bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘The Protectorate of the World’: the Problem of Just Hegemony in Roman Thought
Authors: Hawley Michael 
Published: January 2020

Abstract
Contemporary normative theory is understandably reluctant to consider how a hegemonic power ought to conduct itself. After all, a truly just international order, characterised by principles of freedom and equality among nations, would not include one polity so able to dominate others. The natural impulse of normative theorists then is to seek to eliminate such an imbalance. Yet, a sober assessment of political reality provides little prospect for such aspirations. The more modest alternative is to examine how hegemonic power might be wielded responsibly. For most of the history of Western political thought, the problem of just hegemony was more theoretical than real, leaving few serious philosophical precedents. Yet for Roman thinkers, of both the late Republic and the early Empire, the issue presented a real and urgent problem. In this article I explore some of the attempts of Roman philosophers and historians to grapple with the unique position of the Roman state. In many cases, their theories depend in some way on Rome’s alleged special moral or constitutional qualities – and yet, they often recognised that the realities of Rome’s use of power undermined those claims to exceptionalism. I examine the Romans’ responses to this problem as they sought to think through the moral dilemmas of their situation. In classical Roman thought, we might find an interlocutor for our own attempt to think through the ethics of superpower.
Between Rhetoric, Social Norms, and Law: Liberty of Speech in Republican Rome
Authors: Arena Valentina 
Published: January 2020

Abstract
Although modern Republicanism, which highly values the right of freedom of speech, finds its inspiration in the historical reality of the Roman Republic, it seems that in the course of the Republican period citizens shared a recognised ability to speak freely in public, but did not enjoy equal status with one another in the domain of speech as protected by law. Of course, Republican Rome knew laws regulating free speech and perhaps even later provisions had been passed concerning iniuria. However, in these cases, as later on under Augustus, these measures acted as means of restraint and inhibition and did not directly address the right of the individual to speak freely. The fundamental question this paper addresses is why, in the course of the Republic, the right to speak freely was not protected by law and never came to be recognised as a formalised subjective right in Republican Rome. The answer, I argue, lies in the fact that in Rome speaking freely was conceived as the positive moral quality that characterised a natural ability of human beings, and thereby it could not have provided a field of legislation. It follows that the Roman Republic would not have passed the ‘straight talk test’ that modern Republicanism requires for the establishment of a free and just society. However, Republican Rome invites us to think about liberty of speech as belonging to the realm of ethics: as a moral quality sustained by contemporary social norms, not subject to legislation, which inevitably ends up protecting the interests of a group or groups and their specific speech regimes.
Quality of Patient Education Sections on Otitis Media Across Different Website Platforms
Authors: Shetty Kunal Ramanand , Wang Rita Yu , Shetty Anisha , Levi Jessica , Aaronson Nicole Leigh 
Published: January 2020

Objective: To determine the quality, content, and readability of patient education materials pertaining to otitis media across several popular online platforms focused on otolaryngology and pediatric primary care education. Methods: Online patient materials related to otitis media and directed toward parents were collected from the American Association for Family Practice (AAFP), ENT-Health section of the American Academy of Otolaryngology—Head and Neck Surgery, Healthychildren.org from the American Academy of Pediatrics, KidsHealth from Nemours, WebMD, and Wikipedia. Materials were analyzed for quality, content, and readability. The DISCERN instrument was used to score quality. A unique content score was generated based on the information provided on each website and on the medical and surgical management of otitis media. Readability scores were calculated using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, Gunning-Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, and Automated Readability Index. Results: Overall, content was well-balanced. Information from AAFP and Healthychildren.org was focused more on medical management than other sources. The average DISCERN scores showed all sources to be of good quality with minimal shortcomings. The AAFP and KidsHealth websites had some readability scores around the 8th-grade reading level, the National Institute of Health’s upper limit recommended for public health information; however, most websites were above this recommended reading level. Conclusion: Patient education materials related to otitis media on academic and certain popular internet sites are good sources to obtain high-quality information on the topic. Patient educational background, prior knowledge and understanding of otitis media, and physician-patient partnership goals should be taken into account when referring patients to online materials.
Investigation of the physical, mechanical and thermal properties of nano and microsized particulate-filled dental composite material
Authors: Yadav Ramkumar , Kumar Mukesh 
Published: January 2020

Objective The purpose of this study was to fabricate bisphenol-a glycidyl methacrylate /tri-ethylene glycol dimethacrylate (TEGDMA)-based nano and micro-sized-filled dental composite and to study the effect of varying silane-treated nano hydroxyapatite on physical, mechanical and thermal properties. Methods The dental resin matrix was fabricated by bisphenol-a glycidyl (53 wt.%), TEGDMA (46 wt.%), camphorquinone (0.3 wt.%) and 2-(dimethylamino) ethyl methacrylate (0.7 wt.%). Silane-treated nano hydroxyapatite (nHA) filler content was varied from 0 to 8 wt.%, while zinc oxide (microsized) remains constant with 20 wt.%. A light curing unit was employed for polymerization of the resinous dental mixture. Results The result revealed that infrared spectra of untreated and treated nHA filler particles were confirmed by Fourier transform infrared spectroscopy. The dental composite filled with 6 wt.% nHA (DHZ6) exhibited maximum compressive strength (249 MPa) and Vickers hardness (49 Hv), while dental composite filled with 8 wt.% nHA (DHZ8) showed minimum depth of cure (5.12 mm), degree of conversion (54%) and polymerization shrinkage (1.12%). Significance Silane treatment of nano hydroxyapatite has a significant role in physical, mechanical, and thermal properties. Bonding strength of coupling agent has been seen between organic and inorganic materials.
Effects of graduated compression stockings, local vibration and their combination on popliteal venous blood velocity
Authors: Espeit Loïc , Lapole Thomas 
Published: January 2020

Objectives The purpose of this pilot study was to examine and compare the effects of graduated compression stockings, local vibration, and combined graduated compression stockings and local vibration on popliteal venous blood velocity. Method Twenty-four healthy subjects received four 15 min interventions (control, graduated compression stockings alone, local vibration alone, and combined graduated compression stockings and local vibration), while resting inactive in the prone position. Popliteal vein blood velocity was investigated before (PRE) and at the end (POST) of each intervention using Doppler ultrasound. Results At POST, peak velocity was reported to be 26.3 ± 53.5% ( p <  0.05) greater for local vibration than control (CONT). Peak velocity was 46.2 ± 54.6% ( p <  0.001) and 21.1 ± 37.6% ( p <  0.01) higher for graduated compression stockings than CONT and local vibration, respectively. Graduated compression stockings + local vibration presented 64.1 ± 58.0% ( p <  0.001), 38.4 ± 52.4% ( p <  0.001) and 15.0 ± 31.6% ( p <  0.05) greater values than CONT, local vibration and graduated compression stockings, respectively. Conclusions This study demonstrated an increase in popliteal venous blood velocity after graduated compression stockings and local vibration application. Their combination provided the greatest effects.
Do journals contribute to the international publication of research in their field? A bibliometric analysis of palliative care journal data
Authors: Walshe Catherine , Ahmed Faraz , Preston Nancy 
Published: January 2020

Background: Research is important internationally, impacting on health service provision and patient benefit. Journals play an important dissemination role, but there may be geographical bias, potentially affecting access to evidence. Aim: To understand if there is a relationship between the continent of journals and that of contributing authors. Design: Bibliometric analysis of journal citation report data (June 2018). Odds ratio of association of an author being from region, region of journal publication, publication model and the number of papers. Setting: Journals specialising in palliative care research, with an impact factor above the median impact factor for their most common indexing category. Results: Five journals: three published in Europe ( Palliative Medicine, BMJ Supportive and Palliative Care, and BMC Palliative Care) and two in North America ( Journal of Pain and Symptom Management and Journal of Palliative Medicine). Authors were from 30+ countries, but mostly North America (54.18%) or Europe (27.94%). Preliminary sensitivity tests show that the odds of an author being from a North American institution increase 16.4 times ( p < 0.01; 95% confidence interval: 12.9, 20.8) if the region of journal publication is North America. The odds of an author being from a European institution is 14.0 times ( p < 0.01; 95% confidence interval: 10.9, 17.9) higher if the region of journal publication is Europe. Conclusion: Publishers, editors and authors are concentrated in North America or Europe. North American authors are more present in North American journals and European authors in European journals. This polarised approach, if replicated across readerships, may lead to research waste, duplication, and be sub-optimal for healthcare development.
Tectonic keratoplasty using small incision lenticule extraction-extracted intrastromal lenticule for corneal lesions
Authors: Pant Om Prakash , Hao Ji-long , Zhou Dan-dan , Pant Manju , Lu Cheng-wei 
Published: January 2020

Objective This study investigated an alternative approach for obtaining donor corneas for keratoplasty that can be used in nations with high corneal demand and high costs for treatment of non-healing ulcers or lesions. Methods Eighteen patients (18 eyes) who underwent tectonic keratoplasty using small incision refractive lenticule extraction (SMILE)-extracted lenticule were included. Data were recorded regarding age, corneal status, corneal lesion location and size, preoperative and postoperative visual acuity, lenticule layer, and additional medical history. Results Corneal thinning and corneal perforation in 13 and 5 patients, respectively, were treated with tectonic keratoplasty using SMILE-extracted lenticule. After tectonic keratoplasty, globe integrity was maintained in 16 of the 18 patients. The mean decimal visual acuity improved from 0.2555±0.3326 preoperatively to 0.3303±0.3487 at the final follow-up. Visual acuity improvement was greater in patients with corneal perforation than in patients with corneal thinning. In addition, visual acuity was most improved in patients with infratemporal lesions. Conclusion Tectonic keratoplasty using SMILE-extracted lenticule is a comparatively safe, effective, and reliable alternative approach for the treatment of corneal lesions.
Fracture Resistance of Commonly Used Self-drilling Mini-implants of Various Diameters
Authors: S. Vinodh , Sangamesh B. , V. Neelakantha Patil , Ahmed Sameer , B. Venkat Naidu 
Published: January 2020

Context: Self-drilling mini-implants are commonly used in orthodontic treatment procedures, but there is limited information regarding their fracture resistance in areas of high-density bone without predrilling. Aims: The objective of this study is to compare and evaluate the maximum insertion torque and fracture resistance of 3 commonly used self-drilling mini-implants in India, and to assess the influence of variation in diameter in torque generation. Materials and methods: 90 mini-implants from 3 different manufacturers with 2 different diameters were drilled into acrylic blocks using a dial indicating torque screwdriver. All mini-implants were drilled at the rate of 20-30 rotations/min, implants were drilled until they fractured. Torque generated at the point of fracture is shown on the dial of the screwdriver. Measurements of the peak insertion torque value for each manufacturer were recorded separately. Statistical analysis: Analysis of variance, post hoc Bonferroni test. Results: Analysis of variance test showed a significant difference among all the manufacturers in both the diameters with P < .05. Implants of 1.6 mm diameter of Ancer group have the highest fracture resistance value when compared with the same diameter of JJ Orthodontics and SK Surgicals. Implants with higher diameter have more resistance than those with lower diameter. Conclusions: The observed highest fracture resistance is 47 Ncm by Ancer and least fracture resistance is 16 Ncm by JJ Orthodontics. The values are higher than the torque required to place mini-implants intraorally. Ancer mini-implants have the highest peak fracture torque, thus more than SK Surgicals and JJ Orthodontics.
The developing role of occupational therapists in school-based practice: Experiences from collaborative action research in Pakistan
Authors: Kramer-Roy Debbie , Hashim Denise , Tahir Nighat , Khan Areeba , Khalid Asma , Faiz Nasira , Minai Rabeea , Jawaid Samreen , Khan Shaheen , Rashid Rakhshanda , Frater Tai 
Published: January 2020

Introduction Occupational therapists around the world increasingly seek to support the participation of children with disabilities and special educational needs in mainstream education. Contemporary school-based occupational therapy practice is progressing from an individual, impairment focus towards collaborative, universal interventions at the whole class and whole school level. Participation-focused practice and collaboration is particularly important, but uncommon, in low-resource contexts such as Pakistan. Methods This article reports on collaborative action research that developed the role of occupational therapy in inclusive education in Karachi, Pakistan. A research team consisting of occupational therapists and teachers worked with five local primary schools, using the action research cycles of plan–implement–observe–reflect to develop practical strategies, materials and inclusive lesson plans to facilitate the participation of all children in all school-based occupations. Findings Support from school management and interdisciplinary collaboration were crucial for implementing change. In addition, strategies like inclusive lesson planning were found to benefit all children in class. Collaborative action research led to increased professional confidence in the teachers and occupational therapists, and skill development through developing a resource guide, running workshops and presenting at (inter)national conferences. Conclusion Collaborative action research was an effective means to develop the occupational therapy role in inclusive education practices in Pakistan, develop culturally appropriate educational resources, and upskill local therapists and teachers.
HLA class I alleles are associated with clinic-based migraine and increased risks of chronic migraine and medication overuse
Authors: Huang Claire , Chen Shih-Pin , Huang Yu-Han , Chen Hsuan-Yu , Wang Yen-Feng , Lee Mei-Hsuan , Wang Shuu-Jiun 
Published: January 2020

Objective We aimed to evaluate associations of human leukocyte antigen variants with migraine or headache in hospital and population-based settings. Methods The case-control study population, aged 30–70, included 605 clinic-based migraine patients in a medical center and 8449 population-based participants in Taiwan Biobank (TWB). Clinic-based cases were ascertained by neurologists. Participants in Taiwan Biobank were interviewed by a structured questionnaire including headache and migraine history; among them, 2394 had headache or migraine history while 6055 were free of headache and served as controls. All subjects were genotyped by Axiom Genome-Wide Single Nucleotide Polymorphism Arrays and imputed for eight classical human leukocyte antigen genes. Human leukocyte antigen frequencies were compared between clinic-based and self-reported patients and controls. We utilized likelihood ratio tests to examine human leukocyte antigen-disease associations and logistic regressions to estimate the effect of human leukocyte antigen alleles on migraine. Results Human leukocyte antigen -B and C showed significant associations with clinic-based migraine ( q-value < 0.05). Human leukocyte antigen -B*39:01, human leukocyte antigen -B*51:01, human leukocyte antigen -B*58:01 and human leukocyte antigen -C*03:02 were significantly associated with migraine, with age and sex-adjusted odds ratios (95% CIs) of 1.80 (1.28–2.53), 1.50 (1.15–1.97), 1.36 (1.14–1.62) and 1.36 (1.14–1.62), correspondingly. Clinic-based migraineurs carrying human leukocyte antigen -B*58:01 or human leukocyte antigen -C*03:02 had 1.63 (1.11–2.39) -fold likelihood to have chronic migraine with medication-overuse headache compared to episodic migraine. However, no human leukocyte antigen genes were associated with self-reported headache or migraine in the community. Conclusions Human leukocyte antigen class I genetic variants are positively associated with risk of clinic-based migraine but not self-reported migraine or headache and may contribute to migraine chronification and medication overuse.
The stranger in my room: The fellow patient as the fourth dimension of patient satisfaction
Authors: Hantel Saskia , Benkenstein Martin 
Published: January 2020

Objective To test the hypothesis that the fellow patient is a relevant dimension of patient satisfaction and has a notable influence on patient evaluations of hospitals. Data sources/study setting An empirical survey was conducted to collect primary data. In the study, patients in German hospitals were asked about their perceived satisfaction with fellow patients, physicians, nursing staff, and facilities. Study design Linear regression models were used to estimate the influence of each dimension on patient satisfaction. Various quality criteria further confirmed the quality of the extended patient satisfaction model. Principal findings The study confirmed fellow patient influence as a fourth dimension of patient satisfaction. The fellow patient had the highest impact on patient satisfaction and increases the variance of the patient satisfaction model significantly. Conclusion The findings suggest that patient satisfaction models should include the fourth dimension, “fellow patient.” In addition to the impact of the other satisfaction dimensions, both studies highlighted the significant influence of the fellow patient on patient satisfaction. Moreover, hospital managers should try to use the impact of the fellow patient to create satisfaction, which would benefit both hospitals and patients.
Features reported after exposure to automatic dishwashing rinse aids
Authors: Day R , Bradberry SM , Sandilands EA , Thomas SHL , Thompson JP , Vale JA 
Published: January 2020

Introduction: Automatic dishwashing rinse aids are drying aids which contain non-ionic surfactants, usually ethoxylated alcohols, typically at concentrations of ≤30%. Objective: To assess the reported toxicity of rinse aids. Methods: Telephone enquiries to the UK National Poisons Information Service were analysed from January 2008 to June 2019. Results: Ingestion: Ingestion was involved in 976 cases and produced gastrointestinal features, coughing and central nervous system depression, particularly in young children. In those in whom the amount ingested was known, the majority (56%) of children <18 years and of adults (57%) ingested <50 mL of rinse aid. Although moderate or severe exposures (Poisoning Severity Score (PSS) ≥ 2) were uncommon, they occurred significantly ( p < 0.0008) more often in adults (9.0%) than in children (1.8%); however, three of the four adults with PSS ≥ 2 co-ingested other substances. Eye exposure: Ocular exposure was reported in 35 cases, of whom 29 developed features. Eye irritation ( n = 10, 28.6%) and eye pain ( n = 10, 28.6%) were reported most commonly, and three patients (8.6%) developed corneal abrasions (PSS 2). Dermal exposure: Thirty-four patients were exposed dermally, and six (17.6%) reported features, including rash, numbness, pruritus and burns (PSS 1). Conclusions: Overall, clinical features developed in 47% of patients exposed to rinse aids, but more severe features (PSS ≥ 2) were rare (<3%) following exposure by any route.
Nurses’ experiences of working under time pressure in care for older persons
Authors: Dierckx de Casterlé Bernadette , Mertens Evelyne , Steenacker Jessica , Denier Yvonne 
Published: January 2020

Background The international health workforce crisis had led to an increasing shortage of nurses, which has substantial implications for the quality of patient care. This shortage potentially results in nurse-perceived time pressure, which can be particularly challenging for nurses who provide care for older persons. Objective This study aimed to show how geriatric nurses experience working under time pressure, perceive its impact on care and deal with time pressure in daily care. Research design A qualitative descriptive interview design was used. Participants and research context Purposive sampling led to the inclusion of 11 nurses from three geriatric nursing wards in two general hospitals in Flanders (Belgium). Data were collected using semi-structured in-depth interviews and analysed using the QUAGOL (Qualitative Analysis Guide of Leuven). Ethical considerations The study protocol was approved by the Ethics Committee of the University Hospitals Leuven (Ethics committee of the University Hospitals Leuven). Findings In all interviews, time pressure was described as ubiquitous in the daily care of older persons. A sense of failure in providing care was the common thread in many interviews. Nurses felt compelled to ‘reduce’ good-quality care to basic care by focusing on the physical and visible aspects of care. Nevertheless, personal experiences with time pressure and strategies to cope with it differed among the interviewees. These variations were related to the working environment and the nurses themselves. They underscored the importance of nurses’ perspectives for a good understanding of the phenomenon of time pressure. Discussion and conclusion Working under time pressure in the care of older persons leads to various important challenges for nursing ethics. The findings show that providing care that promotes the human dignity of older persons in busy working environments in which care is rationed is an important ethical challenge. As such, our study offers a baseline for further research and discussion on how to support nurses working under time pressure.