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Background: The Delta variant (Pango lineage B.1.617.2) is one of the most significant and aggressive variants of SARS-CoV-2. To the best of our knowledge, this is the first paper specifically studying pulmonary morphopathology in COVID-19 caused by the B.1.617.2 Delta variant. Methods: The study included 10 deceased patients (40-83 years) with the COVID-19 Delta variant. The necrotic lung fragments were obtained either by biopsy (six cases) or autopsy (four cases). Tissue samples were subjected to virology analysis for identification of the SARS-CoV-2 variant, histopathology, and immunohistochemistry (anti-SARS coronavirus mouse anti-virus antibody). Results: Virology analysis identified B.1.617.2 through genetic sequencing in eight cases, and in two cases, specific mutations of B.1.617.2 were identified. Macroscopically, in all autopsied cases, the lung had a particular appearance, purple in color, with increased consistency on palpation and abolished crepitations. Histopathologically, the most frequently observed lesions were acute pulmonary edema (70%) and diffuse alveolar damage at different stages. The immunohistochemical examination was positive for proteins of SARS-CoV-2 in 60% of cases on alveolocytes and in endothelial cells. Conclusions: The histopathological lung findings in the B.1.617.2 Delta variant are similar to those previously described in COVID-19. Spike protein-binding antibodies were identified immunohistochemically both on alveolocytes and in the endothelial cells, showing the potential of indirect damage from thrombosis.

The presence of SARS-CoV-2 in the middle ear reveals the etiopathogenesis of otitis media in COVID-19, as well as an epidemiological risk during otologic examination and surgical procedures in COVID-19 patients. The study included 8 deceased patients with COVID-19. Tissue samples from the middle ear were subjected to virology, histopathology, scanning (SEM) and transmission (TEM) electron microscopy investigation. Ethmoidal mucosa samples were processed for virology analyses. qPCR resulted positive for 75% of nasal mucosa samples and 50% of middle ear samples. Ct values showed lower viral loads in middle ear samples. A proportion of 66.6% patients with positive results in the nasal mucosa showed positive results in the middle ear, and the subtype analysis of the complete genome sequences indicated B.1.1.7 lineage for all samples. In histopathological and SEM samples, no pathological aspects were identified. TEM revealed on the background of death critical alteration of cellular morphology, suggestive structures resembling SARS-CoV-2, goblet cells and immune cells. SARS-CoV-2 can be present in the middle ear of COVID-19 patients even if there is not clinical evidence of acute otitis media. Otolaryngologists could be particularly exposed to COVID-19 infection.

(1) Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is one of the most studied rhinological disorders. Modifications of the respiratory nasal mucosa in COVID-19 patients are so far unknown. This paper presents a comparative morphological characterization of the respiratory nasal mucosa in CRSwNP versus COVID-19 and tissue interleukin (IL)-33 concentration. (2) Methods: We analyzed CRSwNP and COVID-19 samples through histopathology, scanning and transmission electron microscopy and performed proteomic determination of IL-33. (3) Results: Histopathologically, stromal edema (p &lt, 0.0001) and basal membrane thickening (p = 0.0768) were found more frequently in CRSwNP than in COVID-19. Inflammatory infiltrate was mainly eosinophil-dominant in CRSwNP and lymphocyte-dominant in COVID-19 (p = 0.3666). A viral cytopathic effect was identified in COVID-19. Scanning electron microscopy detected biofilms only in CRSwNP, while most COVID-19 samples showed microbial aggregates (p = 0.0148) and immune cells (p = 0.1452). Transmission electron microscopy of CRSwNP samples identified biofilms, mucous cell hyperplasia (p = 0.0011), eosinophils, fibrocytes, mastocytes, and collagen fibers. Extracellular suggestive structures for SARS-CoV-2 and multiple Golgi apparatus in epithelial cells were detected in COVID-19 samples. The tissue IL-33 concentration in CRSwNP (210.0 pg/7 μg total protein) was higher than in COVID-19 (52.77 pg/7 μg total protein) (p &lt, 0.0001), also suggesting a different inflammatory pattern. (4) Conclusions: The inflammatory pattern is different in each of these disorders. Results suggested the presence of nasal dysbiosis in both conditions, which could be a determining factor in CRSwNP and a secondary factor in COVID-19.

Microleakage is the most common cause of bracket debonding. Moreover, different thermal expansion coefficients between the enamel, the adhesive, and the bracket bases will cause repeated expansion and contraction, adding more stress to the bonding strength. Debonding represents the failure of the adhesion between the brackets and the tooth enamel. The debonding of brackets from the enamel surface is the result of several factors, such as acid-etching and drying, adhesive application, and the time and type of photo activation. The under polymerization process of composite photo activation may lead to early bracket debonding. Objective. The aim of this research is to review the available studies assessing bracket debonding due to microleakage. Material and Methods. An electronic search in Pub Med database and Web of Science was conducted between September-October 2018. The inclusion criteria were articles written in English, full-text articles, studies published in the last 5 years, studies in vivo, ex vivo, and in vitro. The outcome measures in this research were the conditions that determine orthodontic bracket debonding due to microleakage. Results. The MEDLINE search resulted in 510 titles and abstracts that were relevant to the present topic; after selecting the articles published in the last five years, 74 were available for further selection. After the exclusion of all the studies irrelevant for the aim of the paper, 13 articles were finally included in this research. In vitro studies showed that microleakage score was higher in the gingival margin at the enamel-adhesive interfaces and in the occlusal margin at the adhesive-metal bracket interfaces. Conclusion. Bracket debonding remains the main concern during the orthodontic treatment, despite the new techniques.

Our study aimed to describe and assess the impact of legal aspects on dentists’ practices during the COVID-19 pandemic. The objectives were: (a) to explore dentists’ and dental managers’ knowledge about dental liability during the COVID-19 pandemic; (b) to inquire about the respondents’ perceptions of immunity for prejudices resulting from non-urgent dental procedures during the COVID-19 pandemic; and (c) to assess respondents’ “good faith” in handling challenges in the pandemic context. We conducted an observational, cross-sectional, exploratory study based on a survey. The target population was represented by active dentists in Romania from 11 March 2020 to 31 January 2022. An email, professional groups on WhatsApp, and Facebook invitation to participate were sent at the end of January 2022. Data were collected using a self-administrated electronic questionnaire. The responses of sixty-one participants, the majority younger than 41 years (82%) and women (77%), were analyzed. Most respondents (72%) appropriately thought that patients could complain about being infected with COVID-19 during their visits for dental treatment. Most respondents agreed that all dental personnel should benefit from legal immunity (72%). The respondents indicated that clinic or office management is responsible for failing to implement/respect the safety measures and protocols specific to the COVID-19 pandemic (83%). Outcomes showed that the respondents are aware of the possibility of being sued and would not be surprised to see COVID-19 raised in litigation, while the state’s immunity is expected for all dental care personnel, not only dentists.

"Background: Scientific paper authorship represents an important form of academic attainment for research professionals and brings specific benefits (e.g., contribution science, recognizing the author’s intellectual efforts). Authors certify their work’s integrity by accepting the responsability of the published content. The principal two important unethical authorship is honorary authors (the criteria of authorship not met) and ghost authors (contributed substantially but not listed as an author). Aim: The current study has two-fold aim: to determine the prevalence of authorship violations in the biomedical journals according to the Web of Science classification and to evaluate its variation by article type (e.g., research, review, or editorial) and presence/absence authors contributions requirements. Materials and Methods: The following steps will be apply: 1) Identification of journal categories of interest – data source: Journal Citation Reports 2020 (JCR2020); 2) Identification of the eligible journal – JCR2020 by selection of journals weighted according to the number of jorunals in a specific category. The selection will be stratified by the Rank by Journal Citation Indicator (JCI); 3) Collection of characteristics of the included journals regarding the year 2020: total number of articles, number of articles and references, number of reviews and associated references; JCI percentile, open access policy and publication fee if applicable; 4) Random selection (simple random method) of authors who published in 2020. The selection will be done weighted according to the number of manuscripts published in 2020; 5) Development and validation of the questionnaire; 6) Invitation of the corresponding author to participate in the study; 7) Online anonymously data collection. The study protocol will be deposited in an international database. "

"Besides its undoubtable significant contribution to morbidity and mortality worldwide, the COVID-19 pandemic has had numerous political, social, economic, and public health implications. Vaccination, an already long debated public health ethics theme, has reoccurred in force, as the efforts of the scientific community to curb the pandemic resulted in a viable vaccine less than one year since COVID-19 was declared a pandemic. High-level, international negotiations dictated states’ COVID-19 vaccine availability in the first few months, therefore each national Government had to develop and deploy vaccination campaigns prioritizing certain population categories. This paper aims to present Romanian COVID-19 vaccination campaign, from its inception to the present days, by focusing on the ethical considerations (e.g. prioritization, coercion, non-discrimination) and their practical implications ( e.g. vaccination hesitancy, rates, fake news). Like most countries in the European Community, Romania has initially adopted a Rawlsian approach to vaccination, prioritizing the older adults and the individuals with chronic conditions. However, unlike other European countries, coercion was not considered in any form (e.g. extended mobility facilities for the vaccinated), more recently incentives such as food vouchers being discussed. The impact of these decisions on the vaccination rates and hesitancy are discussed in the context of other European countries examples of vaccination campaigns. "

(1) Background: Chronic rhinosinusitis (CRS) represents a wide range of infectious-inflammatory processes affecting, simultaneously, the nose and paranasal sinuses mucosa. The paper presents outcomes of the investigation of CRS microbiological characteristics in a group of 32 patients. (2) Methods: The purulent samples were collected during functional endoscopic sinus surgery. Agar plates were incubated and examined. All types of colonies were identified using Matrix-Assisted Laser Desorption - Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF MS). For scanning electron microscopy, samples were fixed and sputter-coated with 10 nm gold and analyzed using a scanning electron microscope. For transmission electron microscopy, samples were fixed, postfixed, and dehydrated. After polymerization, ultrathin sections were collected on carbon coated copper grids and analyzed with Jeol JEM1010 TEM. (3) Results: Positive microbiological diagnosis was obtained in 62.5% of cases. The most frequent species found are Staphylococcus aureus and Streptococcus constellatus subsp. pharyngis. Corynebacterium aurimucosum and Eggerthia catenaformis were unreported species in CRS until the present. Biofilm was evidenced in 43.7% of sinus mucosa samples. Ciliary disorientation, atrophy, and no ciliated cells were also identified. (4) Conclusion: The microbial factor—pathogen or opportunistic—is one of the most important pathological links in chronic rhinosinusitis. MALDI-TOF MS allows easily and quickly identification of germs.

"In March 2020, many countries in commissions and medical societies moved very quickly to draft fair and transparent triage guidelines; this in order to plan ahead for possible resource bottlenecks in the treatment of COVID-19 patients in intensive care units. There are a lot of consciously chosen (but also less reflected) ethical values in these guidelines. Our presentation compares the values of eight of such guidelines, but first shows how to read such values in the first place. Many health professionals are hardly aware of the explicit presentation of ethical-philosophical values. From a methodological point of view, this presentation is based on a hermeneutic-ethical approach. The guidelines are interpreted, an interpretation aid is developed, and the values of the guidelines are reconsidered in comparison. On a meta-level, we could identify different types of values, besides medical and ethical values, the guidelines were also filled with procedural, structural and legal-political values. On a content level, the unreflective handling of the value of autonomy, which often competes with the value of public health, is particularly evident. This competition is little reflected. Another point of divergence between the guidelines is the degree of precision or the difference between long-term and short-term medical prognosis. We believe that with our analysis we can contribute to making value discussions in health care more open and explicit. We would like to present these conclusions for discussion at this year’s EACME conference in Cluj. "

Citation of a manuscript could be seen as a measure of study visibility and usefulness. Citations depends by many factors such as the subject of the article, authors (number and collaborations, authors' achievement measures), accessibility (access to the full text of the manuscript), visibility (paper length, no. of figures and tables, journal), age of the paper, methods used to make the article known (personal/academic/research pages, dedicated websites, social media), number of cited references, etc. Age of papers and citation windows are essential factors influencing citation patterns but if all publication ethics are followed is expected to have no post retraction citation or at least a proper citation of the retracted manuscript with associated retraction notice. However, when a retracted article is cited must clearly result that the paper was retracted either from the text of the paper or from the reference list. This protocol address the post retraction citation of manuscripts reporting a radiology-imaging diagnostic.

Background: Establishing the diagnosis of COVID-19 and Pneumocystis jirovecii pulmonary coinfection is difficult due to clinical and radiological similarities that exist between the two disorders. For the moment, fungal coinfections are underestimated in COVID-19 patients. Case presentation: We report the case of a 52-year-old male patient, who presented to the emergency department for severe dyspnea and died 17 h later. The RT-PCR test performed at his admission was negative for SARS-CoV-2. Retesting of lung fragments collected during autopsy revealed a positive result for SARS-CoV-2. Histopathological examination showed preexisting lesions, due to comorbidities, as well as recent lesions: massive lung thromboses, alveolar exudate rich in foam cells, suprapleural and intra-alveolar Pneumocystis jirovecii cystic forms, and bilateral adrenal hemorrhage. The existing coinfection was identified after the autopsy. Establishing the diagnosis of this coinfection is difficult due to clinical and radiological similarities that exist between the two disorders. For the moment, fungal coinfections are underestimated in COVID-19 patients. Conclusion: COVID-19 and P. jirovecii coinfection should be considered, particularly in critically ill patients, and we recommend the systematic search for P. jirovecii in respiratory samples.

Introduction The purpose of this study was to evaluate the scientific evidence regarding a potential role of telocytes in myocardial infarction. Materials and methods To this purpose, we performed a systematic review of relevant scientific literature, indexed in PubMed, Web of Science, and Scopus. Results and discussions We found six articles containing relevant studies aimed at liking myocardial infarction and telocytes. The studies that were analysed in this review failed to show, beyond a reasonable doubt, that telocytes do actually have significant roles in myocardial regeneration after myocardial infarction. The main issues to be addressed in future studies are a correct characterization of telocytes, and a differentiation from other cell types that either have similar morphologies (using electron microscopy) or similar immunophenotypes, with emphasis on endothelial progenitors, which were previously shown to have similar morphology, and functions in cardiac regeneration after myocardial infarction.

Our study aimed to evaluate the trends of post retraction citations of articles reporting a radiology-imaging diagnostic method and to find if a different pattern exists between manuscripts reporting an ultrasound method and those reporting other radiology diagnostic methods. This study reviewed retractions stored in PubMed on the subject of radiology-imaging diagnosis to identify the motivation, time from publication to retraction, and citations before and after retraction. The PubMed database was searched on June 2017 to retrieve the retracted articles, and the Scopus database was screened to identify the post-retraction citations. The full text was screened to see the type of post-retraction citation (positive/negative) and whether the cited article appears or not as retracted. One hundred and two retractions were identified, representing 3.5% of the retracted articles indexed by PubMed, out of which 54 were included in the analysis. Half of the articles were retracted in the first 24 months after publication, and the number of post retraction citations was higher than the number of citations before retraction in 30 out of 54 cases (US methods: 9/20, other diagnostic methods 21/34, P-value = 0.2312). The plagiarism was the most common reason for retraction (31%), followed by repetitive publication (26%), and errors in data/manuscript (24%). In less than 2% of cases, the retracted articles appear as retracted in the text or reference list, while the negative citation is observed in 4.84% among manuscripts reporting an US diagnostic method and 0.32% among manuscripts reporting a diagnostic method other than US (P-value = 0.0004). No significant differences were observed when post retraction weighted citation index (WCI, no. of citations weighted by citation window) was compared to WCI prior retraction (P-value = 0.5972). In light of the reported results, we enumerated some recommendations that could potentially minimize the referral to retracted studies as valid.