complex interplay of psychotic and anxiety symptoms. Increased clinical awareness and targeted treatment of comorbid anxiety can significantly improve the quality of life of patients with schizophrenia.

The Valsalva maneuver, named after Antonio Maria Valsalva, is one of the vagal maneuvers. It is defined as a forced expiration against a closed glottis, leading to an increase in intrathoracic and intra-abdominal pressure. Over the years it has become a subject of interest to many clinical researchers who have comprehensively studied its physiology and clinical significance. As a result, the application of the Valsalva maneuver has expanded to become a versatile technique applied across a wide range of medical specialties as a diagnostic and therapeutic tool. Additionally, it has found its use in sport among athletes. The aim of this article is to present the current state of knowledge about the clinical significance of the Valsalva maneuver and show that this simple physiological technique described in the 18th century remains a valuable tool in modern clinical practice and has found its use in sport. The review was based on chosen literature obtained from the PubMed electronic database, Google Scholar electronic database, and other scientific articles. Search terms included keywords listed below. Keywords: Valsalva maneuver; vagal maneuver; respiratory maneuver; autonomic system

Schizophrenia is a chronic and severe mental illness that affects multiple areas of life. Patients with schizophrenia are prone to developing serious and even fatal disorders when it comes to their physical health. They have a higher mortality risk and an average of 14,5 years of potential life lost compared to the general population. Physical activity decreases mortality, reduces cardiovascular risk, and improves mental health. Within this article, we explore the topic of physical activity and its influence on the physical and mental health of schizophrenia patients and their treatment.

This online structured survey has demonstrated the global impact of the COVID-19 pandemic on vascular services. The majority of centres have documented marked reductions in operating and services provided to vascular patients. In the months during recovery from the resource restrictions imposed during the pandemic peaks, there will be a significant vascular disease burden awaiting surgeons. One of the most affected specialties.

Abstract Background Osteoprotegerin (OPG) and osteopontin (OPN) are vascular calcification inhibitors with a known role in the atherosclerotic and inflammatory process. We investigated their relationship with adverse outcomes (restenosis/adverse cardiovascular events) after endovascular revascularisation of patients with peripheral arterial disease (PAD). Methods 203 consecutive patients were enrolled in the PAD group (PADG) and 78 age and sex-matched subjects with less than two cardiovascular risk factors served as control group (COG). PADG underwent standard medical assessment at baseline and 12 months after the procedure. During follow up major adverse cardiovascular events (MACEs) including arterial restenosis with need for reintervention were documented and the PADG was divided accordingly into two subgroups. Results During 12-month follow-up, 82 MACE were recorded (MACE subgroup). The rest of 124 PAD patients remained free of MACE (non-MACE subgroup). At baseline, OPG (9.89 ± 2.85 ng/ml vs 3.47 ± 1.95 ng/ml, p

Acute aortic dissection in the immediate postoperative period after endovascular abdominal aortic aneurysm repair (EVAR) has been linked to technical factors such as excessive endograft oversizing or aortic wall injuries during the procedure. In contrast, dissections that occur later are more likely to be de novo. Regardless of their etiology, aortic dissection can extend into the abdominal aorta, causing collapse and occlusion of the endograft with devastating complications. To the best of our knowledge, no studies have reported on aortic dissection in EVAR patients in whom EndoAnchors (Medtronic, Minneapolis, MN) had been used. We present two cases of de novo type B aortic dissection after EVAR with entry tears in the descending thoracic aorta. In both of our patients, the dissection flap appeared to stop abruptly at the site of endograft fixation with the EndoAnchors, suggesting that EndoAnchors might prevent the propagation of aortic dissection beyond the EndoAnchor fixation level and thus protect the EVAR from collapse.

Introduction: Electrophysiology (EP) procedures are nowadays the gold-standard method for tachyarrhythmia treatment with impressive success rates, but also with a considerable risk of complications, mainly vascular. A systematic review and meta-analysis was performed to evaluate the safety of ultrasound (US)-guided femoral vein access in EP procedures compared to the traditional anatomic landmark-guided method. Methods: We searched Pubmed (MEDLINE), Embase, Web of Science, and Cochrane electronic databases for relevant entries, dated from January 1st, 2000 to June 30th, 2021. Only observational studies and randomized controlled trials were included in this analysis. Data extraction included study details, patient characteristics, procedure details, and all types of vascular complications. Complications were classified as major if any intervention, prolongation of hospitalization, or readmission was required. Results: 9 studies (1 randomized controlled trial and 8 observational), with 7858 participants (3743 in the US-guided group, 4115 in the control group), were included in the meta-analysis. Overall vascular complication rates were significantly decreased in the US-guided group compared to the control group (1.2 versus 3.2%, RR = 0.38, 95% CI, 0.27–0.53), in all EP procedures. Sub-group analysis of AF ablation procedures yielded similar results (RR 0.41, 95% CI, 0.29–0.58, p

Objective: To document the recovery of vascular services in Europe following the first COVID-19 pandemic peak. Methods: An online structured vascular service survey with repeated data entry between 23 March and 9 August 2020 was carried out. Unit level data were collected using repeated questionnaires addressing modifications to vascular services during the first peak (March – May 2020, “period 1”), and then again between May and June (“period 2”) and June and July 2020 (“period 3”). The duration of each period was similar. From 2 June, as reductions in cases began to be reported, centres were first asked if they were in a region still affected by rising cases, or if they had passed the peak of the first wave. These centres were asked additional questions about adaptations made to their standard pathways to permit elective surgery to resume. Results: The impact of the pandemic continued to be felt well after countries’ first peak was thought to have passed in 2020. Aneurysm screening had not returned to normal in 21.7% of centres. Carotid surgery was still offered on a case by case basis in 33.8% of centres, and only 52.9% of centres had returned to their normal aneurysm threshold for surgery. Half of centres (49.4%) believed their management of lower limb ischaemia continued to be negatively affected by the pandemic. Reduced operating theatre capacity continued in 45.5% of centres. Twenty per cent of responding centres documented a backlog of at least 20 aortic repairs. At least one negative swab and 14 days of isolation were the most common strategies used for permitting safe elective surgery to recommence. Conclusion: Centres reported a broad return of services approaching pre-pandemic “normal” by July 2020. Many introduced protocols to manage peri-operative COVID-19 risk. Backlogs in cases were reported for all major vascular surgeries.

Abstract Background RBP4 is an adipokine with an established role in atherosclerosis, while adiponectin has unique anti-inflammatory properties. We investigated the association of RBP4 and adiponectin with the presence of symptomatic peripheral artery disease (PAD) and their possible prognostic role in major adverse cardiovascular events (MACE). Methods We enrolled 168 consecutive patients with symptomatic, established PAD, requiring revascularization by endovascular means of any or both of their lower limbs. 88 age- and sex-matched subjects with less than 2 classical cardiovascular risk factors served as controls. Clinical parameters, glycemic and lipid profile, RBP4 and adiponectin levels were assayed. The occurrence of MACE was recorded during the 6-month follow-up and patients were assigned to MACE and non-MACE subgroups. Results The presence of symptomatic PAD was significantly correlated with age, diabetes, hsCRP, RBP4 and low adiponectin levels (p

Photo by Agni B on Unsplash ABSTRACT The number of scientific articles published per year has been steadily increasing; so have the instances of misconduct in medical research. While increasing scientific knowledge is beneficial, it is imperative that research be authentic and bias-free. This article explores why fraud and other misconduct occur, presents the consequences of the phenomenon, and proposes measures to eliminate unethical practices in medical research. The main reason scientists engage in unethical practices is the pressure to publish which is directly related to their academic advancement and career development. Additional factors include the pressure to get research funds, the pressure from funding sources on researchers to deliver results, how scientific publishing has evolved over the years, and the over-publication of research in general. Fraud in medical research damages trust and reliability in science and potentially harms individuals. INTRODUCTION Since the introduction of Evidence-Based Medicine (EBM) in the early 1990s, scientific articles published per year have increased steadily. No one knows the exact number of scientific articles published per year, but several estimates point to around 2,000,000.[1] EBM aims to integrate the clinical experience and the best available scientific knowledge in managing individual patients.[2] The EBM model is based on the accumulation of as much clinical and research data as possible, which has propelled a significant rise in research. Unfortunately, its incentive structure has also led to a rise in research misconduct. “Fraud in science has a long history.”[3] Cases of misconduct began to surface in the late 1980s and increased during the 1990s. Experts suggest that today fraud is “endemic in many scientific disciplines and in most countries.”[4] In recent reporting, the majority of cases of scientific fraud involved falsification and fabrication of the data, while plagiarism was much less frequent. 8 percent of scientists and 10 percent of medical and life-sciences researchers admitted to falsifying data at least once between 2017 and 2021 in a Dutch study of 6,813 researchers, while more than half engaged in at least one questionable research practice.[5] Questionable research practices include research design flaws or unfairness in decisions surrounding publication or grants.[6] In an older study, closer to 2 percent of those surveyed reported having engaged in falsification or fabrication,[7] while in a more recent survey of 3,000 scientists with NIH grants in the United States, 0.3 percent of the scientists responding admitted fabricating research data and 1.4 percent of them admitted plagiarizing.[8] These numbers are almost certainly not reflective of the true incidence of fraud as many scientists admitted that they engaged in a range of behaviors beyond fabrication, falsification, and plagiarism that undermine the integrity of science, such as changing the results of a study under pressure from a funding source or failing to present data that contradicts one’s previous research. It is also unclear whether surveys are the best method to investigate misconduct because a scientist answering the survey may be unsure of anonymity and may not be truthful. This article explores why misconduct occurs, presents the consequences, and proposes measures to eliminate unethical practices in medical research. In the 1999 Joint Consensus Conference on Misconduct in Biomedical Research, “scientific fraud” was defined as any “behavior by a researcher, intentional or not, that falls short of good ethical and scientific standards.”[9] ANALYSIS l. The Scientific Publishing Landscape There are several reasons scientists may commit misconduct and engage in unethical practices. There is an increasing pressure to publish, which the motto "publish or perish reflects.”[10] The number of scientific papers published by a researcher is directly related to their academic advancement and career development. Similarly, academic institutions rely on scientific publications to gain prestige and access research grants. Pressure to get research grants may create environments that make it challenging to research integrity. Researchers are often tempted to alter their data to fulfill the desired results, separately report the results of one research in multiple end publications, commonly referred to as “salami publication,” or even simultaneously submit their scientific articles to more than one journal. This creates a vicious cycle in which the need for funding leads to scientific misconduct, which in turn secures more research funding. Meanwhile, the pressure from the funding sources cannot be overlooked either. Although researchers must report the role of the funding sources, selection and publication bias often may advantage articles that support the interests of the financial sponsor. Disclosure does not alter the conflict of interest. The growing number of scientific articles published per year has practically overwhelmed the peer-review system. Manuscript submissions are often reviewed superficially or assigned to inexperienced reviewers; therefore, misconduct cases may go unnoticed. The rise of “predatory” journals that charge authors publication fees and do not review work for authenticity and the dissemination of information through preprints has worsened the situation. The way that profits influence scientific publishing has very likely contributed to the phenomenon of misconduct. The publishing industry is a highly profitable business.[11] The increased reliance on funding from sources that expect the research to appear in prestigious, open-access journals often creates conflicts of interest and funding bias. On the other hand, high-impact journals have not given space to navigate through negative results and previous failures. Nonsignificant findings commonly remain unpublished, a phenomenon known as “the file drawer problem.” Scientists often manipulate their data to fit their initial hypothesis or change their hypothesis to fit their results, leading to outcome-reporting bias. ll. Misconduct Concerning the Reporting and Publishing Data The types of misconduct vary and have different implications for the scientist’s career and those relying on the research. For example, plagiarism is generally not punished by law currently unless it violates the original author’s copyright. Nevertheless, publishers who detect plagiarism implement penalties such as rejection of the submitted article and expulsion of the author. While plagiarism can be either accidental or deliberate, in either case, it is a serious violation of academic integrity as it involves passing off someone else’s “work or ideas” as one’s own.[12] Plagiarism can be “verbatim” (copying sentences or paragraphs from previously published work without using quotation marks or referencing the source) or rephrasing someone’s work or ideas without citing them. In “mosaic” plagiarism, the work plagiarized comes from various sources. “Self-plagiarism” is defined as an author’s reproduction of their previous publications or ideas in the same or altered words. According to most scientific journals, all authors of an article in part must have contributed to the conception and design of the study, drafted the article, revised it critically, or approved of its final version.[13] The use of a ghost author (usually a professional writer who is not named an author) is generally not ethical, as it undermines the requirement that the listed authors created the article. Moreover, wasteful publication is another practice that contributes to misconduct. Wasteful publication includes dividing the results of one single study into multiple end publications (“salami slicing”), republishing the same results in one or more articles, or extending a previously published article by adding new data without reaching new conclusions. Wasteful publication not only skews the scientific databases, but also wastes the time of the readers, the editors, and the reviewers. It is considered unethical because it unreasonably increases the authors’ citation records. Authors caught engaging in such behaviors may be banned from submitting articles for years while the submitted article is automatically rejected. Wasteful publication is an example of how the pressure to publish more articles leads to dishonest behavior, making it look like a researcher has conducted more studies and has more experience. Conflicts of interest are not strictly prohibited in medicine but require disclosure. Although disclosure of financial interests is a critical step, it does not guarantee the absence of bias. Researchers with financial ties to a pharmaceutical company funding their research are more likely to report results that favor the sponsor, which eventually undermines the integrity of research.[14] Financial sponsors should not be allowed to influence publication; rather authors need to publish their results based on their own decisions and findings. lll. Misconduct in Carrying Out Scientific Research Studies Common forms of fabrication include concealing negative results, changing the results to fit the initial hypothesis or selective reporting of the outcomes. Falsification is the manipulation of experimental data that leads to inaccurate presentation of the research results. Falsified data includes deliberately manipulating images, omitting, or adding data points, and removing outliers in a dataset for the sake of manipulating the outcome. In contrast to plagiarism, this type of misconduct is very difficult to detect. Scientists who fabricate or falsify their data may be banned from receiving funding grants or terminated from their institutions. Falsification and fabrication are dangerous to the public as they can result in people giving and receiving incorrect medical advice. Relying on falsified data can lead to death or injury or lead patients to take a drug, treatment, or use a medical device that is less effective than perceived. Thus, some members of the scientific community support the criminalization of this type of misconduct.[15] Research involving human participants requires respect for persons, beneficence, justice, voluntary consent, respect for autonomy, and confidentiality. Violating those principles constitutes unethical human experimentation. The Declaration of Helsinki is a statement of ethical principles for biomedical research involving human subjects, including research on identifiable human material and data. Similarly, research in which animals are subjects is also regulated. The first set of limits on the practice of animal experimentation was the Cruelty to Animals Act passed in 1876 by the Parliament of the United Kingdom. Currently, all animal experiments in the EU should be carried out in accordance with the European Directive (2010/63/EU),[16] and in the US, there are many state and federal laws governing research involving animals. The incentives to compromise the ethical responsibilities surrounding human and animal practices may differ from the pressure to publish, yet some are in the same vein. They may generally include taking shortcuts, rushing to get necessary approvals, or using duress to get more research subjects, all actions that reflect a sense of urgency. lV. Consequences of Scientific Misconduct Fraud in medical research damages science by creating data that other researchers will be urged to follow or reproduce that wastes time, effort, and funds. Scientific misconduct undermines the trust among researchers and the public’s trust in science. Meanwhile, fraud in medical trials may lead to the release of ineffective or unsafe drugs or processes that could potentially harm individuals. Most recently, a study conducted by Surgisphere Corporation supported the efficacy of hydroxychloroquine for the treatment of COVID-19 disease.[17] The scientific article that presented the results of the study was retracted shortly after its release due to concerns raised over the validity of the data. Scientific misconduct is associated with reputational and financial costs, including wasted funds for research that is practically useless, costs of an investigation into the fraudulent research, and costs to settle litigation connected with the misconduct. The retraction of scientific articles for misconduct between 1992 and 2002 accounted for $58 million in lost funding by the NIH (which is the primary source of public funds for biomedical research in the US).[18] Of retracted articles, over half are retracted due to “fabrication, falsification, and plagiarism.”[19] Yet it is likely that many articles that contain falsified research are never retracted. A study revealed that of 12,000 journals reviewed, most of the journals had never retracted an article. The same study suggests that some journals have improved oversight, but many do not.[20] V. Oversight and Public Interest Organizations The Committee on Publication Ethics (COPE) was founded in 1997 and established practices and policies for journals and publishers to achieve the highest standards in publication ethics.[21] The Office of Research Integrity (ORI) is an organization created in the US to do the same. In 1996, the International Conference of Harmonization (ICH) adopted the international Good Clinical Practice (GCP) guidelines.[22] Finally, in 2017 the Parliamentary Office of Science and Technology (POST) initiated a formal inquiry into the trends and developments on fraud and misconduct in research and the publication of research results.[23] Despite the increasing efforts of regulatory organizations, scientific misconduct remains a major issue. To eliminate unethical practices in medical research, we must get to the root of the problem: the pressures put on scientists to increase output at the expense of quality. In the absence of altered incentives, criminalization is a possibility. However, several less severe remedies for reducing the prevalence of scientific misconduct exist. Institutions first need to foster open and frank discussion and promote collegiality. Reducing high-stakes competition for career advancement would also help realign incentives to compromise research ethics. In career advancement, emphasis should be given to the quality rather than the quantity of scientific publications. The significance of mentorship by senior, experienced researchers over lab assistants can bolster ethical training. Adopting certain codes of conduct and close supervision of research practices in the lab and beyond should also be formalized. The publication system plays a critical role in preserving research integrity. Computer-assisted tools that detect plagiarism and other types of misconduct need to be developed or upgraded. To improve transparency, scientific journals should establish clear authorship criteria and require that the data supporting the findings of a study be made available, a movement that is underway. Preprint repositories also might help with transparency, but they could lead to people acting on data that has not been peer-reviewed. Finally, publishing negative results is necessary so that the totality of research is not skewed or tainted by informative studies but does not produce the results researchers hoped. Consistently publishing negative results may create a new industry standard and help researchers see that all data is important. CONCLUSION Any medical trial, research project, or scientific publication must be conducted to develop science and improve medicine and public health. However, the pressures from the pharmaceutical industry and academic competition pose significant threats to the trustworthiness of science. Thus, it is up to every scientist to respect and follow ethical rules, while responsible organizations, regulatory bodies, and scientific journals should make every effort to prevent research misconduct. - [1] World Bank. “Scientific and technical journal articles”. World Development Indicators, The World Bank Group. https://data.worldbank.org/indicator/IP.JRN.ARTC.SC?year_low_desc=true. [2] Masic I, Miokovic M, Muhamedagic B. “Evidence Based Medicine - New Approaches and Challenges.” Acta Inform Med. 2008;16(4):219-25. https://www.bibliomed.org/mnsfulltext/6/6-1300616203.pdf?1643160950 [3] Dickenson, D. “The Medical Profession and Human Rights: Handbook for a Changing Agenda.” Zed Books. 2002;28(5):332. doi: 10.1136/jme.28.5.332. [4] Ranstam J, Buyse M, George SL, Evans S, Geller NL, Scherrer B, et al. “Fraud in Medical Research: an International Survey of Biostatisticians, ISCB Subcommittee on Fraud. Control Clin Trials. 2000;21(5):415-27. doi: 10.1016/s0197-2456(00)00069-6. [5] Gopalakrishna, G., Riet, G. T., Vink, G., Stoop, I., Wicherts, J. M., & Bouter, L. (2021, “Prevalence of questionable research practices, research misconduct and their potential explanatory factors: a survey among academic researchers in The Netherlands.” MetaArXiv. July 6, 2021. doi:10.31222/osf.io/vk9yt; Chawla, Dalmeet Singh, “8% of researchers in Dutch survey have falsified or fabricated data.” Nature. 2021. https://www.nature.com/articles/d41586-021-02035-2 (The Dutch study’s author suggests the results could be an underestimate; she also notes an older similar study that found 4.5 percent.) [6] Chawla. [7] Fanelli D. How many scientists fabricate and falsify research? A systematic review and meta-analysis of survey data. PLoS One. 2009;4(5):e5738. doi:10.1371/journal.pone.0005738 [8] Martinson BC, Anderson MS, de Vries R. “Scientists behaving badly” Nature. 2005;435(7043):737-8. https://www.nature.com/articles/435737a. [9] Munby J, Weetman, DF. Joint Consensus Conference on Misconduct in Biomedical Research: The Royal College of Physicians of Edinburgh. Indoor Built Environ. 1999;8:336–338. doi: 10.1177/1420326X9900800511. [10] Stephen Beale “Large Dutch Survey Shines Light on Fraud and Questionable Research Practices in Medical Studies Published in Scientific Journals,” The Dark Daily, Aug 30, 2021. https://www.darkdaily.com/2021/08/30/large-dutch-survey-shines-light-on-fraud-and-questionable-research-practices-in-medical-studies-published-in-scientific-journals/ [11] Buranyi S. Is the staggeringly profitable business of scientific publishing bad for science? The Guardian. June 27, 2017. https://www.theguardian.com/science/2017/jun/27/profitable-business-scientific-publishing-bad-for-science [12] Cambridge English Dictionary. https://dictionary.cambridge.org/us/dictionary/english/plagiarism [13] International Committee of Medical Journal Editors. Defining the Role of Authors and Contributors http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html [14] Resnik DB, Elliott KC. “Taking Financial Relationships into Account When Assessing Research.” Accountability in Research. 2013;20(3):184-205. doi: 10.1080/08989621.2013.788383. [15] Bülow W, Helgesson G. Criminalization of scientific misconduct. Med Health Care and Philos. 2019;22:245–252. [16] Directive 2010/63/EU of the European Parliament and of the Council of 22 September 2010 on the protection of animals used for scientific purposes. 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Chronic rhinosinusitis (CRS) presents with two basic phenotypes, CRS with (CRSwNP) or without nasal polyps (CRSsNP). The present study’s objective was to evaluate the clinical characteristics in a Greek population of CRSwNP patients and their relation to the frequency of CD4 + and CD8 + T cells as well as the CD4 + /CD8 + ratio as prognostic biomarkers. Thirty-three adult CRSwNP patients were recruited at the ENT Department of “G. Papanikolaou” General Hospital of Thessaloniki. Tissue samples from nasal polyps were collected during functional endoscopic sinus surgery. Hadley’s nasal endoscopy scores, preoperative Lund-Mackay CT scores, and 22-item Sinonasal Outcome Test, were recorded for each patient. The presence of CD4 + and CD8 + lymphocytes was evaluated in tissue sections by immunohistochemistry. Blood eosinophil and neutrophil counts were also included in the analysis. All data were analyzed with SPSS (version 21.0). Twenty-one males and 12 females were included in the analysis with mean age of 49.5 ± 14.5. LMS ( P 5%, LMS and SNOT 22 were negatively correlated to CD4 + cells ( P = 0.029 r = −0.654, P = 0.043, r = −0.618, respectively). In CRSwNP patients with CD4 + /CD8 + ratio

The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with aneurysms of the abdominal aorta and iliac arteries in succession to the 2011 and 2019 versions, with the aim of assisting physicians and patients in selecting the best management strategy. The guideline is based on scientific evidence completed with expert opinion on the matter. By summarising and evaluating the best available evidence, recommendations for the evaluation and treatment of patients have been formulated. The recommendations are graded according to a modified European Society of Cardiology grading system, where the strength (class) of each recommendation is graded from I to III and the letters A to C mark the level of evidence. A total of 160 recommendations have been issued on the following topics: Service standards, including surgical volume and training; Epidemiology, diagnosis, and screening; Management of patients with small abdominal aortic aneurysm (AAA), including surveillance, cardiovascular risk reduction, and indication for repair; Elective AAA repair, including operative risk assessment, open and endovascular repair, and early complications; Ruptured and symptomatic AAA, including peri-operative management, such as permissive hypotension and use of aortic occlusion balloon, open and endovascular repair, and early complications, such as abdominal compartment syndrome and colonic ischaemia; Long term outcome and follow up after AAA repair, including graft infection, endoleaks and follow up routines; Management of complex AAA, including open and endovascular repair; Management of iliac artery aneurysm, including indication for repair and open and endovascular repair; and Miscellaneous aortic problems, including mycotic, inflammatory, and saccular aortic aneurysm. In addition, Shared decision making is being addressed, with supporting information for patients, and Unresolved issues are discussed. The ESVS Clinical Practice Guidelines provide the most comprehensive, up to date, and unbiased advice to clinicians and patients on the management of abdominal aorto-iliac artery aneurysms. [ABSTRACT FROM AUTHOR]

Plexiform neurofibromas are benign tumors that tend to occur in patients suffering from neurofibromatosis type 1 (NF-1). This report addresses a rare case where the tumor affected the parotid gland, deriving almost exclusively from the peripheral portion of the facial nerve. A 6-year-old male was referred to us complaining about a gradually enlarging swelling over the right parotid area. Imaging localized the lesion to the superficial lobe of the parotid gland, suggesting a neurofibroma. Cosmetic disfigurement and a functional deficit led us to perform complete surgical resection. Meticulous surgical dissection as well as auriculotemporal nerve origin made complete extirpation possible with almost zero morbidity and ensured alleviation of both aesthetic impairment and pain. This is the first case of an intraparotid PN in a pediatric NF-1 patient, which originated from branches of the auriculotemporal nerve and particularly from fibers of the autonomic nervous system. Radical surgical excision was decided according to established decision-making algorithms.

The article presents the analysis of competitiveness of time and cost of carriage charges by three transport branches: road, rail, and inland navigation. The authors tried to take into consideration all costs involved in transporting a particular type of cargo for different branches of transport. The cost of transportation and cargo handling costs are adopted in force at April 2015. The authors try to prove by what class of waterways, inland navigation would become competitive with other branches of transport.