bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural networks for modelling the energy consumption of metro trains
Authors: Martínez Fernández Pablo , Salvador Zuriaga Pablo , Villalba Sanchís Ignacio , Insa Franco Ricardo
Published: July 2019

This paper presents the application of machine learning systems based on neural networks to model the energy consumption of electric metro trains, as a first step in a research project that aims to optimise the energy consumed for traction in the Metro Network of Valencia (Spain). An experimental dataset was gathered and used for training. Four input variables (train speed and acceleration, track slope and curvature) and one output variable (traction power) were considered. The fully trained neural network shows good agreement with the target data, with relative mean square error around 21%. Additional tests with independent datasets also give good results (relative mean square error = 16%). The neural network has been applied to five simple case studies to assess its performance – and has proven to correctly model basic consumption trends (e.g. the influence of the slope) – and to properly reproduce acceleration, holding and braking, although it tends to slightly underestimate the energy regenerated during braking. Overall, the neural network provides a consistent estimation of traction power and the global energy consumption of metro trains, and thus may be used as a modelling tool during further stages of research.
Guidelines for designing a realistic peripheral venous catheter insertion simulator: A literature review
Authors: Torossian Kevin , Benayoun Stéphane , Ottenio Mélanie , Brulez Anne-Catherine
Published: July 2019

A literature review was conducted to develop more realistic medical simulators that better prepare aspiring health professionals to perform a medical procedure in vivo. Thus, this review proposes an approach that might assist researchers design improved medical simulators, particularly new materials that would enhance the sensation of touch for skin substitutes. By targeting the current needs in the field of simulation learning, we concluded that peripheral venous catheter insertion simulators lack realistic haptic feedback. Enhanced peripheral venous catheter insertion simulators will accelerate the mastery of the medical procedure, thus decreasing the number of failures in patients and costs related to this procedure.
Participatory Communication Approach for RD: Evidence from Two Grassroots CR Stations in Rural India
Authors: Patil Dhanraj A.
Published: July 2019

The traditional approach of communication for rural development (RD) was greatly influenced by the dominant paradigm of development. The retort against this paradigm gave birth to the participatory approach of communication wherein the common people in rural areas were considered as the ‘subjects’ of development in conjunction with their active involvement. It is the era when alternative communication medium like community radio (CR) was accepted as a tool of participatory RD in developing counters like India. Based on case studies of India’s pioneer CRs (Sangam Radio and Radio Bundelkhand), using media ethnography tools, a qualitative enquiry was carried out to explore its role in the process of RD by inclusion of voices of rural subalterns in their own development.
A Person-Centred Approach When Encountering Students With Recurrent Pain: School Nurses’ Experiences
Authors: Wigert Helena , Fors Andreas , Nilsson Stefan , Dalenius Kristina , Golsäter Marie
Published: July 2019

Stress has a negative impact on students’ daily lives and can be associated with recurrent pain. School nurses play a key role in supporting young people with stress-related pain. The purpose of this qualitative interview study was to elucidate school nurses’ experiences of encountering students with recurrent pain when practicing person-centred care. The school nurses were based at public and private schools and worked with students aged 12-19. Data were collected through interviews with 18 school nurses and analyzed with deductive content analysis. The school nurses felt that actively listening to the students’ narratives about daily life with recurrent pain, and co-creation of a health plan, encouraged the students to participate as partners in their own care and strengthened their relation with the students. The application of a person-centred approach in school health care meant that traditional knowledge transfer was replaced with a dialogue that reflects both the student’s and school nurse’s perspective.
Receiving Leniency After Hurting a Female Norm-Violator: The Mediating Role of Victim and Harm-Doer Empathy
Authors: Johnson James D. , Raj Nishael , Smith-Enoe Shonell , Lecci Len
Published: July 2019

Data from 140 participants from the South Pacific, where domestic violence rates are high, demonstrated less punitive responding toward the male harm-doer of a female sexual norm-violator (SNV) relative to a control victim. The impact of victim type on punitive responding was mediated by empathy toward the victim and harm-doer. In Study 2, data from 240 individuals from the South Pacific demonstrated less punitive responding toward the harm-doer of an SNV victim relative to a control and a career-focused mother victim. The victim type-punitive responding relationship was also mediated by victim blame attributions and victim moral outrage.
The determinants of the hotel sector revenues: The case of French Polynesia
Authors: Montant Gil
Published: July 2019

This article is an empirical analysis focused on the hotel sector in French Polynesia in 2007–2017. One assesses the impact of a set of variables on the French Polynesian hotel sector monthly revenues through a gravity model. First, one specifies a basic model that embeds several potential explanatory variables (the exchange rate (both nominal and real), the rate of unemployment, the geographical distance, some specific historical events, etc.). Next, a second model is specified so as to assess the impact of hotel capacities measured by the number of bedrooms offered. Estimates rest on an unbalanced monthly panel database that embeds main countries from where tourists present in French Polynesia are originated. In order to compare results, each specification is estimated by two methods: classical panel regression (Ordinary least squares /Generalized least squares) and pseudo Poisson maximum likelihood. Both methods lead to coherent results.
Legal advice privilege and artificial legal intelligence: Can robots give privileged legal advice?
Authors: Stockdale Michael , Mitchell Rebecca
Published: July 2019

Legal professional privilege entitles parties to legal proceedings to object to disclosing communications. The form of legal professional privilege that is now commonly known as ‘legal advice privilege’ attaches to communications between a client and its lawyers in connection with the provision of legal advice. The provision of legal advice increasingly involves the use of technology across a wide spectrum of activities with varying degrees of human interaction or supervision. Use of technology ranges from a lawyer conducting a keyword search of a legal database to legal advice given online by fully automated systems. With technology becoming more integrated into legal practice, an important issue that has not been explored is whether legal advice privilege attaches to communications between client and legal services provider regardless of the degree of human involvement and even if the ‘lawyer’ might constitute a fully automated advice algorithm. In essence, our central research question is: If a robot gives legal advice, is that advice privileged? This article makes an original and distinctive contribution to discourse in this area through offering novel perspectives on and solutions to a question which has not previously been investigated by legal academics.
Mapping the Passions: Toward a High-Dimensional Taxonomy of Emotional Experience and Expression
Authors: Cowen Alan , Sauter Disa , Tracy Jessica L. , Keltner Dacher
Published: July 2019

What would a comprehensive atlas of human emotions include? For 50 years, scientists have sought to map emotion-related experience, expression, physiology, and recognition in terms of the “basic six”—anger, disgust, fear, happiness, sadness, and surprise. Claims about the relationships between these six emotions and prototypical facial configurations have provided the basis for a long-standing debate over the diagnostic value of expression (for review and latest installment in this debate, see Barrett et al., p. 1). Building on recent empirical findings and methodologies, we offer an alternative conceptual and methodological approach that reveals a richer taxonomy of emotion. Dozens of distinct varieties of emotion are reliably distinguished by language, evoked in distinct circumstances, and perceived in distinct expressions of the face, body, and voice. Traditional models—both the basic six and affective-circumplex model (valence and arousal)—capture a fraction of the systematic variability in emotional response. In contrast, emotion-related responses (e.g., the smile of embarrassment, triumphant postures, sympathetic vocalizations, blends of distinct expressions) can be explained by richer models of emotion. Given these developments, we discuss why tests of a basic-six model of emotion are not tests of the diagnostic value of facial expression more generally. Determining the full extent of what facial expressions can tell us, marginally and in conjunction with other behavioral and contextual cues, will require mapping the high-dimensional, continuous space of facial, bodily, and vocal signals onto richly multifaceted experiences using large-scale statistical modeling and machine-learning methods.
PRDX4 and Its Roles in Various Cancers
Authors: Jia Wenqiao , Chen Pengxiang , Cheng Yufeng
Published: July 2019

Reactive oxygen species play a vital role in cell survival by regulating physiological metabolism and signal transduction of cells. The imbalance of oxidant and antioxidant states induces oxidative stress within a cell. Redox regulation and oxidative stress are closely related to survival and proliferation of stem cells, cancer cells, and cancer stem cells. Peroxiredoxin 4, a typical endoplasmic reticulum-resident 2-Cys antioxidant of peroxiredoxins, can fine-tune hydrogen peroxide catabolism which affects cell survival by affecting redox balance, oxidative protein folding, and regulation of hydrogen peroxide signaling. Recent studies revealed the overexpression of peroxiredoxin 4 in several kinds of cancers, such as breast cancer, prostate cancer, ovarian cancer, colorectal cancer, and lung cancer. And it has been demonstrated that peroxiredoxin 4 causally contributes to tumorigenesis, therapeutic resistance, metastasis, and recurrence of tumors. In this article, the characteristics of peroxiredoxin 4 in physiological functions and the cancer-related research progress of mammalian peroxiredoxin 4 is reviewed. We believe that peroxiredoxin 4 has the potential of serving as a novel target for multiple cancers.
Limb Salvage Using Combined Linking Perforator Free Flaps
Authors: Kim Youn Hwan , Kim Gyeong Hoe , Pafitanis Georgios , Miller Rob , Kim Sang Wha
Published: July 2019

Microsurgical free tissue transfer is the most effective method for extensive reconstruction of lower limb defects. The purpose of this report is to describe our experience of using microsurgically fabricated combined linking perforator flaps for one-stage reconstruction of extensive lower limb defects. Between April 2008 and November 2016, 16 cases of extensive lower defects were reconstructed using combined linking flaps. Of the patients, 10 were males, and the mean age was 45.3 years (range = 20-76 years). The flaps used were thoracodorsal artery perforator flaps together with deep inferior epigastric artery perforator flaps or anterolateral thigh flaps. There were no total flap failures; however, 3 anterolateral thigh flaps were partially lost and required skin grafts. One wound disruption healed conservatively. Donor site healing was achieved primarily without any dehiscence. The follow-up period was 15.4 months (range = 8-24 months). The use of combined linking perforator flaps for lower limb defects is uncommon; however, in cases of extensive limb defects these flaps can salvage limbs by means of one-stage operations.
Surgical Patients’ Perception About Behaviors of Humanized Nursing Care
Authors: Garza-Hernández Rosalinda , Melendez-Méndez Concepción , Castillo-Martínez Guillermo , González-Salinas Fernanda , Fang-Huerta María de los Ángeles , Hidalgo Hortensia Castañeda
Published: July 2019

Introduction:

One of the greatest challenges that health professionals face is providing humanized care, especially when technological advancements contribute to the depersonalization of care delivery. In this sense, nursing care not only requires the nurse to be scientific, academic, and clinical but also a humanitarian and moral agent, as a partner in human transactions.

Method:

Quantitative, descriptive, and transversal study. In a nonprobabilistic sampling for convenience, in 150 surgical patients, with more than 3 days of hospital stay, the instrument “Perception of Behaviors of Humanized Nursing Care” was used (third version). The study adhered to the legal and ethical research guidelines in Mexico.

Results:

According to the general objective of the study, the findings determined were that 67% of the participants perceived humanized nursing care as favorable

Conclusion:

More than half of the patients always perceived behaviors of humanized care, provided by nurses, during their hospitalization in surgical services.
The Lifetime Risk and Prognosis of Chronic Prostatitis/Chronic Pelvic Pain Syndrome in the Middle-Aged Chinese Males
Authors: Zhang Jianzhong , Zhang Xinyu , Cai Zhonglin , Li Ni , Li Hongjun
Published: July 2019

Knowledge is limited about the lifetime risk of chronic pelvic pain syndrome (CPPS) occurrence in Chinese middle-aged males and the prognosis of CPPS patients with and without treatment. Noninstitutionalized Chinese males aged 40 to 81 years were enrolled in this study from a total of 76 local communities across 30 provinces of China. Information about the occurrence of CPPS, symptom relief, and previous treatment was collected. Based on completed answers to specific questions about self-reported and physician-diagnosed CPPS, the lifetime risk of CPPS occurrence was 25.3% (1,091 out of 4,315) in Chinese males aged 40 to 81 years. Over 77% of patients with CPPS had received treatment. The symptom relief rate was not significantly different between the treatment (57.3%, 142/248) and nontreatment (50.1%, 422/843) groups. Regardless of whether patients had received medical treatment, engagement in sedentary work and regular alcohol consumption had a significant negative influence, while marriage had a positive influence, on the prognosis of CPPS. A good prognosis could be achieved without treatment for some cases of CPPS, while others required a timely symptom-orientated treatment using adequate medications combined with lifestyle adjustment and follow-up.
A path planning method for a surface inspection system based on two-dimensional laser profile scanner
Authors: Li Lina , Xu De , Niu Linkai , Lan Yuan , Xiong Xiaoyan
Published: July 2019

In this article, a method for two-dimensional scanning path planning based on robot is proposed. In this method, a section division algorithm based on neighborhood search method for scanning orientation determination is firstly produced. The scanning paths which meet constraints of the system are then generated. Finally, the experiment is carried out on robot-based scanning platform. The two-dimensional data from scanner and the robot position are combined to form three-dimensional surface data of measured workpiece. The experiment results verify the effectiveness of proposed method.
Antibiotic Use and Computed Tomography Imaging for Rhinosinusitis as Quality Metrics in Modern Health Care
Authors: Xiao Christopher C. , Kshirsagar Rijul S. , Liang Jonathan
Published: July 2019

Background

American Academy of Otolaryngology-Head and Neck Surgery rhinosinusitis guidelines have been adapted into quality measures intended to be a basis for adjusting physician reimbursement and as public information to help patients select physicians. Early and continual evaluation of these measures is therefore important, given the impacts these may have.

Objective

To examine the metrics used in by Medicare for reimbursement in the Physician Quality Reporting System (PQRS) used in Merit-based Incentive Payment System (MIPS).

Methods

This study is a retrospective review of the 2015–2016 Center for Medicare and Medicaid Services Physician Compare Initiative regarding quality metrics for acute and chronic rhinosinusitis for providers participating in MIPS.

Results

Data for 726 providers were extracted from the PQRS database. Otolaryngologists had a low enrollment with less than 50 responding for any 1 measure. Of the reported quality metrics, otolaryngologists prescribed a significantly greater number of antibiotics than other providers within 7 days of diagnosis or within 10 days after symptom onset (48.3% vs 11.3%, P < .001). There was a significant difference in the mean compliance between otolaryngologists and all other providers for the use of CT scans within 28 days of diagnosis (2.3% vs 0.2%, P < .001). There was no significant difference in the mean compliance for the use of multiple CT scans within 90 days of diagnosis (2.0% vs 2.3%, P = .8). Inverse metrics comprise 3 out of 4 measures.

Conclusion

This review of the quality metrics used in MIPS shows several differences between otolaryngologists and nonspecialists, but raise concerns regarding applicability.
Comparison of three antimicrobial strategies in diabetic foot infections post-amputation
Authors: Shah Samarth P. , Negrete Ana , Self Timothy , Bergeron Jaclyn , Twilla Jennifer D.
Published: July 2019

Background:

The 2012 Infectious Disease Society of America (IDSA) guidelines recommend antimicrobial treatment of diabetic foot infections (DFIs) post-amputation, but the optimal route and duration are poorly defined.

Objective:

The objective of this study was to determine whether the selection of a specific antimicrobial treatment modality affected hospital and patient outcomes.

Methods:

This was a retrospective review of hospital admissions of adults admitted to ourhealthcare system with a primary diagnosis of DFIs post-amputation. The groups were separated into patients who received intravenous antimicrobials (IV), oral antimicrobials (PO), or no antimicrobials (NA). Outcomes included average length of stay among others.

Results:

Of the 200 patients screened, 120 patients were included (IV n = 72; PO n = 20; NA n = 28). No statistically significant differences were identified in average LOS (IV = 9.97 ± 5.85, PO = 8.83 ± 7.37, NA = 9.33 ± 5.91 days; p = 0.73). However, post-operative (post-op) LOS was significantly shorter in the PO group (PO = 3.43 ± 2.56, IV = 7.34 ± 5.95, NA = 5.81 ± 4.18 days; p = 0.0001).

Conclusion:

The results of our study indicate that a PO antimicrobial treatment strategy post amputation for DFIs has the potential to decrease post-op LOS without increasing the risk of readmission. Based on the results of our study, we feel consideration should be given to transition to oral antimicrobials soon after amputation to facilitate discharge and decrease the utilization of intravenous antimicrobials.
Participatory food events as collaborative public engagement opportunities
Authors: Pettinger Clare , Parsons Julie M , Letherby Gayle , Cunningham Miranda , Withers Lyndsey , Whiteford Andrew
Published: July 2019

There is an urgent need to ‘get creative’ with the way we tackle social and nutritional inequalities. The Food as a Lifestyle Motivator (FLM) project has explored the use of creative participatory approaches to engage ‘harder to reach’ communities in dialogues to improve their well-being and life skills. Preliminary findings have confirmed that food can be a powerful catalyst for social inclusion with the potential to empower ‘marginalised’ individuals. Part of this exploratory study has involved two participatory food events (November 2015 and November 2016) run in a local day centre for drug and alcohol rehabilitation. The aim of these events was to bring together key stakeholders (from the service user and provider communities) to exchange food-based knowledge, using collaborative and co-creative participatory approaches. Following ethical clearance, a range of data were collected at the events to assess their ‘social impact’. These consisted of (1) audio interviews (service providers and users), (2) oral surveys (service users and key workers) and (3) observations of social cooking and eating engagement, and creative visual arts (photography, collage, food games and quizzes). In this article, we detail how the range of creative approaches used has successfully engaged individuals (average attendance: n = 80, service users: n = 32) to participate in these food-themed events. We reflect on the overarching themes from data capture of the social and therapeutic aspects of food (activities). We also reflect on the collation (and curation) of findings, systematically critiquing the approaches used, including consideration of ethics, and drivers for engagement. Finally, we consider how the utility of such creative approaches can optimise public engagement activities, not only to enhance research impact but also to inform collaborative developments with and between service users, service providers and other stakeholders, with the potential to lead to transformative food-related changes.
Focal-time analysis: A new method for stratigraphic depth control of microseismicity and induced seismic events
Authors: Poulin Andrew , Weir Ron , Eaton David , Igonin Nadine , Chen Yukuan , Lines Laurence , Lawton Donald
Published: July 2019

Focal-time analysis is a straightforward data-driven method to obtain robust stratigraphic depth control for microseismicity or induced seismic events. The method eliminates the necessity to build an explicit, calibrated velocity model for hypocenter depth estimation, although it requires multicomponent 3D seismic data that are colocated with surface or near-surface microseismic observations. Event focal depths are initially expressed in terms of zero-offset focal time (two-way P-P reflection time) to facilitate registration and visualization with 3D seismic data. Application of the focal-time method requires (1) high-quality P- and S-wave time picks, which are extrapolated to zero offset and (2) registration of correlative P-P and P-S reflections to provide [Formula: see text] and [Formula: see text] time-depth control. We determine the utility of this method by applying it to a microseismic and induced-seismicity data set recorded with a shallow-borehole monitoring array in Alberta, Canada, combined with high-quality multicomponent surface seismic data. The calculated depth distribution of events is in good agreement with hypocenter locations obtained independently using a nonlinear global-search method. Our results reveal that individual event clusters have distinct depth distributions that can provide important clues about the mechanisms of fault activation.
“Freak Letters”
Authors: Flores-Villalobos Joan
Published: July 2019

This essay explores the archival presence of West Indian women in the archives of the Isthmian Canal Commission, the biggest repository of original documents regarding the construction of the Panama Canal. Using a 1909 photograph of a nude black West Indian woman found in a file labeled “Freak Letters,” it considers the difficulties of recovering historical subjects structured by imperial frameworks of productivity and perversity, tracing instead the counternarratives of mobility, affect, and self-determination that might have shaped this black woman’s life. Using this approach, the essay uncovers the archival logic behind “Freak Letters” and recreates the woman’s milieu, highlighting her mobility and diasporic connections. It argues that this woman’s embodied intervention simultaneously confirms and challenges the narratives of US empire that sexualized and limited her. Ultimately, the essay seeks to build an empathetic, archipelagic counterdiscourse as the basis for our explorations of subjects historically silenced or denigrated.
Ancestral Coda
Authors: Persard Suzanne C.
Published: July 2019

This series of poems operates somewhere between the Bronx, Half Way Tree (Kingston), and memory. Indian indentureship in Jamaica is epistemologically eclipsed; queer death is unmemorialized; an opening of sugar packets evokes the violence of empire. These poems reckon with loss—whether through grammar, digitization, or death. Yet there remains an abiding desire to explode the beauty of (extra)ordinary moments and scenes. Diasporic and hyperlocal, these poems entangle language(s), archives, and memory to map constellations of identities formed and complicated by colonization.
Pairing interactions between nucleobases and ligands in aptamer:ligand complexes of riboswitches: crystal structure analysis, classification, optimal structures, and accurate interaction energies
Authors: Seelam Preethi P. , Mitra Abhijit , Sharma Purshotam
Published: July 2019

In the present work, 67 crystal structures of the aptamer domains of RNA riboswitches are chosen for analysis of the structure and strength of hydrogen bonding (pairing) interactions between nucleobases constituting the aptamer binding pockets and the bound ligands. A total of 80 unique base:ligand hydrogen-bonded pairs containing at least two hydrogen bonds were identified through visual inspection. Classification of these contacts in terms of the interacting edge of the aptamer nucleobase revealed that interactions involving the Watson–Crick edge are the most common, followed by the sugar edge of purines and the Hoogsteen edge of uracil. Alternatively, classification in terms of the chemical constitution of the ligand yields five unique classes of base:ligand pairs: base:base, base:amino acid, base:sugar, base:phosphate, and base:other. Further, quantum mechanical (QM) geometry optimizations revealed that 67 out of 80 pairs exhibit stable geometries and optimal deviations from their macromolecular crystal occurrences. This indicates that these contacts are well-defined RNA aptamer:ligand interaction motifs. QM calculated interaction energies of base:ligand pairs reveal a rich hydrogen bonding landscape, ranging from weak interactions (base:other, −3 kcal/mol) to strong (base:phosphate, −48 kcal/mol) contacts. The analysis was further extended to study the biological importance of base:ligand interactions in the binding pocket of the tetrahydrofolate riboswitch and thiamine pyrophosphate riboswitch. Overall, our study helps in understanding the structural and energetic features of base:ligand pairs in riboswitches, which could aid in developing meaningful hypotheses in the context of RNA:ligand recognition. This can, in turn, contribute toward current efforts to develop antimicrobials that target RNAs.
Ανθρωπότητα, Μελλοντικές Γενεές και Βιοηθική
Authors: Κουκουζέλης (Kostas Ν. Koukouzelis) Κώστας Ν.
Published: July 2019

The moral status of future persons and future generations is one of the pertinent issues under discussion in bioethics and in particular environmental bioethics. There is, indeed, a vast skepticism on whether future generations have rights or whether we have duties towards them and of what kind. However, the main question, which the present essay puts forward, comes at a prior point. Do we have an interest in whether future generations will exist after all or whether humanity will continue to exist and what kind of interest is this? It is argued that we are in a sense dependent on future generations’ existence in a way we are not dependent on the continuation of our individual lives. This is because humanity’s existence into the future makes us value certain things and practices in our lives now, indeed it conditions valuing. After evaluating three objections to the aforementioned argument, I argue that our interest in the existence of future generations is something crucial for how human practical rationality and action works, it has an egalitarian nature, but does not involve future generations’ welfare. It finally stems from practical rationality itself.
Surrogacy and Heterologous Fertilisation on the move
Authors: Tsalidis (Αντώνης Τσαλίδης) Antonios
Published: July 2019

Since the day when the first child was born with the aid of assisted reproduction (Louise Brown), the scientific community has always been interested in the implementation and the application of assisted reproduction methods. Although these methods help people around the globe to become parents, they may cause serious health risks, raising at the same time crucial legal and ethical issues. Moreover, the aforementioned issues deepen further due to the development of "reproductive tourism" since people travel to countries where the law permits the application of methods that are prohibited in their home country, thus circumventing the law. This situation can be perilous for the parties involved and evoke serious social and legal issues. Most major issues will be outlined by this comparative study of Greek and German legislation by examining surrogacy and heterologous fertilisation, a field where most delicate situations arise. Last but not least, the need of a common European legal framework, which will protect the public health and the rights of children and parents, is undeniable.
Η παθητική ευθανασία και το δικαίωμα στον θάνατο
Authors: Πρωτοπαπαδάκης (Evangelos Protopapadakis) Ευάγγελος
Published: July 2019

The right to die is probably the most pivotal notion when it comes to the debate on euthanasia – provided, of course, that the issue of euthanasia is being discussed on a basis that concerns moral rights; on the emotional level it is definitely the most engaging and, hence, greatly influential. The right to die is often being challenged and, even, dismissed on grounds of being undocumented, unsound, and devoid of any actual meaning. In this short paper I will argue that the right to die in the case of passive euthanasia might find proper moral justification if it is considered as an autonomy-right.
Το εννοιολογικό πλαίσιο των βιοηθικών προβλημάτων: ένας ενδεικτικός σχολιασμός
Authors: Χωριανοπούλου (Maria Chorianopoulou) Μαρία
Published: July 2019

The aim of this study is to briefly examine and critically evaluate certain philosophical approaches of the utmost importance on the concepts of human dignity and autonomy. Since these notions are systematically invoked in the context of the current bioethical debates, it is imperative that their exact content be clarified. Thus, aspects of the human dignity are traced back to the stoic, Christian, Kantian, and post-Kantian tradition, while on the other hand two major conceptions of autonomy are analysed (autonomy conceived as self-determination and as self-restriction) along with their respective bioethical implications. Human dignity and autonomy being related to extremely divergent meanings, it follows that conceptual clarity is an indispensable prerequisite for conducting fruitful bioethical discussions
Φαρμακογονιδιωματική: Ηθικά διλήμματα
Authors: Κορδόνης (Thomas Kordonis) Θωμάς
Published: July 2019

In the present article I will depict some of the emerging controversies that are expected to be of serious concern in the developing field of pharmacogenomics. Pharmacogenomics is the branch of genetics concerned with determining the likely response of an individual to therapeutic medications. The first upcoming issue is the voluntary agreement of the patients, concerning the research of their genome, that is also reflected in their relatives, as well as in their wider social group (s). Secondly, the great financial costs of pharmacogeonomic therapies is most likely to lead to new social inequalities or upsurge the existing ones in commodity of health. Furthermore, this will possibly lead to more group minorities, based on the rarity of some alleles among individuals and their following response to the applied medication. As for cognitive functions, pharmacogenomics seems to be a great challenge for the enhancement of both cognitive dysregulation in patients and intellectual ability in healthy individuals. Consequently, this will lead to an unbridgeable gap between the users and nonusers of newer medications regarding their intellectual abilities, that are unachievable by normal training of physical abilities. Last but not least, l will refer to whether or not genetic data regard strictly confidential personal data, not allowed to be published, despite of possible social benefit and to what extent their carrier has the right of ignoring it.
Εστιάζοντας στην επικοινωνία με τον ασθενή: τo εισαγωγικό μάθημα “Σχέση Ιατρού-Ασθενούς” στην Ιατρική Σχολή του Πανεπιστημίου Κρήτης
Authors: Λιονής (Christos Lionis) Χρήστος
Published: July 2019

This brief report focuses on the communication between doctor-patient and provides the brief description of the skills that should accompany the doctor in his / her meeting with the patient. This review article refers also to the experience gained at the Medical School of Crete where a course on the "doctor-patient relationship" and on “compassionate health care” have been included in its medical curriculum.
Νομικά ζητήματα σχετικά με την παρένθετη μητρότητα στην Ελλάδα
Authors: Συμεωνίδου - Καστανίδου (Elisavet Symeonidou – Kastanidou) Ελισσάβετ
Published: July 2019

The aim of this study is to highlight critical legal issues related to surrogate motherhood and to propose solutions to improve the current legal framework. In particular, it refers to the need for a final court decision to apply surrogate motherhood, the preconditions examined by the court to grant the relevant license, the meaning of the term "medically impossible to get pregnant", the content of the agreement between the applicants and the surrogate mother and finally the preconditions for considering a woman suitable for becoming a surrogate mother, with an emphasis on age-limits.
Το νομοθετικό πλαίσιο της μεταθανάτιας γονιμοποίησης σε Ελλάδα και Σουηδία
Authors: Κηπουρίδου (Kalliopi Kipouridou) Καλλιόπη , Μιλαπήδου (Maria Milapidou) Μαρία
Published: July 2019

Post-mortem fertilization is one of the most controversial methods of M.AR., the implementation of which raises a number of legal, religious, moral and social concerns. Therefore the study of the issue deserves particular attention, as the legislator is faced with unprecedented challenges. This method became possible due to cryopreservation of gametes and fertilized eggs.Several arguments have been presented both for and against this particular form of reproductive technique. Under Greek law, post-mortem fertilization is permissible provided that specific strict requirements are met according to the regulatory framework. Failure to comply with legal requirements entails civil, criminal and administrative consequences.On the contrary, the Swedish legislator has chosen to ban post-mortem fertilization, since the basic requirement to perform M.A.R. applications is that the donors of the genetic material to be alive. This restriction even excludes the use of cryoperserved fertilized eggs. However, in Sweden a debate has been developed on whether post-mortem fertilization should be allowed if the use of the method of reproductive care has begun before the death of the father or the mother. In any case, it is necessary to fully clarify all issues that arise in order to ensure legal certainty and children born through this technique are fully protected by enjoying the rights that the other children born either naturally or by using some other form of M.A.R. enjoy.
Επισκόπηση και καταγραφή των αισθητήρων και των αντίστοιχων τεχνολογιών μέτρησης βιοσημάτων (Βιοαισθητήρες) - Πρωτόκολλα επικοινωνίας - Ηθικά Ζητήματα
Authors: Κοτοπούλη (Maria-Ioanna Kotopouli) Μαρία - Ιωάννα
Published: July 2019

Chronic diseases represent the major expense in healthcare today. Examples include diabetes, asthma, heart failure, chronic obstructive pulmonary disease (COPD), dementia, arthritis, and a number of neurological disorders. The World Health Organization estimates that chronic diseases are the main cause of "disability" in 2020 and that, if not managed properly, will become the most expensive problem for healthcare systems .One of the main goals of modern health care is to ensure that patients with chronic and non-diseases (such as diabetes and COPD), will receive medical monitoring and care at home whenever possible. This would result in lower requirements in necessary sources of health care, in hospital coverage and allow for more targeted delivery of health and care services. Therefore the problem we face is the reliable, easy and fast collection of medical data, i.e. the state of health of an individual. The development of sensor technology, in hardware and software, but also the communication protocols, has enabled wearable, ambient, implantable sensors to be introduced into health service systems. Ideally, this would permit the monitoring of physiological parameters of the patient continuously in contrast to provide a "snapshot" of these parameters when the patient visits the physician or performing some tests.This paper seeks to investigate and analyze simple glucose, pressure, oxygen, and more complex sensor systems available on the market or at research level and to review the communication protocols used in these applications, with particular emphasis on emerging bioethics.
Χαιρετισμός
Authors: Παπαδοπούλου - Κλαμαρή (Dimitra Papadopoulou Klamaris) Δήμητρα
Published: July 2019

Χαιρετισμός της εκδήλωσης τιμής στην μνήμη του Θανάση Παπαχρίστου και ευχαριστίες στην Εθνική Επιτροπή Βιοηθικής για την πολύ ευγενική πρόσκληση
Γενετικά τροποποιημένες καλλιέργειες εναντίον βιοποικιλότητας; Επιστημονικές και φιλοσοφικές προκλήσεις
Authors: Μυλωνά - Γιαννακάκου (Konstantina Mylona-Giannakakou) Κωνσταντίνα Π.
Published: July 2019

Regarding the issue of balance between environmental sustainability and the inherent ecological interventions of agricultural biotechnology, multiannual studies substantiate that loss of biodiversity, due to the use of GM crops, is globally less important than several other practices. Thus, what explains this diametrically extreme confrontation, from part of the scientific community? I presume, that the controversy is a philosophical one, and is expressed mainly by two contrasting materialistic approaches; the so called reductionist (or molecularist) view and the opposing holistic (or organismic) view, both of which, in their comparative analysis, prove, in my view, their incapability in definitely resolving such dilemmas.The first, as an anthropocentric approach, seems unsuccessful in building any concept of ecosystem integrity on the basis of moral duty while the second, as a biocentric approach, does not take into consideration the effects in human populations, and provides limited guidance with respect to the environments in which agriculture has already replaced the natural order. Norton’s concept provides a new perspective, since it recognizes the human duty to conduct agriculture, in a manner that supports survival for the people on this planet, while simultaneously it maintains the ecological dynamics that sustain life. Based on Norton’s “weak anthropocentrism”, we can be easily led to the “convergence” of policies, through a “contextualized” hierarchy of moral choices for the issues of agricultural biotechnology.
Νευροεπιστήμες και ποινικό δίκαιο: υποσχέσεις και περιορισμοί σχετικά με την εκτίμηση της ικανότητας για καταλογισμό
Authors: Γκότση (Georgia-Martha Gkotsi) Γεωργία-Μάρθα
Published: July 2019

In recent years, an explosion of interest in neuroscience has led to the development of "Neuro-law," a new multidisciplinary field of knowledge whose aim is to examine the impact and role of neuroscientific findings in legal proceedings. Neuroscientific evidence is increasingly being used in US and European courts in criminal trials, as part of psychiatric testimony, nourishing the debate about the legal implications of brain research in psychiatric-legal settings.In this paper, we aim to examine the impact of Neuroscientific evidence in the assessment of criminal responsibility. We start with a brief historical survey of the relation between brain sciences and criminal law. We then present two criminal cases in the context of which neuroimaging techniques were introduced as evidence of diminished responsibility or irresponsibility and continue with a presentation of some significant limitations and difficulties that neuroscience faces in the assessment of penal responsibility. These limitations are scientific, legal but also of philosophical and conceptual nature.We conclude that addressing moral or legal responsibility might depend on scientific data, but requires entry to very different conceptual domains. The legal system cannot delegate to another field, scientific or otherwise, the ascription of legal meaning. Neuroscientific data, however accurate and reliable they may become in the future, cannot contribute to the assessment of criminal responsibility, unless they are contextualised and completed -or even confronted- with data collected on other levels of analysis, in particular on a psychological, anamnestic, sociological and economic level. Neurosciences, as sciences, can offer functioning and biological models of behaviours, while the assignment of responsibility is a normative issue. Although neuroscientific evidence can provide assistance in the evaluation of penal responsibility by introducing new determinisms in the behavioural analysis of offenders with mental disturbances, it does not dispense with the need to define the limits of responsibility and irresponsibility of the accused. This analysis, while it needs to take account of social, moral and political factors - in addition to elements contributed by experts - ultimately belongs to the legal sphere.
Τράπεζες ομφαλοπλακουντιακού αίματος: Τρέχουσες προκλήσεις και όραμα
Authors: Δάφνη (Christina Dafni) Χριστίνα , Πεφάνης (Nikolaos Pefanis) Νικόλαος , Δήμου (Danai Dimou) Δανάη , Πούλος (Georgios Poulos) Γεώργιος , Ιωαννίδου (Anna Maria Ioannidou) Άννα Μαρία , Κατσίλα (Theodora Katsila) Θεοδώρα , Πατρινός (Giorgos Patrinos) Γεώργιος
Published: July 2019

Stem cell transplants have been proved beneficial toward optimum disease management. In particular, cord blood has been a valuable source of stem cells with clinically proven applications for the treatment of a series of heamatological and immune system malignancies and several genetic disorders.To this end, cord blood banking has been established in the public and private sector. Nevertheless, current morals and ethics as well as the lack of a well-defined legal framework for the operation of cord blood banks hamper their clinical role and concern the general public.
Ευθανασία: Πρακτικές που εφαρμόζουν οι χώρες της Ευρωπαϊκής Ένωσης
Authors: Κοζαμάνη (Alexandra Kozamani) Αλεξάνδρα
Published: July 2019

Euthanasia is one of the issues that bioethics deals with, which is one of the outmost importance. Furthermore it is very up-to-date. In Greece and in most countries of the European Union euthanasia has not been subject to specialized legislation. It is only occasionally debated, resulting in tension and conflict. On one hand, people have the right to self determination, so the end of life should be among them. On the other hand, life is considered to be of the highest value and it is the duty of healthcare personnel to guard and preserve it by any means, using their expertise and knowledge.In this paper, a brief report is made to the practices used across countries in the European Union regarding the end of life. Most countries are opposed to euthanasia while acknowledging the right of a patient to refuse or receive treatment. Only three countries have passed bills that legalize euthanasia under strict conditions. The rest, due to sensitivity in this matter, have not yet proceeded in reforming their laws accordingly. It seems that society does not have the necessary reassurances so that they can engulf that issue guarding the true will of a person.
Is quality a strategy or an operation?
Authors: Toussaint John Stephen , Mead Elaine
Published: July 2019

Traditional healthcare management needs an overhaul. Medical errors have become a norm and costs continue to escalate. A new management philosophy is emerging at a few NHS Trusts. Recent research has shown that operational excellence, the management approach described in this article, leads to improved patient cost and quality outcomes. However, it requires healthcare leaders to behave and act differently. The approach is anchored by a standardised set of management practices that all managers and leaders need to follow. The authors will describe changes leaders have made and what impact these changes have on staff, patient, and organisational outcomes.
Primary biliary cholangitis: an update on treatment
Authors: Mortimore Gerri
Published: July 2019

Gerri Mortimore, Senior Lecturer at the University of Derby, provides an updated clinical review on therapeutic options in light of the latest guidance
Non-alcoholic fatty liver disease (NAFLD): survey of awareness and understanding among professionals in secondary care
Authors: Williams Bronwen , Tania Nurun , Corless Lynsey
Published: July 2019

Background:

Non-alcoholic fatty liver disease (NAFLD) refers to a spectrum of hepatic conditions unrelated to alcohol consumption and affects around 30% of the UK adult population. It can progress from steatosis to non-alcoholic steatohepatitis (NASH), increasing the risk of cirrhosis and hepatocellular carcinoma.

Methods:

To explore baseline understanding and awareness, health professionals in various roles (excluding gastroenterology and hepatology) at a secondary-care teaching hospital in England received a questionnaire consisting of 21 multiple-choice questions, 16 on NAFLD and five on demographics.

Results:

Roles included qualified nurses, clinicians, non-clinical staff, medical students, student nurses, nursing support workers and allied health professionals. Of these, 85% had heard of NAFLD and 58% of NASH; by role, these numbers ranged from 100% for clinicians and medical students to only 54% and 8% respectively for nursing students. Knowledge of risk factors ranged from 81% for high cholesterol to 12% for depression, and only 9% identified all four features of metabolic syndrome (MetS): obesity, hypertension, dyslipidaemia and type 2 diabetes. Incorrectly identified risk factors were excessive alcohol (41%) and caffeine (18%) intake. Practitioners also reported variable understanding of early symptoms, progression, diagnostic investigations, medical history and occurrence in children.

Conclusions:

Practitioners were insufficiently aware that NAFLD is a spectrum of disease that is preventable and reversible in early stages. Improved practitioner education should increase early detection and allow holistic, multidisciplinary care for better patient outcomes.