Mobile phone and e-government in Turkey: practices and technological choices at the cross-road

Enhanced data services through mobile phones are expected to be soon fully transactional and embedded within future mobile consumption practices. While private services will surely continue to take the lead, others such as government and NGOs will become more prominent m-players. It is not yet sure which form of technological standards will take the lead including enhance SMS based operations or Internet based specifically developed mobile phone applications. With the introduction of interactive transactions via mobile phones, currently untapped segment of the populations (without computers) have the potential to be accessed. Our research, as a reflection of the current market situation in an emerging country context, in the case of mobile phones analyzes the current needs or emergence of dependencies regarding the use of m/e-government services from the perspective of municipality officers. We contend that more research is needed to understand current preparatory bottlenecks and front loading activities to be able to encourage future intention to use e-government services through mobile phone technologies. This study highlights and interprets the current emerging practices and praxis for consuming m-government services within government

An actor-network theory (ANT) approach to Turkish e-government gateway initiative

There are various models proposed in the literature to analyze trajectories of e-Government projects in terms of success and failure. Yet, only the Actor-Network Theory (ANT) perspective (Heeks and Stanforth, 2007) considers the interaction factors among network actors and actants. This paper proposes the ANT for approaching to the Turkish e-Government Gateway initiative as a case study. In doing so, it provides valuable insight in terms of both local and global actor-networks which surround the initiative

COPD profiles and treatable traits using minimal resources: identification, decision tree and longitudinal stability

Introduction: Chronic obstructive pulmonary disease (COPD) is highly heterogeneous and complex. Hence, personalising assessments and treatments to this population across different settings and available resources imposes challenges and debate. Research efforts have been made to identify clinical phenotypes or profiles for prognostic and therapeutic purposes. Nevertheless, such profiles often do not describe treatable traits, focus on complex physiological/ pulmonary measures which are frequently not available across settings, lack validation and/or their stability over time is unknown. Objectives: To identify profiles and their treatable traits based on simple and meaningful measures; to develop and validate a profile decision tree; and to explore profiles’ stability over time in people with COPD. Methods: An observational, prospective study was conducted with people with COPD. Clinical characteristics, lung function, symptoms, impact of the disease (COPD assessment test–CAT), healthrelated quality of life, physical activity, lower-limb muscle strength and functional status were collected cross-sectionally and a subsample was followed-up monthly over six months. A principal component analysis and a clustering procedure with k-medoids were applied to identify profiles. Pulmonary and extrapulmonary (i.e., physical, symptoms and health status, and behavioural/life-style risk factors) treatable traits were identified in each profile based on the established cut-offs for each measure available in the literature. The decision tree was developed with 70% and validated with 30% of the sample, cross-sectionally. Agreement between the profile predicted by the decision tree and the profile defined by the clustering procedure was determined using Cohen’s Kappa. Stability was explored over time with a stability score defined as the percentage ratio between the number of timepoints that a participant was classified in the same profile (most frequent profile for that participant) and the total number of timepoints (i.e., 6). Results: 352 people with COPD (67.4 ± 9.9 years; 78.1% male; FEV1 = 56.2 ± 20.6% predicted) participated and 90 (67.6 ± 8.9 years; 85.6% male; FEV1 = 52.1 ± 19.9% predicted) were followedup. Four profiles were identified with distinct treatable traits. The decision tree was composed by the CAT, age and FEV1% predicted and had an agreement of 71.7% (Cohen’s Kappa = 0.62, p < 0.001) with the actual profiles. 48.9% of participants remained in the same profile whilst 51.1% moved between two (47.8%) and three (3.3%) profiles over time. The overall stability of profiles was 86.8 ± 15%. Conclusions: Profiles and treatable traits can be identified in people with COPD with simple and meaningful measures possibly available even in minimal-resource settings. Regular assessments are recommended as people with COPD may change profile over time and hence their needs of personalised treatment.publishe

Distinct and stage-specific contributions of TET1 and TET2 to stepwise cytosine oxidation in the transition from naive to primed pluripotency

Cytosine DNA bases can be methylated by DNA methyltransferases and subsequently oxidized by TET proteins. The resulting 5-hydroxymethylcytosine (5hmC), 5-formylcytosine (5fC), and 5-carboxylcytosine (5caC) are considered demethylation intermediates as well as stable epigenetic marks. To dissect the contributions of these cytosine modifying enzymes, we generated combinations of Tet knockout (KO) embryonic stem cells (ESCs) and systematically measured protein and DNA modification levels at the transition from naive to primed pluripotency. Whereas the increase of genomic 5-methylcytosine (5mC) levels during exit from pluripotency correlated with an upregulation of the de novo DNA methyltransferases DNMT3A and DNMT3B, the subsequent oxidation steps turned out to be far more complex. The strong increase of oxidized cytosine bases (5hmC, 5fC, and 5caC) was accompanied by a drop in TET2 levels, yet the analysis of KO cells suggested that TET2 is responsible for most 5fC formation. The comparison of modified cytosine and enzyme levels in Tet KO cells revealed distinct and differentiation-dependent contributions of TET1 and TET2 to 5hmC and 5fC formation arguing against a processive mechanism of 5mC oxidation. The apparent independent steps of 5hmC and 5fC formation suggest yet to be identified mechanisms regulating TET activity that may constitute another layer of epigenetic regulation

Safety and Efficacy of the FRED Jr Flow Re-Direction Endoluminal Device for Intracranial Aneurysms: Retrospective Multicenter Experience With Emphasis on Midterm Results

Background and Purpose: Flow diversion is increasingly used as an endovascular treatment for intracranial aneurysms. In this retrospective multicenter study, we analyzed the safety and efficacy of the treatment of intracranial, unruptured, or previously treated but recanalized aneurysms using Flow Re-Direction Endoluminal Device (FRED) Jr with emphasis on midterm results. Materials and Methods: Clinical and radiological records of 150 patients harboring 159 aneurysms treated with FRED Jr at six centers between October 2014 and February 2020 were reviewed and consecutively included. Clinical outcome was measured by using the modified Rankin Scale (mRS). Anatomical results were assessed according to the O’Kelly-Marotta (OKM) scale and the Cekirge-Saatci Classification (CSC) scale. Results: The overall complication rate was 24/159 (16%). Thrombotic-ischemic events occurred in 18/159 treatments (11%). These resulted in long-term neurological sequelae in two patients (1%) with worsening from pre-treatment mRS 0–2 and mRS 4 after treatment. Complete or near-complete occlusion of the treated aneurysm according to the OKM scale was reached in 54% (85/158) at 6-month, in 68% (90/133) at 1-year, and in 83% (77/93) at 2-year follow-up, respectively. The rates of narrowing or occlusion of a vessel branch originating from the treated aneurysm according to the CSC scale were 11% (12/108) at 6-month, 20% (17/87) at 1-year, and 23% (13/57) at 2-year follow-up, respectively, with all cases being asymptomatic. Conclusions: In this retrospective multicenter study, FRED Jr was safe and effective in the midterm occlusion of cerebral aneurysms. Most importantly, it was associated with a high rate of good clinical outcome

Assessment of the capacity for flood monitoring and early warning in Enlargement and Eastern/ Southern Neighbourhood countries of the European Union

Flooding is a natural disaster that can damage large areas in the vicinity of rivers, and in the case of flash floods, also in the vicinity of smaller streams. The Global Risks Report 2017 lists extreme weather events, of which flooding is the main risk in most countries, as the risk with the second highest potential impact and the highest likelihood of occurrence. It furthermore seems likely that climate change will aggravate flood impacts in many regions. This report presents an assessment of the capacity for flood monitoring and early flood warning in 17 of the 22 countries which belong to the Eastern and Southern neighbourhood policy of the European Union and the enlargement candidate countries. Many of these receive external funding to improve their systems, but this is often on an ad hoc basis and through individual projects.JRC.E.1-Disaster Risk Managemen

What facilitates the delivery of dignified care to older people? A survey of health care professionals Geriatrics

Background: Whilst the past decade has seen a growing emphasis placed upon ensuring dignity in the care of older people this policy objective is not being consistently achieved and there appears a gap between policy and practice. We need to understand how dignified care for older people is understood and delivered by the health and social care workforce and how organisational structures and policies can promote and facilitate, or hinder, the delivery of such care. Methods: To achieve our objective of understanding the facilitators and to the delivery of dignified care we undertook a survey with health and social care professionals across four NHS Trusts in England. Participants were asked provide free text answers identifying any facilitators/barriers to the provision of dignified care. Survey data was entered into SPSSv15 and analysed using descriptive statistics. These data provided the overall context describing staff attitudes and beliefs about dignity and the provision of dignified care. Qualitative data from the survey were transcribed verbatim and categorised into themes using thematic analysis. Results: 192 respondents were included in the analysis. 79 % of respondents identified factors within their working environment that helped them provide dignified care and 68 % identified barriers to achieving this policy objective. Facilitators and barriers to delivering dignified care were categorised into three domains: 'organisational level'; 'ward level' and 'individual level'. Within the these levels, respondents reported factors that both supported and hindered dignity in care including 'time', 'staffing levels', training',' 'ward environment', 'staff attitudes', 'support', 'involving family/carers', and 'reflection'. Conclusion: Facilitators and barriers to the delivery of dignity as perceived by health and social care professionals are multi-faceted and range from practical issues to interpersonal and training needs. Thus interventions to support health and social care professionals in delivering dignified care, need to take a range of issues into account to ensure that older people receive a high standard of care in NHS Trusts.Professor David Oliver, Professor Andree le May, Dr. Sally Richards, Dr Wendy Marti

Elliptic flow of charged particles in Pb-Pb collisions at 2.76 TeV

We report the first measurement of charged particle elliptic flow in Pb-Pb collisions at 2.76 TeV with the ALICE detector at the CERN Large Hadron Collider. The measurement is performed in the central pseudorapidity region (|$\eta$|<0.8) and transverse momentum range 0.2< $p_{\rm T}$< 5.0 GeV/$c$. The elliptic flow signal v$_2$, measured using the 4-particle correlation method, averaged over transverse momentum and pseudorapidity is 0.087 $\pm$ 0.002 (stat) $\pm$ 0.004 (syst) in the 40-50% centrality class. The differential elliptic flow v$_2(p_{\rm T})$ reaches a maximum of 0.2 near $p_{\rm T}$ = 3 GeV/$c$. Compared to RHIC Au-Au collisions at 200 GeV, the elliptic flow increases by about 30%. Some hydrodynamic model predictions which include viscous corrections are in agreement with the observed increase.Comment: 10 pages, 4 captioned figures, published version, figures at http://aliceinfo.cern.ch/ArtSubmission/node/389