bluuebunny/crossref_metadata_2025 huggingface dataset:
Automated Smartphone Audiometry: A Preliminary Validation of a Bone-Conduction Threshold Test App
Authors: Dewyer Nicholas A. , Jiradejvong Patpong , Lee David S. , Kemmer Jacquelyn D. , Henderson Sabes Jennifer , Limb Charles J.
Published: February 2019

Objective:

To develop and validate an automated smartphone app that determines bone-conduction pure-tone thresholds.

Methods:

A novel app, called EarBone, was developed as an automated test to determine best-cochlea pure-tone bone-conduction thresholds using a smartphone driving a professional-grade bone oscillator. Adult, English-speaking patients who were undergoing audiometric assessment by audiologists at an academic health system as part of their prescribed care were invited to use the EarBone app. Best-ear bone-conduction thresholds determined by the app and the gold standard audiologist were compared.

Results:

Forty subjects with varied hearing thresholds were tested. Sixty-one percent of app-determined thresholds were within 5 dB of audiologist-determined thresholds, and 79% were within 10 dB. Nearly all subjects required assistance with placing the bone oscillator on their mastoid.

Conclusion:

Best-cochlea bone-conduction thresholds determined by the EarBone automated smartphone audiometry app approximate those determined by an audiologist. This serves as a proof of concept for automated smartphone-based bone-conduction threshold testing. Further improvements, such as the addition of contralateral ear masking, are needed to make the app clinically useful.
Factors Affecting California College Students’ Attitudes Toward Assisted Dying
Authors: Miltiades Helen B.
Published: February 2019

This study focuses on college students’ experiences and beliefs, which affect attitudes toward assisted dying. Of 324 students, 35% wanted the option of assisted dying for a family member with a life-threatening illness. Results of multiple logistic regression indicate students who favored assisted dying were significantly influenced by having a family member die, experiencing hospitalization, thinking about end-of-life issues, and being comfortable with palliative care. Belief in an afterlife and being a caregiver were negatively associated with assisted dying. Students need to receive training in end-of-life care issues, as increasingly professionals will face such requests.
Aspects of Depression Among Socioeconomically Disadvantaged African American Young Adults
Authors: Kosma Maria , Buchanan David R.
Published: February 2019

The purpose of this phronetic/pragmatic, mixed-methods study was to integrate quantitative data with qualitative data in examining the complex relations among depression, exercise, screen-viewing time, and life plans among 14 socioeconomically disadvantaged African American young adults. Based on the thematic analysis, the two emerging themes were as follows: life priorities (passing the General Educational Development [GED] test, pursuing profession/career, and being dedicated to church/ministry) and challenges in passing GED examination (e.g., difficulties with the GED test, high stress and low confidence, low interest in studying, health issues, and feelings of rejection/isolation). Based on cross tabulation, depression was highly associated with aerobic exercise and screen-viewing time (Cramer’s V = .44 and .42, respectively). Participants’ life challenges diminished the antidepressant effect of exercise and were linked to depression and excessive screen use. Two active men and a somewhat active woman experienced educational or health-related struggles, heavy screen watching, and severe depression. All three active men experienced educational challenges and severe depression. Two inactive participants reported limited screen use and limited depression, possibly because of their valued life goals (e.g., writing poetry and spiritually helping others). Contrary to the dominant cultural stereotype about African Americans being lazy, the study results show that the participants had highly similar career goals to the majority population yet faced many, significant structural barriers that interfered with their progress and thus sapped their motivation in achieving their life plans. Policy change is needed to reduce social structural barriers and racial systems of oppression in order to decrease poverty and depression.
The process of transfer: The micro-influences of power, time and learning
Authors: Dolowitz David Peter , Plugaru Rodica , Saurugger Sabine
Published: February 2019

To date, there have been a number of studies that have examined how policies move from one jurisdiction to another. However, few of these studies have examined the micro-interactive effects of actors. This is necessary to understand how actors shape outcomes over time. The aim of this paper is to engage with this micro-level literature through an empirical study of policy transfer in the field of architectural norms in hospital construction in post-Soviet states. To do this, we generate several theoretical assumptions to link the transfer literature to wider debates in the governance framework. The goal is to discover how the power of actors interacts in the policymaking processes to influence outcomes over time and in light of learning. What we hope to do is bring the interactive and dynamic effects that occur between agents attempting to shape the transfer process back into the transfer picture. The aim is to show that power flows and that these flows alter the shape and outcome of the transfer process.
Genomewide analysis of 6-methyladenine DNA in peripheral blood mononuclear cells of systemic lupus erythematosus
Authors: Zheng F , Tang D , Xu H , Xu Y , Dai W , Zhang X , Hong X , Liu D , Dai Y
Published: February 2019

Aim

The aim of this paper is to explore the expression of 6-methyladenine (6mA) DNA and to elucidate its gene regulation role in systemic lupus erythematosus (SLE).

Methods

Twenty SLE patients and 20 normal control healthy individuals (HCs) were included in this study. Genomic DNA was isolated from peripheral blood mononuclear cells and subsequently underwent 6mA-immunoprecipitation-sequencing (6mA-IP-Seq) after DNA quality control and 6mA precipitation. Bioinformation analysis was applied to the raw data comparing 6mA levels between SLE patients and HCs.

Results

We identified 5462 hypermethylation and 431 hypomethylation genes in PBMCs of individuals with SLE, which indicated that a high level of 6mA participates in the pathogenesis of SLE. Gene ontology analysis revealed that hypermethylation genes might regulate the inflammatory process, which has been well documented in the pathogenesis of SLE.

Conclusion

6mA may be involved in the initial development of SLE, which may lead to its potential use as an early diagnostic marker and therapeutic target.
Effect of pericardial effusion on outcomes in children admitted with systemic lupus erythematosus: a multicenter retrospective cohort study from the United States
Authors: Dalby S T , Tang X , Daily J A , Sukumaran S , Collins R T , Bolin E H
Published: February 2019

Objective

We sought to describe characteristics of children admitted with pericardial effusion (PCE) and systemic lupus erythematosus (SLE) and determine the association between PCE and outcomes of interest.

Methods

We performed a retrospective cohort study of the Pediatric Health Information System (PHIS). Patients were included if they were admitted to a PHIS participating hospital from 2004 to 2015 with a diagnosis of SLE and age ≤18 years. Children with congenital heart disease or who had undergone heart surgery were excluded. PCE was the primary predictor variable; multivariable analysis was used to evaluate the effect of PCE on the following outcomes: mortality, length of stay (LOS), and readmission within 30 days.

Results

There were 5679 admissions, of which 705 (12.4%) had PCE. Median age at admission was 15 years (interquartile range: 13–17). There were no significant differences for age or sex between patients admitted either with or without PCE. A significantly higher percentage of children in the PCE group were black compared with those without PCE (43% vs. 31%, p < 0.001). In multivariable analysis, the odds of a black patient having PCE were 1.7 higher than non-black patients ( p < 0.001). In-hospital mortality was 2.5 times higher in children with PCE compared with those without PCE ( p = 0.027). Those with PCE also had 1.5 greater odds of readmission within 30 days ( p < 0.001). PCE was not associated with increased LOS (0.99, p = 0.753).

Conclusion

PCE is common in admissions of children with SLE. There are disproportionately more black patients with SLE affected by PCE than non-black. PCE is associated with significantly higher mortality and rates of readmission.
Usefulness of composite indices in the assessment of joint involvement in systemic lupus erythematosus patients: correlation with ultrasonographic score
Authors: Ceccarelli F , Perricone C , Cipriano E , Massaro L , Natalucci F , Spinelli F R , Alessandri C , Valesini G , Conti F
Published: February 2019

Specific indices are not available to evaluate systemic lupus erythematosus (SLE) joint involvement; indeed, the application of indices validated for rheumatoid arthritis has been suggested. We evaluated the usefulness of organ specific composite indices, i.e. the Disease Activity Score on 28 joints (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), and the ratio of swollen to tender joints (STR), to assess SLE joint activity by analyzing the correlation between these indices and ultrasonography (US) inflammatory status. We evaluated SLE patients with arthralgia and/or arthritis: the above-mentioned indices were calculated and the SLE Disease Activity Index 2000 (SLEDAI-2k) was applied to assess global disease activity. US of I–V metacarpophalangeal, I–V proximal interphalangeal, wrist, and knee bilateral was performed. Synovial effusion/hypertrophy and power Doppler findings were scored according to a semi-quantitative scale (0–3) to obtain an inflammatory total score (0–216). One hundred and six patients (M/F 7/99, median age 49.5 years (IQR 17.0), median disease duration 8.5 years (IQR 17.0)) were enrolled. We identified a positive correlation between US score and DAS28-CRP ( r = 0.3, p = 0.007), STR ( r = 0.42, p = 0.0005), SDAI ( r = 0.33, p = 0.02), CDAI ( r = 0.29, p = 0.03); US score reflected different levels of clinimetric joint activity. In conclusion, we suggest the ability of composite indices in detecting SLE joint inflammation and their possible real-life use.
Trends in Health-Care Utilization at the End of Life Among Patients With Hematologic Malignancies in a Middle-Income Country: Challenges and Opportunities in Brazil
Authors: Soares Luiz Guilherme L. , Gomes Renato Vieira , Japiassu André M.
Published: February 2019

Patients with hematologic malignancies (HMs) often receive poor-quality end-of-life care. This study aimed to identify trends in end-of-life care among patients with HM in Brazil. We conducted a retrospective cohort study (2015-2018) of patients who died with HM, using electronic medical records linked to health insurance databank, to evaluate outcomes consistent with health-care resource utilization at the end of life. Among 111 patients with HM, in the last 30 days of life, we found high rates of emergency department visits (67%, n = 75), intensive care unit admissions (56%, n = 62), acute renal replacement therapy (10%, n = 11), blood transfusions (45%, n = 50), and medical imaging utilization (59%, n = 66). Patients received an average of 13 days of inpatient care and the majority of them died in the hospital (53%, n = 58). We also found that almost 40% of patients (38%, n = 42) used chemotherapy in the last 14 days of life. These patients were more likely to be male (64% vs 22%; P < .001), to receive blood transfusions (57% vs 38%; P = .05), and to die in the hospital (76% vs 39%; P = .009) than patients who did not use chemotherapy in the last 14 days of life. This study suggests that patients with HM have high rates of health-care utilization at the end of life in Brazil. Patients who used chemotherapy in the last 14 days of life were more likely to receive blood transfusions and to die in the hospital.
Physical, cognitive and psychosocial effects of telerehabilitation-based motor imagery training in people with multiple sclerosis: A randomized controlled pilot trial
Authors: Kahraman Turhan , Savci Sema , Ozdogar Asiye Tuba , Gedik Zumrut , Idiman Egemen
Published: February 2019

Introduction

Motor imagery training delivered at home via telerehabilitation is a novel rehabilitation concept. The aim was to investigate the effects of telerehabilitation-based motor imaging training (Tele-MIT) on gait, balance and cognitive and psychosocial outcomes in people with multiple sclerosis (pwMS).

Methods

This randomized, controlled pilot trial included pwMS and healthy individuals. pwMS were randomly divided into two groups, intervention and control. The intervention group received Tele-MIT twice a week for 8 weeks. The control group was a wait-list group without any additional specific treatment. Healthy participants served as a baseline comparison. The Dynamic Gait Index, used to assess dynamic balance during walking, was the primary outcome. Secondary outcomes included assessments of walking speed, endurance and perceived ability, balance performance assessed by a computerized posturography device, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life.

Results

Baseline comparisons with healthy individuals revealed that motor imagery abilities were preserved in pwMS ( p > 0.05). The intervention group exhibited significant improvements in dynamic balance during walking ( p = 0.002), walking speed ( p = 0.007), perceived walking ability ( p = 0.008), balance confidence ( p = 0.002), most cognitive functions ( p = 0.001–0.008), fatigue ( p = 0.001), anxiety ( p = 0.001), depression ( p = 0.005) and quality of life ( p = 0.002). No significant changes were observed in the control group in any of the outcome measures ( p > 0.05).

Discussion

Tele-MIT is a novel method that proved feasible and effective in improving dynamic balance during walking, walking speed and perceived walking ability, balance confidence, cognitive functions, fatigue, anxiety, depression and quality of life in pwMS.
A neural-network-based approach for diagnosing hardware faults in cloud systems
Authors: Wang Chao , Fu Zhongchuan , Cui Gang
Published: February 2019

In this article, we propose a novel scheme for diagnosing intermittent faults for cloud systems. We have investigated the characteristic of high-level symptomatic behavior on top of a cloud system and identified that (1) arrival counts of high-level symptoms go up with the number of fault injections at different speeds, which may help us to differentiate one fault model from another; (2) the nested level of fatal traps is found to be an indicative of fault duration, which is helpful for fault model diagnosis; (3) fatal traps triggered by certain faulty units is explored, providing useful information for locating faults. Based on these features, an n-dimensional space taking symptom’s arrival rate (grown up skew of the arrival count) as each dimension, which formulates the diagnosis problem as a pattern recognition problem is defined. Then, a backpropagation neural-network-based online hardware fault diagnosis scheme is proposed. Experimental results show that diagnosis accuracy of fault location is 99.2%, the accuracy of fault model is 96.7%, and the latency is affordable. This scheme has been implemented in firmware so that it covers cloud software stacks (virtual machine monitor, virtual machines, and user applications) and incurs zero hardware overhead.
Inflammatory activity and vitamin D levels in an MS population treated with rituximab
Authors: Linden Johan , Granåsen Gabriel , Salzer Jonatan , Svenningsson Anders , Sundström Peter
Published: February 2019

Background

Most multiple sclerosis patients on disease-modifying treatment at Umeå University Hospital are treated with rituximab and the prevalence of vitamin D supplementation has increased over time. Follow-up studies of these off-label treatments are needed.

Objective

To study inflammatory activity and adverse effects in rituximab-treated multiple sclerosis patients, and associations with 25-hydroxy-vitamin D levels.

Methods

Retrospectively collected data on repeated estimates of relapses, disability, side effects, magnetic resonance imaging, laboratory measures including 25-hydroxy-vitamin D levels and self-perceived health.

Results

In 272 multiple sclerosis patients with a mean follow-up of 43 months, we identified seven possible relapses during active rituximab treatment. On magnetic resonance imaging examination, new T2 lesions were seen in 1.3% (10 out of 792 scans), and 0.25% (two out of 785 scans) showed contrast enhancement. Adjusted 25-hydroxy-vitamin D levels in samples drawn close to all magnetic resonance images with new T2 lesions were lower compared to the remainder (62 vs. 81 nmol/l; P = 0.030). Levels of 25-hydroxy-vitamin D were associated with self-perceived health ( r = 0.18, P = 0.041, n = 130) and C-reactive protein ( r = –0.13, P = 0.042) but not with the risk of side effects.

Conclusion

The inflammatory activity in this rituximab-treated multiple sclerosis population that increasingly used vitamin D supplementation was extremely low. Higher 25-hydroxy-vitamin D levels were associated with beneficial outcomes.
Outcomes of Halo Immobilization for Cervical Spine Fractures
Authors: Isidro Stacey , Molinari Robert , Ikpeze Tochukwu , Hernandez Cesar , Mahmoudi Mohamed Salah , Mesfin Addisu
Published: February 2019

Study Design:

Retrospective.

Objectives:

To evaluate complications and outcomes of halo immobilization in patients with cervical spine fractures treated at a level I trauma center.

Methods:

A retrospective evaluation of patients treated at a single institution with halo immobilization from August 2000 to February 2016 was performed. Demographic information, mechanism of injury, level and type of spine fracture, length of halo immobilization, complications associated with halo immobilization, and length of patient follow-up were collected.

Results:

A total of 189 patients treated with halos were identified. Of the 189 patients, 121 (64%) received halos for the management of cervical spine fractures and were included in the study. A total of 49.6% were males and 50.4% were females. The average age was 50.8 years (range 1-89 years). Overall, 10.7% sustained C1 fractures, 71.1% C2 fractures, and 18.2% subaxial spine (C3-C7) fractures. In all, 47.1% of the upper cervical fractures were either odontoid or hangman-type fractures. A total of 25.1% of patients had multiple cervical fractures. At latest follow-up, 81% had healed fractures with good alignment, minimal pain, and return to normal activities. There was an 8.3% mortality rate. The mortality group had an average age of 64.7 years (range 19-84 years). A total of 10.7% of patients failed halo immobilization and 46.3% of patients had complications such as pin site infections (5.8%), loose pins (1.7%), neck pain (20.7%), decreased range of motion (14%), thoracic skin ulcers (2.4%), and dysphagia (1.7%).

Conclusions:

The use of halo immobilization for cervical spine fractures resulted in clinical success in 81% of patients. Complication rates in geriatric patients were lower than previously reported in the literature.
Critical Success Factors for Project Manufacturing Environments
Authors: Pacagnella Antônio Carlos , da Silva Sérgio Luis , Pacífico Ornella , de Arruda Ignacio Paulo Sergio , da Silva Alessandro Lucas
Published: February 2019

The goal of this article is to identify and understand the relationship between the critical success factors (CSFs) of project manufacturing environments and project performance. This article explores those relationships through the logistic regression method, using a sample of 182 respondents and quantifying the influence of CSFs on success achievement in four dimensions (efficiency, impact on consumers, impact on the team, and preparation for the future). The results show that not all CSFs are significant in explaining project success. Thus, project managers must evaluate the influence of each one and consider it in their decisions.
RETRACTED ARTICLE: MicroRNA-325-3p inhibits cell proliferation and induces apoptosis in hepatitis B virus-related hepatocellular carcinoma by down-regulation of aquaporin 5
Authors: Zhang Zhitao , Han Yanzhen , Sun Guangxin , Liu Xiaohong , Jia Xiaoyan , Yu Xiangjun
Published: February 2019

Background

Hepatitis B virus (HBV) infection is acknowledged as the main cause of hepatocellular carcinoma (HCC). Moreover, previous studies have revealed that microRNAs (miRNAs) widely participate in regulation of various cellular processes, such as viral replication. Hence, the purpose of this study was to investigate the roles of aquaporin 5 (AQP5) and miR-325-3p in the proliferation and apoptosis of HBV-related HCC cells.

Methods

AQP5 and miR-325-3p expression in both normal and HBV-HCC tissues or cells (both Huh7–1.3 and HepG2.2.15) was detected using qRT-PCR. AQP5 expression was knocked down in HBV-related Huh7–1.3 and HepG2.2.15 cells using small interfering RNA (siRNA) technology. Down-regulation was confirmed using real-time PCR and Western blot analysis. Effects of AQP5 down-regulation on the proliferation and apoptosis were assessed. Dual luciferase reporter gene assay, Western blot and qRT-PCR were employed to evaluate the effect of miR-325-3p on the luciferase activity and expression of AQP5. Moreover, miR-325-3p mimic-induced changes in cellular proliferation and apoptosis were detected through CCK-8 assay, BrdU assay, flow cytometry analysis and ELISA.

Results

In this study, the expression of AQP5 was up-regulated in human HBV-HCC tissue, Huh7–1.3 and HepG2.2.15 cells. Knockdown of AQP5 significantly inhibited the proliferation and promoted apoptosis of HBV-HCC cells. Next, miR-325-3p was obviously down-regulated in HBV-HCC. In concordance with this, MiR-325-3p directly targeted AQP5, and reduced both mRNA and protein levels of AQP5, which promoted cell proliferation and suppressed cell apoptosis in HCC cells. Overexpression of miR-325-3p dramatically inhibited cell proliferation and induced cell apoptosis.

Conclusions

Our findings clearly demonstrated that introduction of miR-325-3p inhibited proliferation and induced apoptosis of Huh7–1.3 and HepG2.2.15 cells by directly decreasing AQP5 expression, and that silencing AQP5 expression was essential for the pro-apoptotic effect of miR-325-3p overexpression on Huh7–1.3 and HepG2.2.15 cells. It is beneficial to gain insight into the mechanism of HBV infection and pathophysiology of HBV-related HCC.
RETRACTED ARTICLE: Image processing algorithm of Hartmann method aberration automatic measurement system with tensor product model
Authors: Fan Linyuan
Published: February 2019

Nowadays, the society has entered the digital information age, and the information contained in the image is far more than the sum of the information contained in other media. In the Internet industry, image processing technology can be used to quickly find the required picture information. Other applications include disaster prevention, industrial automation production lines, semiconductor, electronics, tobacco, and food industries. After the meter glyph spot image is collected, there are several spots in the image, and the corresponding pixel values are stored in memory. In order to process images, they should be distinguished and marked so that the spot has definite eigenvalues. To this end, this paper proposes an image processing method. Firstly, an image denoising method combining self-snake model and P-M model is introduced. Secondly, the recursive HOSVD dimensionality reduction algorithm based on tensor product model is used to further process the image. The center of the Hartmann aperture image is solved by the centroid of all the spots, and the center overlap algorithm for determining the centroid distance of the aperture image by the symmetry of the centroid of the spot centroid can reduce the number of calculations. The experimental results show that this method can effectively identify and process the spot of the image and greatly reduce the time complexity and computational complexity of the algorithm.
Development of performance indicators for systems of urgent and emergency care in the Republic of Ireland. Update of a systematic review and consensus development exercise
Authors: Boyle Siobhan , Dennehy Rebecca , Healy Orla , Browne John
Published: February 2019

Objectives: To develop a set of performance indicators to monitor the performance of emergency and urgent care systems in the Republic of Ireland.

Design: This study comprised of an update of a previously performed systematic review and a formal consensus development exercise. The literature search was conducted in PubMed and covered the period 2008 to 2014. The results of the review were used to inform a consensus group of 17 national experts on urgent and emergency care in Ireland. The consensus development exercise comprised an online survey followed by a face-to-face nominal group technique meeting. During this meeting participants had the opportunity to revise their preferences for different indicators after listening to the views of other group members. A final online survey was then used to confirm the preferences of participants.

Results: Initial literature searches yielded 2339 article titles.  After further searches, sixty items were identified for full-text review. Following this review, fifty-seven were excluded. Three articles were identified for inclusion in the systematic review. These papers produced 42 unique indicators for consideration during the consensus development exercise. In total, 17 indicators had a median of greater than 7 following the meeting and met our pre-specified criterion for acceptable consensus.

Discussion: Using this systematic review and nominal group consensus development exercise, we have identified a set of 17 indicators, which a consensus of different experts regard as potentially good measures of the performance of urgent and emergency care systems in Ireland. Pragmatic implications are discussed with reference to three subsequently performed original studies which used some of the indicators
Nations Reborn: Poland and Mexico in the Aftermath of World War I
Authors: Derwich Karol
Published: February 2019

The aim of the article is to present the situation of Poland and Mexico in the years prior to the establishment of bilateral relations. It is reasonable to have a panorama of very particular conditions that determined the existence of these two countries at the beginning of the 1920s. As Poland reappeared on the political map of Europe it encountered significant difficulties in rebuilding its independent existence. These difficulties were both of an international and domestic dimension. The same can be said about Mexico that was entering the new chapter of its history after a bloody revolution that was aimed to change the domestic situation of the country. In this sense, at the beginning of the 1920s both nations can be described as “Nations reborn”.
La relación México-Polonia en la mirada de la burocracia mexicana en el extranjero (1928-1935)
Authors: Trejo Terreros Abraham
Published: February 2019

By examining the political reports written by the representatives of Mexico in Warsaw, the article studies the actions of the Mexican bureaucracy abroad to promote a positive image of the Latin American country. I argue that the reports prepared by these agents of the State were informed by the Mexican experience itself on its way to political centralization and State formation after the Revolution of 1910. At first I address the context in which Mexico and Poland established diplomatic relations. Then I use that context as a backdrop to the following two sections, where I discuss the ways in which Mexican representatives sought to promote a positive image of Mexico in interwar Europe, and particularly in Poland, in two specific areas: promotion of migratory flows and a favourable image of the country.
Strengthening Polish-Mexican Academic Cooperation: Present and Future Perspectives
Authors: Gocłowska-Bolek Joanna
Published: February 2019

Science and higher education have always been intensely internationalized areas of human activity. Especially in the era of globalization, higher education systems around the world face the challenge of internationalization. Internationalization not only strengthens opportunities for development, but is seen as an inevitable necessity in the globalizing and strongly competitive world. Although there is a long-standing tradition of academic cooperation between Poland and Mexico, the changing reality enforces increased efforts to build a more conscious, comprehensive relationship with measurable, long-lasting results. Since ad hoc contacts between individual researchers are not sufficient any longer, a complex, realistic vision of such cooperation is needed. Universities in Poland and Mexico start to see the opportunity to intensify cooperation, which – effectively explored – can significantly contribute to a nation’s economic competitiveness in general and to understanding the nature of trends and challenges in international higher education. The author discusses current activities within the framework of academic cooperation between the two countries and the most important initiatives that may bring closer cooperation in the future. A special focus will be put on the challenges faced by both countries in higher education cooperation schemes, as seen from the Polish perspective.
Conflicted Cultural Memory and U.S. Foreign Policy: The “Lost Ca(u)se” of the U.S. Radar Base in the Czech Republic
Authors: Kozák Kryštof
Published: February 2019

This article analyzes the developments in cultural memory in Czech-U.S. relations since the end of the Cold War with a special emphasis on the heated debate about placing a U.S. radar base on Czech soil in 2008. It first describes the abrupt transformation in cultural memory related to the transition from communist rule from the transatlantic perspective. It claims that the debate about the radar base is a clear indication of the shift within cultural memory, which became much more contested, especially when compared with the previous period culminating with the Czech Republic’s entry into NATO. As cultural memory is closely linked to dominant historical narratives as well as identity, the findings have serious implications for the future of the transatlantic ties in the region.
Successful Against All Odds? – Margaret Fuller: The Self-Made Woman in the Nineteenth Century
Authors: Szymkowska-Bartyzel Jolanta
Published: February 2019

Margaret Fuller was an American philosopher, writer, journalist and one of the first gender theorists. The article examines Fuller’s work and life in the context of 19th century American culture and social determinants influencing women’s lives. From a very early age, Fuller perceived her role in society different from the role designed for her as a biological girl by the cultural model of the times she lived in. The article focuses on Fuller’s achievements in the context of the self-made man/woman concept.
Vitamin D supplements can help to improve bone health
Authors: Patience Sara
Published: February 2019

Osteoporosis is a debilitating disease whose prevalence increases with age. Osteoporosis can often be undetected until a fragility fracture occurs. Such fractures were estimated to have cost the NHS over £4.4billion in 2010. Good bone health begins in childhood with bone mass increasing throughout adolescence and peaking in young adult life. Healthcare managers, commissioners and policy makers should be aware of existing lifestyle recommendations for bone health as well as the guidelines for vitamin D supplementation. Vitamin D supplements should be used to their full potential to ensure bone health is promoted during early life when bone mass is accrued.
Financial risk in health and social care budgets
Authors: Jones Rodney
Published: February 2019

The last year of life is characterised by failing cognitive and functional ability necessitating increasing dependence on others for care, including nursing home and in-home care. As a result, social care costs will be very high, as will hospital inpatient costs where around half of a person's lifetime admissions and bed occupancy are compressed into the final year. Hence, it is the variation in the absolute number of deaths, not the age-standardised mortality, which drives the marginal variation in budgetary pressure. The year-to-year variation in deaths throughout 397 English and Welsh local government areas were investigated over an 18-year period. Because of size, smaller government areas experienced higher volatility than larger ones, however, some locations appeared to show higher intrinsic volatility in deaths than others. A method is presented to calculate the financial risk reserve, which must be deducted from each year's budget to cover for higher than expected variation – somewhat like an insurance premium. While variation is important, deaths have risen in some locations than others, and this will place greater pressure on the budget against funds allocated via a formula that ignores the effects of the absolute number of deaths on costs.
Satisfied patients? An investigation of eye care services in hospitals in South India
Authors: Thomas Bejoy John , Ganesan Suganya
Published: February 2019

Background:

Competition across the healthcare sector has arguably led to better services and improved efficiency. In this market, patient satisfaction remains an extremely important indicator of quality. Patient satisfaction is a person's feeling of pleasure, or disappointment, resulting from a comparison between a perceived expectation against their outcome. Satisfied patients may help to drive changes in hospitals, which could result in a better understanding of patient quality.

Aim:

The aim of this study was to identify patient's satisfaction levels in different cluster groups regarding eye care services in South India.

Method:

A questionnaire was distributed to 454 patients who had already visited leading eye care hospitals. Descriptive statistics and cluster analysis were used to test the number of groups.

Results:

Three cluster groups were identified as: unmarried young students, middle-aged males, and an elderly female group.

Managerial implications:

Healthcare providers and managers can analyse the quality of service across the various groups through segmentation and clustering so that healthcare services can be provided according to the patients' needs and expectations.
Preliminary piloting and validation of a questionnaire identifying basic clinical skills practised by research nurses
Authors: Kirkpatrick Suriya , Harding Sam , Pollard Katherine , Tacchi Paul
Published: February 2019

Clinical research nurses (CRNs) need to be competent in both clinical and research skills. In the past 10 years there has been increasing focus on developing the research competencies of CRNs. Employers, however, use the nurses' registered status as a proxy measure of clinical competence to perform their duties. The true extent of what clinical skills are practised by CRNs in a large NHS trust is unclear and there is a lack of validated measures to obtain this information. By using a mixed-methods approach of questionnaire and semi-structured interview, we aimed to pilot and validate a questionnaire to identify CRNs' self-reported confidence with clinical skills.
The perception of clinical risk among students of different health professions: a multicentre study
Authors: Castello Michele , Ferrara Paolo , Destrebecq Anne , Terzoni Stefano
Published: February 2019

Background:

the need for health care to be safe is increasingly guiding the development of policies to improve clinical practice and education; risk management and patient safety are essential competencies for health professionals.

Objective:

to examine how students working towards different degrees in Italy perceived their competence in clinical risk management and patient safety when learning in the classroom and the clinical setting.

Methods:

the Italian version of the H-PEPSS questionnaire was given to 154 students; 78 were studying for a nursing degree and 76 were on the cardio-circulatory pathophysiology and cardiovascular perfusion techniques (CPCPT) degree course.

Results:

nearly half of the students (46.10%) did not feel confident about their competence in patient safety and risk management during clinical training.

Conclusion:

significant differences in confidence between the two types of students were found in many areas, including in critical aspects of clinical risk management. However, both types of students had similar levels of confidence in some essential areas.
Lawfully admitting a person who lacks decision-making capacity to hospital
Authors: Griffith Richard
Published: February 2019

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the legal options available to a nurse who believes their patient should be moved from home to hospital for treatment when the person lacks decision-making capacity to consent to the move
No catch-up programme planned for HPV immunisation in boys
Authors: Lepkowska Dorothy
Published: February 2019

Last year, the government announced that the HPV immunisation programme would be rollled out to boys; however, unlike for girls this would not include a catch-up programme. Dorothy Lepkowska explains
An investigation into specialty trainee engagement with e-learning
Authors: Brown Jeremy M , Kinloch Karen , Shaw Nigel J
Published: February 2019

Aim:

The objectives of this study were to determine paediatric specialty trainees' engagement with e-learning in Health Education England North West and the characteristics of sites accessed by specialty trainees, and to assess the quality of web interfaces being used and whether this aligns with the best evidence for e-learning provision.

Methods:

A two-phase mixed methods design was used: a scoping exercise to elicit specialty trainees' preferred e-learning tools and a quality assessment of the named sites, and specialty trainee telephone interviews.

Results:

A total of 135 respondents identified 86 sites. Quality assessment found considerable variation across sites and a number of barriers to access, one issue being uncertainty about quality and validity of sites.

Conclusions:

E-learning is viewed as an integral part of both mandatory and speciality training but there is considerable variation in access to and quality of sites. Specialty trainees value the convenience and breadth of e-learning available but express concerns about assessing the validity and legitimacy of such sites.
Huge rise in home education sparks ‘off-rolling’ accusations
Authors: Henshaw Pete
Published: February 2019

Report reveals tales of schools putting pressure on ‘harassed parents’ to home-school challenging students or those with SEN
Mental health workshops for parents
Authors: Knightsmith Pooky
Published: February 2019

Many schools run wellbeing or mental health workshops for parents to help support children and families. Dr Pooky Knightsmith offers her tips for organising effective and engaging events
Football hooliganism, the death drive and Millwall fandom as symbolic masochism
Authors: Bleakley Paul
Published: February 2019

Despite their reputation for violence and hooligan behaviour, south-east London’s Millwall football club has sustained a strong fan base thanks significantly to the siege mentality that has developed around its supporters. This siege mentality is fuelled largely by the antipathy of wider society; by undertaking a Freudian analysis of Millwall fandom as it was during the zenith of the club’s notoriety in the 1970s and 1980s, it is possible to view this collective persecution complex as a manifestation internalized masochism described in the philosopher’s ‘death drive’ theory. Combined with a Lacanian interpretation of the death drive, it is possible to perceive Millwall fandom as a form of symbolic masochism, explaining to some degree the continued support for a team treated in a consistently pejorative manner.
Impact of funding on cost-time aspects of public and social buildings
Authors: Tijanić Ksenija , Car-Pušić Diana , Čulo Ksenija
Published: February 2019

The comparison of the traditional (budget-funded) public building procurement model with the public private partnership (non-budget funded) model is presented in the paper. Public service buildings procured based on the traditional model and those procured according to the PPP model are compared in the scope of research involving nine buildings realized in the Republic of Croatia. The results point to greater efficiency of the PPP model in the construction of public service buildings, with regard to both cost and time of construction work.
Development and Validation of a Novel Diagnostic Nomogram to Differentiate Between Intestinal Tuberculosis and Crohn's Disease: A 6-year Prospective Multicenter Study
Authors: He Yao , Zhu Zhenhua , Chen Yujun , Chen Fang , Wang Yufang , Ouyang Chunhui , Yang Hong , Huang Meifang , Zhuang Xiaodong , Mao Ren , Ben-Horin Shomron , Wu Xiaoping , Ouyang Qin , Qian Jiaming , Lu Nonghua , Hu Pinjing , Chen Minhu
Published: February 2019

OBJECTIVES:

Differentiating Crohn's disease (CD) from intestinal tuberculosis (ITB) remains a diagnostic challenge. Misdiagnosis carries potential grave implications. We aimed to develop and validate a novel diagnostic nomogram for differentiating them.

METHODS:

In total, 310 eligible patients were recruited from 6 tertiary inflammatory bowel disease centers. Among them, 212 consecutive patients (143 CD and 69 ITB) were used in the derivation cohort for the establishment of diagnostic equation and nomogram; 7 investigative modalities including clinical manifestations, laboratory results, endoscopic findings, computed tomography enterography features, and histology results were used to derive the diagnostic model and nomogram. Ninety-eight consecutive patients (76 CD and 22 ITB) were included for validation of the diagnostic model.

RESULTS:

Eight out of total 79 parameters were identified as valuable parameters used for establishing diagnostic equations. Two regression models were built based on 7 differential variables: age, transverse ulcer, rectum involvement, skipped involvement of the small bowel, target sign, comb sign, and interferon-gamma release assays (for model 1) or purified protein derivative (for model 2), respectively. Accordingly, 2 nomograms of the above 2 models were developed for clinical practical use, respectively. Further validation test verified the efficacy of the nomogram 1 with 90.9% specificity, 86.8% sensitivity, 97.1% PPV, 66.7% negative predictive value (NPV), and 87.8% accuracy for identifying CD, and the efficacy of the nomogram 2 with 100% specificity, 84.2% sensitivity, 100% positive predictive value, 64.7% NPV, and 87.8% accuracy for diagnosing CD.

CONCLUSIONS:

The derivation and validation cohorts identified and validated 2 highly accurate and practical diagnostic nomograms for differentiating CD from ITB. These diagnostic nomograms can be conveniently used to identify some difficult CD or ITB cases, allowing for decision-making in a clinical setting.
Burden and Cost of Outpatient Hemorrhoids in the United States Employer-Insured Population, 2014
Authors: Yang Jeff Y. , Peery Anne F. , Lund Jennifer L. , Pate Virginia , Sandler Robert S.
Published: February 2019

INTRODUCTION:

Although hemorrhoids are a common indication for seeking health care, there are no contemporary estimates of burden and cost. We examined data from an administrative claims database to estimate health care use and aggregate costs.

METHODS:

We conducted a cross-sectional study using the MarketScan Commercial Claims and Encounters Database for 2014. The analysis included 18.9 million individuals who were aged 18–64 and continuously enrolled with prescription coverage. Outpatient hemorrhoid claims were captured using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes in the first position, as well as Common Procedural Terminology codes. Prescription medications were identified using National Drug Codes. Annual prevalence and costs were determined by summing gross payments for prescription medications, physician encounters, and facility costs. We used validated weights to standardize annual cost estimates to the US employer-insured population.

RESULTS:

In 2014, we identified 227,638 individuals with at least one outpatient hemorrhoid-related claim (annual prevalence, 1.2%). Among those, 119,120 had prescription medication claims, 136,125 had physician claims, and 28,663 had facility claims. After standardizing, we estimated that 1.4 million individuals in the US employer-insured population sought care for hemorrhoids in 2014 for a total annual cost of $770 million. This included $322 million in physician claims, $361 million in outpatient facility claims, and $88 million in prescription medication claims.

CONCLUSIONS:

The estimated economic burden of hemorrhoids in the employer-insured population approaches $800 million annually. Given the substantial and rising burden and cost, expanded research attention should be directed to hemorrhoidal etiology, prevention, and treatment.
Filing for Moral Bankruptcy: An Examination of How Affect and Empathy Predict Moral Competence
Authors: Surdel Nicholas , Klimenko Marina A.
Published: February 2019

What does being moral mean? On one hand people may justify mercy killing as sparing omeone’s suffering, but on the other hand they are still, in-fact, taking another’s life. According to Lind’s theory of moral competence (2008), it is based on consistent utilization of moral principles. Although common sense tells us that people’s affective states and levels of empathy may explain the differences, there is little direct evidence. The purpose of this study was to fill this gap by examining the relative contribution of empathy and affective state to moral competence. Results of the study revealed that although perspective taking and negative affective state were both significant predictors of moral competence, perspective taking was a stronger contributor. This suggests that the next time you deliberate over a moral dilemma (e.g., euthanasia), you should try understanding another person’s perspective rather than feeling empathy to make the best moral judgment.
Religiöse Erziehung und Moralentwicklung: Der Einfluss einer religiös geprägten Kindheit auf die moralische Orientierung und Kompetenz
Authors: Akin Asli
Published: February 2019

The previous moral psychological research on educational institutions highlighted the influence on the development of moral orientation and competence. With the help of the present quantitative study, the influence of early childhood education on moral abilities has been explored. Since the moral education of children is often associated with religious norms and values, and religions are debated in relation to their general meaning and functionality, the religious moral education has been investigated. Therefore, students of various disciplines from Berlin were asked about their religious education in their early childhood and were examined on their current moral orientationand competence. The Moral-Competence-Test by Lind and a self-constructed and piloted questionnaire for the examination of religious education and religiosity have been used for the measurement. The results of the online study have shown that the moral skills of dogmatically educated students are significantly reduced, but not related to the differences in educational experience or the current preservation of religiousness.