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

Intravenous alteplase for stroke with unknown time of onset guided by advanced imaging: systematic review and meta-analysis of individual patient data

Background: Patients who have had a stroke with unknown time of onset have been previously excluded from thrombolysis. We aimed to establish whether intravenous alteplase is safe and effective in such patients when salvageable tissue has been identified with imaging biomarkers. Methods: We did a systematic review and meta-analysis of individual patient data for trials published before Sept 21, 2020. Randomised trials of intravenous alteplase versus standard of care or placebo in adults with stroke with unknown time of onset with perfusion-diffusion MRI, perfusion CT, or MRI with diffusion weighted imaging-fluid attenuated inversion recovery (DWI-FLAIR) mismatch were eligible. The primary outcome was favourable functional outcome (score of 0–1 on the modified Rankin Scale [mRS]) at 90 days indicating no disability using an unconditional mixed-effect logistic-regression model fitted to estimate the treatment effect. Secondary outcomes were mRS shift towards a better functional outcome and independent outcome (mRS 0–2) at 90 days. Safety outcomes included death, severe disability or death (mRS score 4–6), and symptomatic intracranial haemorrhage. This study is registered with PROSPERO, CRD42020166903. Findings: Of 249 identified abstracts, four trials met our eligibility criteria for inclusion: WAKE-UP, EXTEND, THAWS, and ECASS-4. The four trials provided individual patient data for 843 individuals, of whom 429 (51%) were assigned to alteplase and 414 (49%) to placebo or standard care. A favourable outcome occurred in 199 (47%) of 420 patients with alteplase and in 160 (39%) of 409 patients among controls (adjusted odds ratio [OR] 1·49 [95% CI 1·10–2·03]; p=0·011), with low heterogeneity across studies (I2=27%). Alteplase was associated with a significant shift towards better functional outcome (adjusted common OR 1·38 [95% CI 1·05–1·80]; p=0·019), and a higher odds of independent outcome (adjusted OR 1·50 [1·06–2·12]; p=0·022). In the alteplase group, 90 (21%) patients were severely disabled or died (mRS score 4–6), compared with 102 (25%) patients in the control group (adjusted OR 0·76 [0·52–1·11]; p=0·15). 27 (6%) patients died in the alteplase group and 14 (3%) patients died among controls (adjusted OR 2·06 [1·03–4·09]; p=0·040). The prevalence of symptomatic intracranial haemorrhage was higher in the alteplase group than among controls (11 [3%] vs two [<1%], adjusted OR 5·58 [1·22–25·50]; p=0·024). Interpretation: In patients who have had a stroke with unknown time of onset with a DWI-FLAIR or perfusion mismatch, intravenous alteplase resulted in better functional outcome at 90 days than placebo or standard care. A net benefit was observed for all functional outcomes despite an increased risk of symptomatic intracranial haemorrhage. Although there were more deaths with alteplase than placebo, there were fewer cases of severe disability or death. Funding: None

Age of epilepsy onset as modulating factor for naming deficit after epilepsy surgery: a voxel-based lesion-symptom mapping study

Abstract Age at onset of epilepsy is an important predictor of deterioration in naming ability following epilepsy surgery. In 141 patients with left hemispheric epilepsy and language dominance who received epilepsy surgery at the Epilepsy Centre Erlangen, naming of objects (Boston naming test, BNT) was assessed preoperatively and 6 months postoperatively. Surgical lesions were plotted on postoperative MRI and normalized for statistical analysis using voxel-based lesion-symptom mapping (VBLSM). The correlation between lesion and presence of postoperative naming deterioration was examined varying the considered age range of epilepsy onsets. The VBLSM analysis showed that volumes of cortex areas in the left temporal lobe, which were associated with postoperative decline of naming, increased with each year of later epilepsy onset. In patients with later onset, an increasing left posterior temporobasal area was significantly associated with a postoperative deficit when included in the resection. For late epilepsy onset, the temporomesial expansion also included the left hippocampus. The results underline that early onset of epilepsy is a good prognostic factor for unchanged postoperative naming ability following epilepsy surgery. For later age of epilepsy onset, the extent of the area at risk of postoperative naming deficit at 6 months after surgery included an increasing left temporobasal area which finally also comprised the hippocampus

How Are We Doing After 30 Years? A Meta-Analytic Review of the Antecedents and Outcomes of Feedback-Seeking Behavior

This study provides meta-analytic estimates of the antecedents and consequences of feedback-seeking behavior (FSB). Clear support was found for the guiding cost/benefit framework in the feedback-seeking domain. Organizational tenure, job tenure, and age were negatively related to FSB. Learning and performance goal orientation, external feedback propensity, frequent positive feedback, high self-esteem, a transformational leadership style, and a high-quality relationship were positively associated with FSB. Challenging some of the dominant views in the feedback-seeking domain, the relationship between uncertainty and FSB was negative and the relationship between FSB and performance was small. Finally, inquiry and monitoring are not interchangeable feedback-seeking tactics. So FSB is best represented as an aggregate model instead of a latent model. In the discussion, gaps in the current FSB knowledge are identified and a research agenda for the future is put forward. Future research may benefit from (a) a systematic and integrative effort examining antecedents of both feedback-seeking strategies on the basis of a self-motives framework, (b) adopting a process perspective of feedback-seeking interactions, and (c) taking the iterative nature of feedback into account