Towards new educational potentialities: Review and commentary of the Preliminary draft Act on higher education

The Higher Education Act is a long-awaited legal act. A number of uncompleted attempts to prepare it have been undertaken in the course of the last three years. So far without success. Having been and still being a matter of highest social priority, the renewed effort to create and subsequently to enact this act is welcome as a worthwhile and a highly productive endeavor. Welcome also are the main innovations offered by this act, particularly its conspicuous consistency with the Bologna Declaration and other internationally launched and accepted documents. The draft act follows the international documents tracing down the paths of the future development of the educational systems of the European countries and providing for their mutual compatibility. A number of other positive contributions of the draft act are singled out, such as introducing clear and rigorous criteria and procedures for accreditation and quality control, introducing a wide coverage of arts and sciences as a precondition for an institution of higher education to qualify as a university, flexibility in the regime of studying including the domestic and international mobility of the students and requirement for the schools of higher education to have large cores of permanently employed teaching staff. A much larger part of the paper is, however, devoted to critical commentaries. To begin with, the draft is produced without any participation of the private universities, which is seen as a form of discrimination. The organizational pattern of a university is laid out with insufficient clarity and the status of departments (faculties) is particularly short of precision and even contradictory. The draft seems to be laden with the old bias towards excessive and potentially disastrous centralization, drastically reducing the decision making capacity of the system. The treatment of the property of the departments (faculties) is found inconsistent and legally unfounded. Inconsistency is also revealed in a number of prerogatives of the university vis-a-vis its departments and vice versa

Presence of Concomitant Systemic Cancer is Not Associated with Worse Functional Long-Term Outcome in Patients with Intracerebral Hemorrhage

Background: Data on clinical characteristics and outcome of patients with intracerebral hemorrhage (ICH) and concomitant systemic cancer disease are very limited. Methods: Nine hundred and seventy three consecutive primary ICH patients were analyzed using our prospective institutional registry over a period of 9 years (2006-2014). We compared clinical and radiological parameters as well as outcome - scored using the modified Rankin Scale (mRS) and analyzed in a dichotomized fashion as favorable outcome (mRS = 0-3) and unfavorable outcome (mRS = 4-6) - of ICH patients with and without cancer. Relevant imbalances in baseline clinical and radiological characteristics were adjusted using propensity score (PS) matching. Results: Prevalence of systemic cancer among patients with ICH was 8.5% (83/973). ICH patients with cancer were older (77 [70-82] vs. 72 [63-80] years; p = 0.002), had more often prior renal dysfunction (19/83 [22.9%] vs.107/890 [12.0%]; p = 0.005), and smaller hemorrhage volumes (10.1 [4.8-24.3] vs. 15.3 [5.4-42.9] mL; p = 0.017). After PS-matching there were no significant differences neither in mortality nor in functional outcome both at 3 months (mortality: 33/81 [40.7%] vs. 55/158 [34.8%]; p = 0.368; mRS = 0-3: 28/81 [34.6%] vs. 52/158 [32.9%]; p = 0.797) and 12 months (mortality: 39/78 [50.0%] vs. 70/150 [46.7%]; p = 0.633; mRS = 0-3: 25/78 [32.1%] vs. 53/150 [35.3%]; p = 0.620) among patients with and without concomitant systemic cancer. ICH volume tended to be highest in patients with hematooncologic malignancy and smallest in urothelial cancer. Conclusions: Patients with ICH and concomitant systemic cancer on average are older; however, they show smaller ICH volumes compared to patients without cancer. Yet, mortality and functional outcome is not different in ICH patients with and without cancer. Thus, the clinical history or the de novo diagnosis of concomitant malignancies in ICH patients should not lead to unjustified treatment restrictions

Supplementary Material for: Presence of Concomitant Systemic Cancer is Not Associated with Worse Functional Long-Term Outcome in Patients with Intracerebral Hemorrhage

<p><b><i>Background:</i></b> Data on clinical characteristics and outcome of patients with intracerebral hemorrhage (ICH) and concomitant systemic cancer disease are very limited. <b><i>Methods:</i></b> Nine hundred and seventy three consecutive primary ICH patients were analyzed using our prospective institutional registry over a period of 9 years (2006-2014). We compared clinical and radiological parameters as well as outcome - scored using the modified Rankin Scale (mRS) and analyzed in a dichotomized fashion as favorable outcome (mRS = 0-3) and unfavorable outcome (mRS = 4-6) - of ICH patients with and without cancer. Relevant imbalances in baseline clinical and radiological characteristics were adjusted using propensity score (PS) matching. <b><i>Results:</i></b> Prevalence of systemic cancer among patients with ICH was 8.5% (83/973). ICH patients with cancer were older (77 [70-82] vs. 72 [63-80] years; <i>p</i> = 0.002), had more often prior renal dysfunction (19/83 [22.9%] vs.107/890 [12.0%]; <i>p</i> = 0.005), and smaller hemorrhage volumes (10.1 [4.8-24.3] vs. 15.3 [5.4-42.9] mL; <i>p</i> = 0.017). After PS-matching there were no significant differences neither in mortality nor in functional outcome both at 3 months (mortality: 33/81 [40.7%] vs. 55/158 [34.8%]; <i>p</i> = 0.368; mRS = 0-3: 28/81 [34.6%] vs. 52/158 [32.9%]; <i>p</i> = 0.797) and 12 months (mortality: 39/78 [50.0%] vs. 70/150 [46.7%]; <i>p</i> = 0.633; mRS = 0-3: 25/78 [32.1%] vs. 53/150 [35.3%]; <i>p</i> = 0.620) among patients with and without concomitant systemic cancer. ICH volume tended to be highest in patients with hematooncologic malignancy and smallest in urothelial cancer. <b><i>Conclusions:</i></b> Patients with ICH and concomitant systemic cancer on average are older; however, they show smaller ICH volumes compared to patients without cancer. Yet, mortality and functional outcome is not different in ICH patients with and without cancer. Thus, the clinical history or the de novo diagnosis of concomitant malignancies in ICH patients should not lead to unjustified treatment restrictions.</p