bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redescribing the Nation
Authors: Häkkinen Ville 
Published: August 2018

Abstract
Boosting national spirit through projection of otherness is not a new phenomenon, at least in authoritarian regimes. Yet the role of anti-Semitism in the Numerus Clausus debates in the Hungarian parliament in 1920 and 1928 is worth deeper analysis, as it bore a peculiar role in the Hungarian interwar counterrevolutionary nation-building. The Numerus Clausus law of 1920 set ethnic quotas to university enrolment; the explicit argument for this was countering the Jewish ‘over-representation’ in Hungarian society. However, in 1928 the law was amended, abolishing (in principle) the said quotas; this time the arguments favoured national consolidation, where segregation was to be moderated. In both cases, the national elites construed and made use of nation-centred political rhetoric, but used it for differing ends in different times. This article shall analyse the debates of the Hungarian Parliament concerning the Numerus Clausus laws, especially from the viewpoints of nation-building and rhetoric of exclusion.
The art of survival: community-based arts organisations in times of austerity
Authors: Rimmer Mark 
Published: August 2018

Abstract
This article examines the consequences of shifts in the terms of engagement with the state – since the onset of the global financial crisis in 2008 – for small-scale UK arts-based community organisations. Through an engagement with the accounts of key stakeholders from three case study organisations, the article considers the nature and extent of organisational changes in four main respects: the activities undertaken, the people and groups engaged, the income streams accessed and understandings of role or mission. Having outlined the variable fates of each organisation over this period, the article illuminates how the effects of austerity and associated policy shifts have served to mitigate against organisations’ ability to sustain arts-based work with disadvantaged groups, resist neoliberal ‘enterprise’ agendas or maintain a practical commitment to community development aims.
ESC Council on hypertension position document on the management of hypertensive emergencies
Authors: van den Born Bert-Jan H , Lip Gregory Y H , Brguljan-Hitij Jana , Cremer Antoine , Segura Julian , Morales Enrique , Mahfoud Felix , Amraoui Fouad , Persu Alexandre , Kahan Thomas , Agabiti Rosei Enrico , de Simone Giovanni , Gosse Philippe , Williams Bryan 
Published: August 2018

Abstract
Hypertensive emergencies are those situations where very high blood pressure (BP) values are associated with acute organ damage, and therefore, require immediate, but careful, BP reduction. The type of acute organ damage is the principal determinant of: (i) the drug of choice, (ii) the target BP, and (iii) the timeframe in which BP should be lowered. Key target organs are the heart, retina, brain, kidneys, and large arteries. Patients who lack acute hypertension-mediated end organ damage do not have a hypertensive emergency and can usually be treated with oral BP-lowering agents and usually discharged after a brief period of observation.
Research participation preferences as expressed through a patient portal: implications of demographic characteristics
Authors: Obeid Jihad S , Shoaibi Azza , Oates Jim C , Habrat Melissa L , Hughes-Halbert Chanita , Lenert Leslie A 
Published: August 2018

AbstractObjectiveAs patient portals are increasingly used for research recruitment, it is important to examine the demographic makeup of research registries that are populated via portals and the factors that influence participation in these registries.MethodsWe examined the response to a routine research preference questionnaire among patients who were enrolled in a patient portal at an academic health center and characterized the sub-population that responded and was tracked in a research preferences registry. We examined the factors that influence choices in two research preferences: future contact for research opportunities and biobanking of de-identified specimens.ResultsOut of 79 834 patients to whom the questionnaire was sent, 32% responded. Of those 74% agreed to future contact and 77% to the biobank preference. We found significantly lower odds of agreement in both preferences in minority populations, especially in the population &gt;65 years of age when stratified by race. Individuals with higher comorbidity indexes had significantly higher odds for agreement.DiscussionThe disparities in volunteerism as expressed by agreement to future contact and willingness to participate in biobanking are exacerbated by lower levels of enrollment in the patient portal by minorities, especially in the oldest age group. Future work should examine other socioeconomic factors and the differences across age groups, sicker individuals, and payer categories.ConclusionAlthough patient portals can be more efficient for recruitment, researchers have to be cognizant of, and proactively address, potential biases when recruiting participants from these registries.
Endoscopic Transsphenoidal Surgery of Microprolactinomas: A Reappraisal of Cure Rate Based on Radiological Criteria
Authors: Micko Alexander , Vila Greisa , Höftberger Romana , Knosp Engelbert , Wolfsberger Stefan 
Published: August 2018

AbstractBackgroundCurrent standard treatment of microprolactinomas is dopamine agonist therapy. As this drug treatment is lifelong in up to 80% of cases, many patients consult pituitary surgeons regarding a surgical alternative.ObjectiveTo identify prognostic criteria for surgical remission, we reviewed outcomes of our series of microprolactinomas treated with endoscopic transsphenoidal surgery, with a special emphasis on magnetic resonance adenoma delineation and position.MethodsOur study cohort comprises a single center series of 60 patients operated for histopathologically verified magnetic resonance imaging unequivocally identifiable endosellar microprolactinoma between 2003 and 2017. In 31 patients the adenoma was enclosed by pituitary gland (group ENC), in 29 patients the adenoma was located lateral to the gland adherent to the medial cavernous sinus wall (group LAT).ResultsAfter a mean follow-up of 37 mo (range 4-143 mo), remission rate was significantly higher in adenomas enclosed by pituitary gland (group ENC) than adenomas located lateral to the gland (group LAT), with 87% vs 45%,P = .01. Intraoperatively, 4 patients showed signs of invasiveness. Preoperative prolactin levels did not differ between the groups (mean 155 and 187 ng/ml in group ENC and LAT, respectively).A binary logistic regression model revealed that only the radiological criteria applied showed a significant correlation (P = .003) with endocrine remission.CONCLUSIONAccording to our results, remission rate is significantly higher in microprolactinomas enclosed by the pituitary gland. However, the decision for surgery should take into account surgeons experience and possibility of complications.
Becoming a Clinical Teacher: Identity Formation in Context
Authors: Cantillon Peter , Dornan Tim , De Grave Willem 
Published: August 2018

Purpose
Most clinical teachers have not been trained to teach, and faculty development for clinical teachers is undermined by poor attendance, inadequate knowledge transfer, and unsustainability. A crucial question for faculty developers to consider is how clinicians become teachers “on the job.” Such knowledge is important in the design of future workplace-based faculty development initiatives. The authors conducted a scoping review of research on the relationship between becoming a clinical teacher and the clinical environments in which those teachers work.

Method
In June 2017, using the scoping review design described by Levac et al (2010), the authors searched 12 databases. They subjected the articles discovered to four phases of screening, using iteratively developed inclusion/exclusion criteria. They charted data from the final selection of articles and used thematic analysis to synthesize findings.

Results
Thirty-four research reports met the inclusion criteria. Most (n = 24) took an individualist stance toward identity, focusing on how teachers individually construct their teacher identity in tension with their clinician identities. Only 10 studies conceptualized clinical teacher identity formation as a social relational phenomenon, negotiated within hierarchical social structures. Twenty-nine of the included studies made little or no use of explicit theoretical frameworks, which limited their rigor and transferability.

Conclusions
Clinicians reconciled their identities as teachers with their identities as clinicians by juggling the two, finding mutuality between them, or forging merged identities that minimized tensions between educational and clinical roles. They did so in hierarchical social settings where patient care and research were prioritized above teaching.
Using Machine Learning to Assess Physician Competence: A Systematic Review
Authors: Dias Roger D. , Gupta Avni , Yule Steven J. 
Published: August 2018

Purpose
To identify the different machine learning (ML) techniques that have been applied to automate physician competence assessment and evaluate how these techniques can be used to assess different competence domains in several medical specialties.

Method
In May 2017, MEDLINE, EMBASE, PsycINFO, Web of Science, ACM Digital Library, IEEE Xplore Digital Library, PROSPERO, and Cochrane Database of Systematic Reviews were searched for articles published from inception to April 30, 2017. Studies were included if they applied at least one ML technique to assess medical students’, residents’, fellows’, or attending physicians’ competence. Information on sample size, participants, study setting and design, medical specialty, ML techniques, competence domains, outcomes, and methodological quality was extracted. MERSQI was used to evaluate quality, and a qualitative narrative synthesis of the medical specialties, ML techniques, and competence domains was conducted.

Results
Of 4,953 initial articles, 69 met inclusion criteria. General surgery (24; 34.8%) and radiology (15; 21.7%) were the most studied specialties; natural language processing (24; 34.8%), support vector machine (15; 21.7%), and hidden Markov models (14; 20.3%) were the ML techniques most often applied; and patient care (63; 91.3%) and medical knowledge (45; 65.2%) were the most assessed competence domains.

Conclusions
A growing number of studies have attempted to apply ML techniques to physician competence assessment. Although many studies have investigated the feasibility of certain techniques, more validation research is needed. The use of ML techniques may have the potential to integrate and analyze pragmatic information that could be used in real-time assessments and interventions.
The Effectiveness of Full-body EOS Compared With Conventional Chest X-ray in Preoperative Evaluation of the Chest for Patients Undergoing Spine Operations
Authors: Hey Hwee Weng Dennis , Chan Chloe Xiaoyun , Wong Ying Mei , Sng Jonathan Weizhong , Ong Han Yang , Tan Chuen Seng , Liu Gabriel Ka-Po , Wong Hee-Kit , Quek Swee-Tian 
Published: August 2018

Study Design.
A prospective radiographic comparative study.

Objective.
The aim of this study was to compare full-body EOS with conventional chest X-ray (CXR) for use in the preoperative evaluation of the chest in patients undergoing spine operations.

Summary of Background Data.
The full-body EOS reproduces an image of the chest similar to a routine CXR. The potential for the former replacing the latter is plausible. This is especially applicable in spine patients who would routinely have a preoperative full-body EOS performed.

Methods.
A radiographic comparative study of 266 patients was conducted at a single tertiary center from January 2013 to July 2016. Each patient had EOS and CXR done in random order <2 weeks apart. Two radiologists reported the image findings using a checklist. A third radiologist was consulted in cases of discrepancy. Interobserver agreement was calculated using Gwet AC1 and a comparison between EOS and CXR findings was analyzed using paired Chi-squared test. Multivariate analysis was performed to identify predictors for abnormal radiological findings. The institutional ethics committee approved this prospective study and waiver of informed consent was obtained.

Results.
There were 84 males (31.6%) and 182 females (68.4%). The mean age was 38.9 years (SD = 25.0 years). High interobserver agreement was found for EOS and CXR (Gwet AC1 0.993 and 0.988, respectively). There were no significant differences between both imaging modalities. Rare diagnoses precluded comparison of certain conditions. Age >18 years [odds ratio (OR) 7.69; P = 0.009] and American Society of Anesthesiologists physical status 3 (OR 6.64; P = 0.018) were independent predictors of abnormal radiological findings.

Conclusion.
EOS is not inferior to, and may be used to replace CXR in preoperative radiological screening of thoracic conditions especially in low-risk patients ≤18 years old and patients with ASA <3. Preoperative assessment should never rely on a single modality. High-risk patients should be sent for a thorough work-up before spine surgery.

Level of Evidence: 4
Monitoring of Metabolic, Cardiac, and Endocrine Indicators in Youth Treated With Antipsychotics as Reported by Health Care Professionals
Authors: Minjon Lenneke , van den Ban Els , de Jong Emma , Egberts Toine C.G. , Heerdink Eibert R. 
Published: August 2018

Abstract

Background
It is unclear how youth treated with antipsychotics are monitored. The purpose of this study was to assess monitoring of metabolic, cardiac, and endocrine indicators in youth (<18 years old) treated with antipsychotics as reported by health care professionals in the Netherlands.

Methods
A questionnaire was designed to collect information from health care professionals regarding the monitoring of youth treated with antipsychotics. Data were collected at a national conference.

Findings and Results
Fifty-nine health care professionals completed the questionnaire, of which 53 (89.8%) were child and adolescent psychiatrists (approximately 20% of all child and adolescent psychiatrists in the Netherlands). More than 80% of respondents reported monitoring physical indicators—weight, height, body mass index, heart rate, and blood pressure—and over 50% reported monitoring laboratory indicators—lipid profile, blood glucose, and prolactin level. Most of the respondents reported monitoring physical indicators more than twice per year and laboratory indicators once per year. Almost all respondents (56/59, 94.9%) reported monitoring according to a clinical guideline or protocol. Only 1 respondent reported monitoring the indicators completely according to the clinical guideline. Respondents mentioned that facilitating factors for monitoring, such as access to electrocardiogram facilities, were insufficiently available.

Conclusions
Although all health care professionals reported monitoring metabolic, cardiac, and endocrine indicators in youth treated with antipsychotics, great variability exists in reported monitoring practices. Factors contributing to this variability must be assessed to optimize the benefit-risk ratio for the individual patient.
Developing a Quality Measurement Strategy in an Academic Primary Care Setting: An Environmental Scan
Authors: Dalton Alexandra F. , Lyon Corey , Parnes Bennett , Fernald Douglas , Lewis Carmen L. 
Published: August 2018

ABSTRACT

Purpose:
The purpose of this project was to: (1) develop a strategy for primary care quality measurement using an environmental scan and interviews to identify best practices and candidate measures; (2) present recommendations to facilitate successful measurement.

Methods:
Following stakeholder interviews and review of existing measures, we created a three-tiered recommendation system for selecting and implementing measures. We also developed a framework for reviewing and prioritizing measures and prepared a detailed project report.

Results:
Interviews provided a broader perspective on measuring quality, including implementing measures, measuring value, and identifying measurement gaps. Our recommendations fall into three tiers: Tier 1 measures can be implemented quickly and include clinical processes and outcomes for preventive care and disease states. Tier 2 measures require modifications to electronic health record, workflows, and/or staff preparation. Tier 3 (Strategic Vision) addresses topics that should be incorporated in the future to ensure high-quality primary care (adherence, patient activation, patient experience, teamness, staff satisfaction, and value), and infrastructure development to support ongoing quality measurement.

Conclusions:
Implementing a quality measurement strategy is challenging and labor-intensive but is necessary to improve healthcare quality. Our work demonstrates the effort and investment required to progress quality measurement and offers recommendations for successfully undertaking this type of endeavor.
Normative Data for the Sway Balance System
Authors: Brett Benjamin L. , Zuckerman Scott L. , Terry Douglas P. , Solomon Gary S. , Iverson Grant L. 
Published: August 2018

Objective:Static balance, postural stability, and reaction time are commonly impaired after a sport-related concussion. The Sway Balance System assesses postural sway (ie, stability) and simple reaction time using the triaxial accelerometer built into iOS mobile devices. The purpose of this study was to provide normative data for children and adolescents and to examine for age and sex differences on the Sway Balance System.Design:Cross-sectional study.Setting:Middle and high schools across the United States.Participants:Participants were 3763 youth aged 9 to 21 years who completed the Sway Balance System Sports protocol in accordance with the company's recommended methods (ie, 1 acclimation trial and 2-3 baseline tests).Independent Variables:Age and sex.Main Outcome Measures:Sway Balance score (0-100) and Sway Reaction Time score (0-100).Statistical Analysis:A multivariate analysis of variance examined the effects of age and sex on balance and reaction time scores.Results:Sway Balance and Reaction Time scores significantly differed by age [F(10, 7494) = 39.68,P< 0.001, V = 0.10, = 0.05] and sex [F(4, 7494) = 55.29,P< 0.001, V = 0.06, = 0.03]. Post hoc analyses revealed that older groups generally had better scores than younger groups on all balance comparisons (ps < 0.001) and many reaction time comparisons. Girls performed better than boys on balance [F(2, 3747) = 53.79,P< 0.001, = 0.03] and boys had faster reaction times [F(2, 3747) = 37.11,P< 0.001, = 0.02].Conclusions:Age and sex are important factors to consider when assessing Balance and Reaction Time scores using the Sway Balance System's Sports protocol in youth. We provide age- and sex-based normative values for the Sway Balance System, which will likely be helpful when using this technology to assess and manage concussions.
Concussion in Motorsport? Experience, Knowledge, Attitudes, and Priorities of Medical Personnel and Drivers
Authors: Adams Stephanie A. , Turner Anthony P. , Richards Hugh , Hutchinson Peter J. 
Published: August 2018

Objective:To assess concussion experiences, knowledge, and attitudes of motorsport medical personnel and drivers and to determine priority areas regarding concussion within the sport.Design:Sequential mixed-method design. Part 1: stakeholder interviews; part 2: cross-sectional online survey.Setting:United Kingdom.Participants:Part 1: key motorsport stakeholders (N = 8); part 2: motorsport medical personnel and drivers (N = 209) representing amateur and/or professional 4-wheeled motorsport.Main Outcome Measures:Concussion experience, knowledge, attitudes, and perceived priority areas.Results:Thirty-one percent of surveyed drivers (age = 37.91 ± 13.49 years: 89% male) reported suffering from concussion in motorsport. Eighty-seven percent of surveyed medical personnel (age = 48.60 ± 10.68 years: 74% male) reported experience with concussed drivers, and 34% reported feeling pressured to clear a driver with concussion. Gaps in knowledge and misperceptions about concussion were reported in both groups, and disparity between concussion attitudes emerged between drivers and medical personnel. Application of assessment and management procedures varied between medical personnel and there was evidence motorsport policy and concussion guidelines may not be directly followed. According to both medical personnel (77%) and drivers (85%), “education and training” is the top priority area for the sport.Conclusions:There is clear evidence of concussions in motorsport, but accurate knowledge about this injury is missing. Concussion education and training for all drivers and medical personnel is required. Additional investigations into concussion attitudes are advised to complement and advance simple educational initiatives. Further investigation is also required to determine how to best support motorsport medical personnel, and general practitioners, who hold significant responsibility in guiding drivers from diagnosis to return to racing, and to support the effective implementation of policy.
Nurse practitioners' recommendations for pharmacotherapy in the management of adolescent concussion
Authors: Graves Janessa M. , Klein Tracy A. , Panther Shannon G. , Moore Megan , Abshire Demetrius , Graham Jasmine 
Published: August 2018

ABSTRACT

Background and purpose:
Nurse practitioners (NPs) frequently treat acute conditions presenting in children and adolescents in the outpatient setting. No evidence-based guidance exists pertaining to the treatment of concussion with medications. The purpose of this study was to examine recommendations by NPs for pharmacotherapy of acute symptoms for adolescent concussion.

Methods:
This is a secondary analysis of data from a web-based census survey of all licensed NPs in Oregon and Washington State, where they practice as independent providers with prescriptive authority. Based on a standardized adolescent patient scenario video, NPs were asked to indicate prescription or nonprescription medication recommendations for concussion symptoms. Open-ended descriptions of medication recommendations were coded, summarized, and described.

Conclusions:
In narrative text, 78.4% of the 991 respondents recommended at least one type of prescription or nonprescription medication. Prescription medications (recommended by 17.2%) included antiemetics and antimigraine medications; nonprescription medications (recommended by 75.5%) included nonsteroidal anti-inflammatory drugs, over-the-counter pain relievers, and herbal medications. Pharmacotherapy recommendations varied by NP practice setting and rurality.

Implications for practice:
Nurse practitioners have full prescriptive authority in many states. No guidelines inform medication use in managing acute concussion symptoms, yet many providers recommend their use.