Unfavorable Consequences Research Articles

Mortality of Laryngeal Cancer before and during the COVID-19 Pandemic

(1) Background: The interplay between coronavirus disease 2019 (COVID-19) and laryngeal cancer represents a substantial challenge for both patients and healthcare. To garner information on recent mortality data for laryngeal cancer, including during the COVID-19 pandemic, we analyzed real-world data from the US Centers for Disease Control and Prevention (CDC). (2) Methods: We searched the CDC WONDER online database 2018–2022 using the ICD-10 code for laryngeal cancer (C32; malignant neoplasm of the larynx). We also performed a sub-analysis between genders and across ten-year age groups. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey’s post hoc test. (3) Results: The trend of age-adjusted mortality ×100,000 did not change significantly between the years 2018 and 2022 (p = 0.553). Males had higher age-adjusted mortality rates (M/F ratios between 4.6 and 5.0), but no significant variation was found in both genders (males: p = 0.676; females: p = 0.596). Although the mortality rate remained unchanged in people aged 35–84 years, the variation reached statistical significance in those aged 85 or older (p = 0.004), displaying a significant increase in 2021 compared to 2018 (p = 0.006) and 2019 (p = 0.039). (4) Conclusions: The impact of the COVID-19 pandemic on mortality for laryngeal cancer seems to be relatively modest in the general US population. Nevertheless, closer attention must be paid to older people, for whom the unfavorable consequences of misdiagnosis or mistreatment of this and other types of cancers can be exacerbated.

Impact of Urbanization on Air Quality of Dehradun District

The increasing trend of urbanization poses a significant challenge to environmental sustainability, particularly concerning air quality. This study examines the impact of rapid urbanization on the Dehradun district land use and land cover (LULC), with the built-up area increasing from 44.2 km² to 276.5 km² between 2000-2019. The LULC analysis highlights a significant expansion of built-up areas influencing regional air quality. A comprehensive analysis of air pollutants and environmental factors spanning 2000 to 2019, utilizing TROPOMI, OMI, MODIS, MOPITT, and CHIRPS data, was also conducted. Spatial variations of air pollutants, including CO i.e. carbon monoxide, HCHO i.e. formaldehyde and NO2 i.e. nitrogen dioxide demonstrate higher concentrations in urbanized areas. Temporal variations exhibit seasonal peaks during the summer months. A 15-year trend analysis indicates a consistent rise in NO2 and HCHO, attributed to urbanization and anthropogenic activities. The correlation matrix highlights strong positive correlations among air pollutants, suggesting common sources or influences. The correlation between NO2 and CO stands at 0.652, between HCHO and CO is 0.583, and between HCHO and NO2 is 0.619. Higher correlation values of more than 0.4 are observed between the land surface temperature and pollutant concentrations, highlighting the influence of anthropogenic activities on temperature rise. In an attempt to mitigate the negative effects of uncontrolled urban sprawl on the district of Dehradun's air quality and overall environmental health, the study underscores the pressing need for sustainable urban planning. These findings contribute valuable insights for decision-makers to formulate effective strategies for environmental conservation against the unfavourable consequences of swift urbanization.

Post-COVID-19 syndrome and its sequelae: a cross-sectional study

BackgroundThe long-term post-COVID is a very complex pandemic phenotype disease. The persistence of manifestations had resulted in classifying COVID-19 infection into bipolar phase which is a post-COVID-19 subacute phase by which the ongoing symptoms extended for 4–12 weeks and chronic or long COVID-19 phase by which the associated symptoms and abnormalities were extending for more than 12 weeks even after the pandemic.AimDetermining the percentage of patients who continued to suffer from different symptoms beyond 12 weeks of COVID-19 exposure and the use of different complementary modalities among patients with post-COVID.Patients and methodsThe present study is a cross-sectional analytical observational study which was conducted through an online questionnaire using Google Forms with a total sample of 123 Egyptian patients older than 30 years old diagnosed with symptomatic and/or laboratory-confirmed COVID-19 infection with persistent health problems over 12 weeks prior to December 2021.ResultThe findings revealed elevated percentages of persistent symptoms and unfavorable long-term consequences extending beyond 12 weeks post-infection, irrespective of vaccination status or hospitalization. These outcomes significantly affected individuals’ health, finances, family dynamics, and lifestyle. Additionally, a notable proportion of cases sought relief through complementary medicine, particularly probiotics and herbal remedies.ConclusionThe questionnaire is an addition for a comprehensive long-term evaluation that might aid the clinician for follow-up of patient infected with COVID-19 and broaden the use of various complementary medical disciplines.

Ferroptosis and its role in gastric and colorectal cancers.

Ferroptosis is a novel mechanism of programmed cell death, characterized by intracellular iron overload, intensified lipid peroxidation, and abnormal accumulation of reactive oxygen species, which ultimately resulting in cell membrane impairment and demise. Research has revealed that cancer cells exhibit a greater demand for iron compared to normal cells, indicating a potential susceptibility of cancer cells to ferroptosis. Stomach and colorectal cancers are common gastrointestinal malignancies, and their elevated occurrence and mortality rates render them a global health concern. Despite significant advancements in medical treatments, certain unfavorable consequences and drug resistance persist. Consequently, directing attention towards the phenomenon of ferroptosis in gastric and colorectal cancers holds promise for enhancing therapeutic efficacy. This review aims to elucidate the intricate cellular metabolism associated with ferroptosis, encompassing lipid and amino acid metabolism, as well as iron metabolic processes. Furthermore, the significance of ferroptosis in the context of gastric and colorectal cancer is thoroughly examined and discussed.

Correlation between the elevated level of interleukin-6 following actemra administration and the mortality rate of seven severe COVID-19 patients

The escalation and involvement of Interleukin 6 (IL-6) in the pathogenesis of COVID-19 have been documented in numerous studies and are recognized as a diagnostic criterion, disease biomarker, and therapeutic objective. Our study aims to explore the correlation between the elevated level of IL-6 following actemra administration and the mortality rate of seven severe COVID-19 patients who were admitted to the special care department of Ardabil city hospital. In this case-series study, 7 patients with severe COVID-19 were admitted to the special care department of Ardabil city hospital were included in the study. Venous blood samples (3 cc) were taken in admission and after actemra injection. The demographic characteristics of the patients, including age, sex, duration of hospitalization, need for intubation, BMI, and interleukin 6 levels, were recorded in a checklist. The patients were then monitored for their clinical course, disease outcome, and complications. The mean IL-6 before and after actemra was 413.57±138.38 and 805.50±128.18, respectively and the difference was significant. After treatment by actemra, 71.4% of patients were discharged from hospital without mortality. Although elevated IL-6 levels have been associated with cytokine storms and unfavorable consequences in COVID-19 patients. This report indicates that high interleukin levels do not guarantee mortality. Young individuals without underlying conditions were ultimately discharged from the ICU despite severe inflammation, thanks to timely treatment and albeit with severe disability.

Nanonematicides: production, mechanisms, efficacy, opportunities and challenges

Summary Classical methods of using many toxic chemical pesticides for managing plant-parasitic nematodes (PPN) on key crops are inappropriate and have unfavourable consequences on human health and the environment. By contrast, nanotechnology can provide a wide range of alternative applications with additional merits based on nanoparticle (NP) pesticides. Three major categories, i.e., physical, chemical and biological methods, have been generally used for synthesis of nanonematicides. The merits and demerits of these methods are highlighted. The biological method generally involves easy, fast, scalable, cheap and environmentally safe techniques. As nanonematicides can reduce the non-selective use of classical nematicides with their high pollution and unhealthy levels, mechanisms underlying PPN population suppression by these nanonematicides are presented to help in their further optimisation. Nanonematicides are guiding a radical change in their efficacy against PPN, but more attention should be given to secure their clean production and application with cost-effective methods.

Sex Differences in Mortality Risk after the First Hospitalisation with Lower Extremity Peripheral Arterial Disease

Lower extremity peripheral arterial disease (PAD) is a severe condition that increases the risk of major adverse cardiovascular events, major adverse limb events, and all cause mortality. This study aimed to investigate the mortality risk among females and males hospitalised for the first time with lower extremity PAD. Three cohorts of patients who were admitted for the first time with lower extremity PAD in 2007 - 2010, 2011 - 2014, and 2015 - 2018 were constructed. For the 2007 - 2010 and 2011 - 2014 cohorts, the 28 day, one year, and five year mortality rates were calculated, assessing survival time from date of hospital admission until date of death, end of study period, or censoring. For the 2015 - 2018 cohort, only 28 day and one year mortality were investigated due to lack of follow up data. Mortality rates of these cohorts were compared with the general population using standardised mortality rates (SMRs), and the risk of death between sexes was evaluated using Cox proportional hazards models. Cox models were adjusted for age, cardiovascular disease, and diabetes mellitus to account for potential confounding factors. In total, 7 950, 9 670, and 13 522 patients were included in the 2007 - 2010, 2011 - 2014, and 2015 - 2018 cohorts, respectively. Over 60% of individuals in each cohort were males. Mortality rates at 28 day and one year remained stable across all cohorts, while the five year mortality rate increased for both males and females in the 2011 - 2014 cohort. The SMRs both of females and males with PAD were significantly higher than in the general population. Multivariable regression analyses found no significant differences in mortality risk between sexes at 28 day and one year. However, the five year mortality risk was lower in females, with a hazard ratio of 0.89 (95% confidence interval [CI] 0.83 - 0.97) in the 2007 - 2010 cohort and 0.88 (95% CI 0.82 - 0.94) in the 2011 - 2014 cohort. The five year mortality risk has increased, and females face a lower mortality risk than males. Lower extremity PAD still carries unfavourable long term consequences compared with the general population.

Exploring the possible link between the spike protein immunoglobulin G4 antibodies and cancer progression

Repeated inoculation with messenger RNA (mRNA) vaccines elicits immunoglobulin G4 (IgG4) antibody production. Such an increase in the concentration of specific and non-specific IgG4 antibodies allows the growth of some types of cancer by blocking the activation of effector immune cells. This work proposes the hypothesis that cancer growth may be indirectly promoted by increased concentrations of non-specific IgG4 antibodies by the following mechanisms: 1) IgG4 antibodies can bind to anti-tumor IgG1 antibodies and block their interaction with receptors located on effector cells, thus preventing the destruction of cancer cells, 2) IgG4 can interact with fragment crystallizable gamma receptor IIb (FcγRIIB) inhibitory receptors, thus reducing effector functions of innate immune cells, and 3) targeting of specific epitopes by IgG4 could be oncogenic by inducing the production of a microenvironment that can promote cancer development. This article reviews the supporting literature and suggests several experimental protocols to evaluate this hypothesis in the context of repeated inoculation with mRNA vaccines. Additionally, this work proposes some management options aimed at reducing the unfavorable molecular consequences that could mediate cancer development when encountering high concentrations of IgG4 antibodies.

Changes in Nutritional Outcomes After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis.

Bariatric surgery (BS) is the most effective treatment for severe obesity and it has beneficial effects on glycemic control and metabolism outcomes. However, the effects of BS on nutritional outcomes are controversial. Therefore, we aimed to evaluate the changes in several nutritional outcomes after Roux-en-Y gastric bypass (RYGB). A comprehensive search was performed using the following databases: PubMed, Embase, Web of Science, Cochrane Library, WanFang and Chinese National Knowledge Infrastructure. The following outcomes were evaluated: vitamin A, 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, parathormone (PTH), iron, ferritin, vitamin B12, folate, and zinc. The pooled outcomes were expressed as standard mean difference (SMD) and 95% confidence interval (CI) using a random effects model. Fifty-six studies including 5645 individuals with obesity met the inclusion criteria. Serum 25(OH)D (SMD = 0.78, 95%CI 0.38 to 1.20, P < 0.001), phosphorus (SMD = 0.48, 95%CI 0.22 to 0.74, P < 0.001), PTH (SMD = 0.35, 95%CI 0.11 to 0.59, P = 0.005), vitamin B12 (SMD = 1.11, 95%CI 0.41 to 1.80, P = 0.002), and folate (SMD = 1.53, 95%CI 0.77 to 2.28, P < 0.001) significantly increased after RYGB compared with the baseline. Serum ferritin (SMD = - 1.67, 95%CI - 2.57 to - 0.77, P < 0.001), vitamin A (SMD = - 0.64, 95%CI - 0.99 to - 0.29, P < 0.001), and plasma zinc (SMD = - 0.58, 95%CI - 1.09 to - 0.06, P = 0.027) significantly decreased after RYGB. No significant changes in serum calcium (SMD = - 0.14, 95%CI - 0.40 to 0.11, P = 0.219) and iron (SMD = 0.26, 95%CI - 0.11 to 0.64, P = 0.165) were observed after RYGB. Despite the increased levels of 25(OH)D, phosphorus, vitamin B12 and folate, this meta-analysis revealed the unfavorable nutritional consequences after RYGB.

Reperfusion therapy for ischemic stroke without prior neuroimaging

Clinical guidelines and the order of providing care in acute cerebrovascular accidents (CVA) have been developed for standard clinical situations, primarily for patients admitted to medical institutions in an emergency state. However, there are clinical situations when a generally accepted order of therapeutic and diagnostic measures concerning patients with stroke is unjustified and, on the contrary, its implementation threatens life and health of a patient. These situations include ischemic strokes developing intraoperatively during such endovascular interventions as diagnostic cerebral and coronary angiography and transcutaneous neuro- and cardiovascular surgery. Ischemic cerebral events after diagnostic endovascular procedures are relatively rare complications, but their development can lead to unfavorable consequences. Thus, the rates of transient cerebral circulatory disorders after cerebral angiography, a stroke with a reversible neurological deficit, and an ischemic stroke with a persistent neurological deficit are 2.45 %, 0.3 %, and 1.0 % respectively, while total mortality due to acute cerebrovascular pathology is 0.14 %. The rate of cerebral stroke after coronary angiography and percutaneous coronary interventions is up to 0.4 %. Prevention of neurologic complications in diagnostic and surgical transcutaneous interventions is strongly dependant on their correct technique, rational perioperative antithrombotic therapy, and lesser duration of endovascular operations.

Delibazione e divorzio nella giurisprudenza della Cassazione: il difficile bilanciamento tra attuazione della normativa concordataria e tutela del coniuge più debole

Exequatur procedure and divorce in the jurisprudence of the Supreme Court: the difficult balance between implementation of the concordat legislation and protection of the weaker spouse ABSTRACT: The 1984 Agreement with the catholic church modified the rules for implementing canonical sentences of nullity of marriage in the Italian legal system, introducing several controls among wich the non-contradiction to Italian public order of such sentences has acquired increasing importance. In recent years, this requirement has been interpreted by the jurisprudence of the Supreme Court in a very restrictive manner in order to limit the recognition proceeding as much as possible, with the aim of avoiding the unfavorable economic consequences deriving from the nullity of the marriage for the spouse who would have been entitled to maintenance allowance in the event of divorce. The work focuses on the relationship between recognition of canonical nullity and divorce, analyzing the repeated interventions of the Court of Cassation to prevent that with the exequatur procedure the economic measures taken in the divorce judgment could be annulled. The protection of the weaker spouse was made even more complete by the recent ruling of the United Sections of the Supreme Court of 2021 that allowes the treatment of economic issues still pending, provided that the divorce decree between the parties was pronounced before the exequatur of the ecclesiastical sentence of marriage nullity. SOMMARIO: 1. Premessa - 2. I tratti salienti dell’attuale procedimento di delibazione - 3. La differente tutela del coniuge nel caso di nullità e di divorzio - 4. Il rapporto delibazione-divorzio tra tesi dottrinali e orientamenti giurisprudenziali dalla metà degli anni Ottanta alla fine degli anni Novanta - 5. Gli interventi della giurisprudenza di vertice su delibazione e divorzio a partire dal 2001 - 6. L’ulteriore passo in avanti della Cassazione: dopo il giudicato di divorzio è possibile la trattazione delle questioni economiche ancora pendenti anche se nelle more sia intervenuto l’exequatur della nullità canonica - 7. Conclusioni.

Perinatal Outcome of Previable Premature Rupture of Membranes Before 24 Weeks of Gestation: A Single-Centered Retrospective Cohort Ctudy

OBJECTIVE: Preterm premature rupture of membranes (PPROM) has unfavorable consequences for the neonate and the mother if it occurs before 24 weeks of gestation. We aim to present our series to elucidate the course of previable PPROM and to detect maternal and neonatal outcomes. STUDY DESIGN: A single-centered retrospective cohort study that involves singleton patients diagnosed with spontaneous PPROM before 24 weeks. Data were retrieved from medical records, and maternal and neonatal outcomes were noted. RESULTS: Seventy-eight women were diagnosed with PPROM before 24 weeks, 42 patients (54%) opted for termination of pregnancy, and seven patients (9%) had spontaneous abortion. Twentynine patients (37%) gave live birth after a median latency of 47 days. Neonatal complications were respiratory distress syndrome (n=19; 65%), early sepsis (n=10; 34%), late sepsis (n=5; 17%), bronchopulmonary dysplasia (n=5;17%), retinopathy of prematurity (n=3; 10%), pneumothorax (n=5; 17%), intracranial hemorrhage (n=2; 6%), necrotizing enterocolitis (n=1; 3%) and meningitis (n=1; 3%). In the liveborn group, the neonatal survival rate was 62%. Of the survivors, twelve babies (66%) were discharged without composite neonatal morbidity. Maternal complications in the expectant management group included clinical chorioamnionitis (n=12, 33%) and placental abruption (n=2, 5%). CONCLUSION: In previable PPROM, overall half of the babies survive after expectant management. While a prolonged latency period and subsequent delivery at advanced gestational ages improve neonatal outcomes, such a conservative approach poses a substantial risk for chorioamnionitis.

Compassion fatigue: A dramatic and unfavorable consequence in the nursing profession

Nurses are one of the most important pillars of the treatment department, who, according to their professional role, are responsible for important tasks such as mental and physical care of the patient, if the above activities do not follow the principles of safety, as well as peace and well-being at work, in the occurrence of physical disorders and the psychology of this group plays a significant role [1]. They are compassionate caregivers who take care of people who experience physical, mental, or spiritual pain, and due to the special conditions of their profession, they experience a lot of pressure and stress that this pressure and stress over time causes adverse consequences in nurses. One of the important and significant consequences is the exhaustion of nurses from compassion for patients [2].

Sleep disorders in patients with bipolar disorder: age and tobacco consumption correlates

IntroductionSleep disruptions are frequently observed in individuals with bipolar disorder and have been linked to various unfavorable consequences, such as an elevated risk of relapse and lower quality of life. Nonetheless, the impact of sociodemographic factors on the development and progression of these disruptions remains largely unexplored. Gaining insight into the relationship between sleep disruptions and sociodemographic factors is essential for designing effective interventions and enhancing clinical outcomes for individuals affected by bipolar disorderObjectivesThe objective of this study is to examine the association between sleep disorders in patients with bipolar disorder II (BDII) and sociodemographic characteristics.MethodsThis is a cross-sectional, descriptive, and analytical study that was conducted over a one-month period from October 1 to October 31, 2022, with patients attending the follow-up unit of the mental health department at Nabeul Hospital ,Tunisia.The study employed a questionnaire as a tool for data collection, and participants provided voluntary and informed consent before responding. The protection of participant confidentiality and anonymity was carefully observed during all stages of the study.ResultsIn this study, we enrolled patients who satisfied the following eligibility criteria: age range of 18 to 60 years, a confirmed diagnosis of type II bipolar disorder based on DSM V criteria, and psychiatric stability as demonstrated by no hospitalization within the preceding 6-month period.Our study included a sample of 40 male patients diagnosed with type II bipolar disorder. The participants had a mean age of 36 ± 13.2 years, and the majority were unmarried and living with their families or alone. Over two-thirds of the participants had attained a university level of education, while a large proportion of the patients, specifically 80%, reported being regular smokers.The results of the study revealed that the mean global score on the Pittsburgh Sleep Quality Index (PSQI) was 7.28 ± 3.35, indicating an overall low quality of sleep. The majority of the participants, that is 65% (26), had poor sleep quality scores (&gt; 5), while 45% (18) reported experiencing poor sleep (PSQI ≥ 8).Our analyses further demonstrated that there was a significant association between tobacco consumption and PSQI scores (p=0.003). Additionally, we found that participants who were above 40 years old had a higher likelihood of experiencing sleep disturbances (p=0.0017).ConclusionsAccording to the findings of our study, it appears that patients diagnosed with type II bipolar disorder may experience impaired sleep quality, which can be influenced by age and tobacco consumption. These results underscore the need for a holistic approach to patient care that addresses both the biological and sociodemographic factors that can impact sleep in this population.Disclosure of InterestNone Declared

Comparison of nine trauma scoring systems in prediction of inhospital outcomes of pediatric trauma patients: a multicenter study

Hereby, we aimed to comprehensively compare different scoring systems for pediatric trauma and their ability to predict in-hospital mortality and intensive care unit (ICU) admission. The current registry-based multicenter study encompassed a comprehensive dataset of 6709 pediatric trauma patients aged ≤ 18 years from July 2016 to September 2023. To ascertain the predictive efficacy of the scoring systems, the area under the receiver operating characteristic curve (AUC) was calculated. A total of 720 individuals (10.7%) required admission to the ICU. The mortality rate was 1.1% (n = 72). The most predictive scoring system for in-hospital mortality was the adjusted trauma and injury severity score (aTRISS) (AUC = 0.982), followed by trauma and injury severity score (TRISS) (AUC = 0.980), new trauma and injury severity score (NTRISS) (AUC = 0.972), Glasgow coma scale (GCS) (AUC = 0.9546), revised trauma score (RTS) (AUC = 0.944), pre-hospital index (PHI) (AUC = 0.936), injury severity score (ISS) (AUC = 0.901), new injury severity score (NISS) (AUC = 0.900), and abbreviated injury scale (AIS) (AUC = 0.734). Given the predictive performance of the scoring systems for ICU admission, NTRISS had the highest predictive performance (AUC = 0.837), followed by aTRISS (AUC = 0.836), TRISS (AUC = 0.823), ISS (AUC = 0.807), NISS (AUC = 0.805), GCS (AUC = 0.735), RTS (AUC = 0.698), PHI (AUC = 0.662), and AIS (AUC = 0.651). In the present study, we concluded the superiority of the TRISS and its two derived counterparts, aTRISS and NTRISS, compared to other scoring systems, to efficiently discerning individuals who possess a heightened susceptibility to unfavorable consequences. The significance of these findings underscores the necessity of incorporating these metrics into the realm of clinical practice.

Issues of Ecological Tourism Development on the Territory of Pribaikalye

Over the past few years, Russians' interest in domestic tourism has been steadily growing. This trend is due not only to external factors, but also to the initiatives of the Russian Government and governors implemented at the federal and regional levels. Tourism is becoming a strategic resource for the development of the Russian economy. The article gives examples of regions that are leaders in eco-tourism, demonstrates data confirming the development of tourism in Russian regions. Irkutsk region is characterized by the richness of flora and fauna, diversity of specially protected natural areas (SPNA). Protected areas are represented by two federal reserves (Baikal-Lensky and Vitimsky), Pribaikalsky National Park, two wildlife sanctuaries (Tofalarsky and Krasny Yar). Also in the Irkutsk region there is a part of the territory subject to protection — Lake Baikal World Natural Heritage Site. The ecosystems of protected areas are fragile in their structure, and serious interference in their structure can lead to destruction and death. Therefore, it is important to strike a balance between the development of tourism infrastructure and the preservation of natural heritage. In the world practice ecological tourism is a tool that allows designing modern ecological centers of international scale. This issue is particularly relevant for Pribaikalsky Krai; a number of documents at the federal and regional levels have identified the development of eco-tourism as one of the priority directions. In this context, it is very important to find such tools and mechanisms that will allow to preserve the environment for future generations, since the influx of tourists not only brings profit, but also leaves behind unfavorable consequences for the environment.

Prevalence of Malocclusions among Schoolchildren from Southwestern Romania.

Malocclusions have a continuously increasing prevalence from one generation to another as a result of climate change, soil, atmosphere, and water pollution. All of these aspects have unfavorable consequences for the nutritional scheme. Thus, nutrition, together with other etiopathogenic factors, contributes to complex alterations in the somatic development of the entire organism and, implicitly, of the cephalic extremity. The study group included 4147 children from randomly selected schools from Vâlcea County, Romania. The aim of this study is to determine the prevalence of malocclusions in schoolchildren in Vâlcea County, Romania, according to the three main classes of malocclusions (according to Angle's classification), age groups (from 6 to 10 years old and from 11 to 14 years old), gender (male and female), and place of origin (rural and urban). For Angle class I malocclusions, we recorded the highest prevalence (48.78% of the total number of schoolchildren with malocclusions), followed by Angle class II malocclusions (45.85% of the total number of schoolchildren with malocclusions), and for Angle class III malocclusions we found the lowest prevalence (5.37% of the total number of schoolchildren with malocclusions). According to gender, we found the highest prevalence in the female gender (29.90% of the total number of female subjects), while in the male gender, we recorded a prevalence of 27.70% of the total number of male subjects. Regarding the place of origin, there is a higher prevalence of malocclusions in urban areas (29.16%). The study subgroup included 140 children randomly selected from the total number of subjects in the study group. They were included in a more advanced study. The aim is to find potential associations between the presence of malocclusions and various oral variables. Categorical variables were expressed as numerical values and percentages, and their association was evaluated with either the Chi-square test of association or homogeneity, or the Fisher Exact test. The acquired data were incorporated into a binomial logistic regression model to assess the likelihood of developing malocclusions in relation to the following variables: defective phonation, bruxism, frequency of teeth brushing, onychophagia, oral respiration, infantile deglutition, placing objects between the maxillaries, thumb sucking, and salivary aspects. It is also aimed at comparing the results obtained with similar ones from the specialized literature.

Does Company Information Environment Affect ESG–Financial Performance Relationship? Evidence from European Markets

This study investigates the relationship between ESG and financial performance and explores the influence of firms’ information environment on this relationship. To do this, we construct an information environment index from several proxy measures, evaluate ESG performance using Refinitiv’s ESG scores, and evaluate financial performance using return on assets and Tobin’s Q. We find that the information environment index has a positive relationship with both return on assets and Tobin’s Q ratio. On the contrary, ESG has a negative association with return on assets but a statistically insignificant relationship with Tobin’s Q. The negative relationship of ESG with return on assets is convex and weaker in companies with better information environments. We also show that in firms with high asset turnover ratios, ESG does not harm profitability. Separately examining the ESG components reveals that each similarly relates to profitability but that governance has a less negative impact. Our study reveals non-linearities in the relationship between ESG and financial performance that can help companies set better targets and implement better practices about ESG. The moderating effect of the information environment reveals the importance of information dissemination in preventing ESG practices from creating unfavorable consequences. This study may shed light on a more effective ESG policy by showing ways to reduce the adverse financial effects of ESG practices.

Technical reasons for delay and denial of regulatory approval of Initial applications for (Abbreviated) New Drugs filed by Indian Companies by USFDA, 2005-2022

Indian pharmaceutical companies are one of the leading sources of generic medicine to the United States. The US Food and Drug Administration (US FDA) conduct regular inspections and assessments of manufacturing facilities in order to confer product quality and to ensure a firm's compliance with applicable laws and regulations, such as the Food, Drug and Cosmetic Act and related Acts. Identified regulatory violations and noncompliance are notified by US FDA to the manufacturer in the form of 483s and warning letter. Warning letters led to the unfavourable consequences to the company such as loss of trust, reputation and affects their financial stability. A trend analysis of warning letters may help Indian pharmaceutical manufacturing companies to adopt cGMP practices as per the requirement of US FDA and thus will result in reduced number and frequency of warning letters. Therefore, a trend analysis of warning letters issued to Indian Pharmaceutical sector between 2005 till 2022 by US FDA was carried out by extracting the information from publicly available FDA archives and dashboard. There is an increasing trend in number of US FDA inspections in India post 2012 which could be due to the new regulations, updated laws, also the changed expectations and mindset of FDA inspectors. The FDA major findings included inadequate investigations systems, lack of authoritative quality units, product contamination and inadequate documentation practices. The study reported here enlists the expectations of US FDA from Indian Pharmaceutical sector. This will help Indian pharmaceutical manufacturers to adopt the strategies to minimize US FDA warning letters.

ENGLISH-MAJORED STUDENTS’ PERCEPTIONS OF USING GOOGLE TRANSLATE IN WRITING ASSIGNMENTS AT DONG NAI TECHNOLOGY UNIVERSITY

The education system has witnessed continuous developments in recent decades, driven by the Internet and computers. These advancements have greatly benefited learners, particularly in the realm of English language acquisition. Google Translate has emerged as an essential tool for English learners in today's education. Google Translate (GT) is revolutionizing the way students do their English writing practice. More precisely, they are exploiting the enhanced precision provided by GT to economize on time and effort when finishing written tasks. Nevertheless, students' ever-increasing reliance on these technologies might yield unfavorable consequences on their writing proficiency. This study examined the use of GT by students at Dong Nai Technology University (DNTU) and students ‘perspectives regarding the employment of GT in their writing tasks. The objective was to determine the influence of GT on students' writing abilities and understand students’ perceptions toward the GT employment. This study utilized a mixed methodology, with participants are sophomores and juniors from the Faculty of Foreign Languages. Data was collected by sending out online questionnaire to 120 students and interviewing 40 students. The findings suggested that students extensively used GT, despite expressing worries about the accuracy of the tool.