bluuebunny/crossref_metadata_2025 huggingface dataset:
Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes
Authors: Bidargaddi Niranjan , Bastiampillai Tarun , Allison Stephen , Jones Gabrielle M , Furber Gareth , Battersby Malcolm , Richards David
Published: May 2015

Introduction

In Australia there is an overwhelming need to provide effective treatment to patients presenting to the Emergency Department (ED) in mental health crisis. We adapted Improving Access to Psychological Therapies service model (IAPT) from the National Health Service (NHS) method for the large scale delivery of psychological therapies throughout the United Kingdom to an Australian ED setting. This telephone-based low intensity therapy was provided to people presenting in crisis to the EDs with combinations of anxiety, depression, substance use, and suicidal thinking.

Methods

This uncontrolled study utilised session-by-session, before-and-after measures of anxiety and depression via Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder-7 (GAD-7).

Results

Of 347 eligible post-crisis ED referred patients, 291 (83.9%) engaged with the IAPT team. Most patients (65%) had attended the ED previously on an average of 3.9 (SD = 6.0) occasions. Two hundred and forty one patients received an average of 4.1 (SD = 2.3) contacts of low-intensity psychological therapies including 1.2 (SD = 1.7) community outreach visits between 20th Oct 2011 and 31st Dec 2012. Treated patients reported clinically significant improvements in anxiety, depression and suicidal ideation. Uncontrolled effect sizes were moderate for anxiety (0.6) and depression (0.6).

Discussion

The Australian ED IAPT program demonstrated that the UK IAPT program could be adapted for emergency mental health patients and be associated with similar clinical benefits as the original program.

Funding

The Flinders Medical Centre IAPT program received Emergency Department project funding from the Australian Commonwealth Government through the Council of Australian Governments (COAG) and the South Australian Government initiative, Every Patient Every Service (EPES).
Suicidal risk and sexual orientation in adolescence: A population-based study in Iceland
Authors: Arnarsson Arsaell , Sveinbjornsdottir Sigrun , Thorsteinsson Einar B. , Bjarnason Thoroddur
Published: May 2015

Aim: Suicidality is an important public health problem, particularly among lesbian, gay, and bisexual (LGB) adolescents and young adults. The purpose of the present study is to compare the rate of suicide ideations and attempts among LGB adolescent to that of non-LGB adolescents in a population-based sample, and to identify important protective factors as well as risk factors Method: We used the Icelandic data set from the 2009/2010 Health Behaviour in School-aged Children (HBSC) study. The sample consisted of 3813 grade 10 Icelandic adolescents; 1876 girls and 1937 boys. The participants were asked about attraction and/or activity, as well as about suicidal ideation and/or attempts. The questionnaire also included various other items regarding health and lifestyle. Results: LGB adolescents were five to six times more likely to have had frequent suicidal ideations. Factors that were associated with less suicide ideations and fewer attempts were easy communication and liking school. The LGB girls were six times more likely to have had frequent suicide attempts, whilst the LGB boys were 17 times more likely to have attempted suicide that often. No specific protective or risk factors were identified for suicidality in LGB adolescents other than bullying. Conclusions: Adolescents that had engaged in heterosexual activity and those that had LGB attraction had similarly heightened risk for suicidality, but sexually active LGB adolescents were far more likely to have suicidal ideations or to have attempted suicide.
The real risks during deadly police shootouts
Authors: Lewinski William J , Avery Ron , Dysterheft Jennifer , Dicks Nathan D , Bushey Jacob
Published: May 2015

This study aimed to examine the level of shooting accuracy demonstrated by law enforcement recruits upon completion of their law enforcement firearms training in comparison with novice shooters. One hundred and ninety-five male and 52 female law enforcement recruits volunteered. Participants were separated by firearms experience into the following groups: expert (completed law enforcement firearms course, n = 83), intermediate (recreational experience, n = 71) and novice (minimal/no experience, n = 93). All subjects were tested for accuracy at target locations from 3 to 75 ft. For all locations, no difference was found in accuracy between expert and intermediate groups ( p > 0.30). Experts and intermediates had better results than novices on all locations ( p < 0.05) except from 3 to 15 ft. Alarmingly, experts were only 10% more accurate than novices between 3 and 15 ft. Finally, novices and intermediate shooters were more likely to hit head locations from 3 ft (57%), whereas experts mainly hit the body location (78%). The results of this study indicate that officers had no advantage over intermediate shooters and a small advantage over novices.
Leadership and collaborative planning: The case of Surakarta, Indonesia
Authors: Fahmi Fikri Zul , Prawira Muhamad Ihsani , Hudalah Delik , Firman Tommy
Published: May 2015

This article examines the extent to which leadership factors contribute to the success of collaborative planning processes. By examining the best practice in urban management in decentralizing Indonesia, we found that leadership encouraged a trustworthy and effective consensus building between the local government and the communities. The local leaders grasped socio-cultural contexts of the city to formulate communication strategies in a way that encourages an open and informal atmosphere flourished. More importantly, this leadership framework effectively restructured the institutional arrangement and created divisible tasks for subordinates and communities who were involved in the collaborative process.
Glycated serum albumin stimulates expression of endothelial cell specific molecule-1 in human umbilical vein endothelial cells: Implication in diabetes mediated endothelial dysfunction
Authors: Nirala Bikesh K , Perumal Vivekanandan , Gohil Nivedita K
Published: May 2015

Pro-inflammatory conditions induced by products of protein glycation in diabetes substantially enhance the risk of endothelial dysfunction and related vascular complications. Endothelial cell specific molecule-1 (ESM-1) or endocan has been demonstrated as a potential biomarker in cancer and sepsis. Its role in diabetes-induced pathologies remains unknown. The expression of ESM-1 gene is under cytokine regulation, indicating its role in endothelium-dependent pathological disorders. In this study, we investigated the effect of advanced glycated human serum albumin (AGE-HSA) on the production of ESM-1. We show that AGE-HSA exerts a modulating role on the expression of ESM-1 in human umbilical vein endothelial cells. It up-regulates expression of ESM-1 protein in a dose-dependent manner which correlates with its messenger RNA (mRNA) transcription. RAGE and galectin-3, both AGE receptors, show antagonistic action on its expression. While gene silencing of RAGE has down-regulatory effect, that of galectin-3 has up-regulatory effect on AGE-induced expression of ESM-1. Inhibition of MAPKKK and JNK pathways did not alter the expression. In contrast, phosphatidylinositol 3 kinase (PI3K) inhibition significantly up-regulated ESM-1 expression. In conclusion, these results suggest that AGE-induced activation of human umbilical vein endothelial cells promotes formation of endocan which is an endothelial dysfunction marker and may be related to vascular disease in diabetes.
Completing the Remedial Sequence and College-Level Credit-Bearing Math
Authors: Davidson J. Cody
Published: May 2015

Mathematics is the most common subject area of remedial need and the majority of remedial math students never pass a college-level credit-bearing math class. The majorities of studies that investigate this phenomenon are conducted at community colleges and use some type of regression model; however, none have used a continuation ratio model. The purpose of this study was to assess student persistence through the remedial math sequence and successfully passing a college-level credit-bearing math course using binary, cumulative, and continuation ratio logistic regression models at 2- and 4-year public institutions. Findings showed the pre-algebra grade was the strongest predictor of completing each course in the remedial sequence and passing a college-level credit-bearing math class. Also, continuation ratio logistic regression provided methodological advantages over binary and cumulative logistic regression.
Secondary Traumatization in Mental Health Professionals
Authors: Baum Nehami
Published: May 2015

The issue of gender is largely ignored in studies of secondary traumatization (STS). This article addresses the question of gender differences in susceptibility to STS among clinicians who treat traumatized clients. It does so by systematically reviewing the very limited body of published findings on this subject to date. These are 10 published studies that measure STS by post-traumatic stress disorder (PTSD) symptomatology and 4 studies that measure it using Stamm’s Professionals Quality of Life Survey (ProQOL), which queries PTSD symptomatology along with other difficulties that may arise in helping traumatized clients. Almost all the studies based on PTSD symptomatology show greater female susceptibility. Although the pattern is less clear in the ProQOL studies, the article argues that the research to date does not really show mixed findings, as is repeatedly claimed, but greater susceptibility among female clinicians. It also points out that the findings do not mean that male clinicians are unaffected by their traumatized clients and notes the various manifestations of their distress reported in the reviewed studies. The article offers a variety of explanations for the heightened female susceptibility.
Childhood Maltreatment and Development of Substance Use Disorders
Authors: Edalati Hanie , Krank Marvin D.
Published: May 2015

Exposure to childhood maltreatment (CM) is associated with increased risk for developing substance use disorders (SUDs). CM exerts negative effects on cognitive abilities including intellectual performance, memory, attention, and executive function. Parallel cognitive impairments have been observed in SUDs. Hence, limited studies have examined the mediating effect of cognitive impairments in the relationship between CM and SUDs. In addition, most studies used concurrent self-report assessments in adult populations. Longitudinal studies that investigated the long-term consequences of CM on psychopathology, including SUDs, throughout childhood, adolescence, and adulthood are rare. Thus, the underlying developmental pathways between CM and SUDs are not clearly understood. In this article, we review the evidence that cognitive impairments mediate, at least in part, the relationship between CM and development of SUDs and propose a model that explains how CM increases the risk for SUDs through the development of a cognitive framework of vulnerability.
Neurovascular reconstruction with flow diverter stents for the treatment of 87 intracranial aneurysms: Clinical results
Authors: Giacomini Leonardo , Piske Ronie L , Baccin Carlos E , Barroso Marcelo , Joaquim Andrei F , Tedeschi Helder
Published: May 2015

Background

Flow diverter stents represent a new endovascular tool to treat complex aneurysms, such as giant, large, wide-necked and fusiform. The highly dense mash of these stents reduces inflow and outflow inside the aneurysm, resulting in intra aneurysmal thrombosis and stent endothelialization.

Objectives

To present the results of treatment of intracranial aneurysms with flow diverter stents in a single center.

Methods

Retrospective review of 77 patients with 87 aneurysms treated using two different types of flow diverter stent, the Pipeline Embolization Device and SILK stent, between October 2010 and September 2013 in an interventional neuroradiology center.

Results

Flow diverter stent placement was successful in 98% of the lesions and resulted in an immediate major stasis within most of the treated aneurysms. The overall aneurysm occlusion rate at six months and 18 months was 80% and 84% respectively. Symptomatic complications occurred in 11 patients (14.3%) with morbidity in eight (10.4%) and mortality in three patients (3.9%).

Conclusion

Flow diversion is a promising technique for treatment of challenging intracranial aneurysms with acceptable morbidity. A high rate of complete occlusion for small large necked aneurysms, a low morbidity and mortality rate and no recanalization encourage their use in these aneurysms. Further studies accessing long-term aneurysm occlusion and recanalization are required.
Risk factors for coil protrusion into the parent artery and associated thrombo-embolic events following unruptured cerebral aneurysm embolization
Authors: Ishihara Hideaki , Ishihara Shoichiro , Niimi Jun , Neki Hiroaki , Kakehi Yoshiaki , Uemiya Nahoko , Kohyama Shinya , Yamane Fumitaka
Published: May 2015

Objective

Advances in vascular reconstruction devices and coil technologies have made coil embolization a popular and effective strategy for treatment of relatively wide-neck cerebral aneurysms. However, coil protrusion occurs occasionally, and little is known about the frequency, the risk factors and the risk of thrombo-embolic complications.

Method

We assessed the frequency and the risk factors for coil protrusion in 330 unruptured aneurysm embolization cases, and examined the occurrence of cerebral infarction by diffusion-weighted magnetic resonance imaging (DW-MRI).

Result

Forty-four instances of coil protrusion were encountered during coil embolization (13.3% of cases), but incidence was reduced to 33 (10% of cases) by balloon press or insertion of the next coil. Coil protrusion occurred more frequently during the last phase of the procedure, and both a wide neck (large fundus to neck ratio) (OR = 1.84, P = 0.03) and an inadequately stable neck frame (OR = 5.49, P = 0.0007) increased protrusion risk. Coil protrusions did not increase the incidence of high-intensity lesions (infarcts) on DW-MRI (33.3% vs 29% of cases with no coil protrusion). However, longer operation time did increase infarct risk ( P = 0.0003). Thus, tail or loop type coil protrusion did not increase the risk of thrombo-embolic complications, if adequate blood flow was maintained.

Conclusion

Coil protrusion tended to occur more frequently in cases of wide-neck aneurysms with loose neck framing. Moderate and less coil protrusion carries no additional thrombo-embolic risk, if blood flow is maintained, which can be aided by additional post-operative antiplatelet therapy.
Rule of Law Lineages: Heroes, Coffins, and Custom
Authors: Rajah Jothie
Published: May 2015

What does rule of law look like from beyond an Anglo-American perspective? This Commentary excavates a subterranean strand of Singapore’s rule of law discourse – rule of law as the necessary subordination of ‘the people’ – to argue that colonial ideologies are inevitably perpetuated and revitalized when the postcolony adopts rule of law as a pillar of the nation-making project.
Need for Empirical Recognition
Authors: Strohminger Nina
Published: May 2015

The life-in-death theory makes empirical claims, and is therefore subject to empirical verification. Even if this theory were purely analytic or phenomenological, it would be accountable to countervailing empirical evidence. If we cannot use empirical evidence to support or refute this theory, then it cannot be compared with competing theories, which defer to observable reality.
Vitamin D in Foot and Ankle Fracture Healing
Authors: Bernhard Andrew , Matuk Jorge
Published: May 2015

Vitamin D is a generic name for a group of essential vitamins, or secosteroids, important in calcium homeostasis and bone metabolism. Specifically, efficacy of vitamin D with regard to bone healing is in question. A literature review was performed, finding mostly large studies involving vitamin D effects on prevention of fractures and randomized animal model studies consisting of controlled fractures with vitamin D interventions. The prevention articles generally focus on at-risk populations, including menopausal women and osteoporotic patients, and also most often include calcium in the treatment group. Few studies look at vitamin D specifically. The animal model studies often focus more on vitamin D supplementation; however the results are still largely inconclusive. While recent case reports appear promising, the ambiguity of results on the topic of fracture healing suggests a need for more, higher level research. A novel study design is proposed to help determine the efficacy on vitamin D in fracture healing.

Levels of Evidence: Therapeutic, Level IV: Systematic Review
Subpial Hematoma and Extravasation in the Interhemispheric Fissure with Subarachnoid Hemorrhage
Authors: Suzuki Kazufumi , Matsuoka Go , Abe Kayoko , Okada Yoshikazu , Sakai Shuji
Published: May 2015

A recent report on computed tomography (CT) findings of contrast extravasation in subarachnoid hemorrhage (SAH) with Sylvian hematoma suggests that the occurrence of the hematoma is secondary to bleeding in the subpial space. Our patient was in his sixties and was admitted to the hospital because of loss of consciousness (Glasgow Coma Scale E4V1M4). SAH was diagnosed in plain head CT, and growing hematomas were observed in the Sylvian and interhemispheric fissures following a subarachnoid hemorrhage. CT angiography (CTA) using a dual-phase scan protocol revealed contrast extravasation in both the fissures in the latter phase, and hematoma in the interhemispheric fissure contained multiple bleeding points. This case indicates that the occurrence of subpial hematoma such as Sylvian hematoma can be a secondary event following subpial bleeding from damaged small vessels elsewhere in the cranium. Instead of four-dimensional (4D) CT, the dual-phase CTA technique may help detect minor extravasations with usual helical CT scanner.
‘In it together’? The political consequences of perceived discommunions of interest in British politics
Authors: Allen Nicholas , Sarmiento-Mirwaldt Katja
Published: May 2015

The presence of shared interests between politicians and citizens is central to many accounts of political representation, yet there has been little empirical research into how citizens perceive these interests and whether they think a ‘communion of interests’ exists between them and their elected representatives. Using new survey data, this paper explores the extent to which Britons think their Members of Parliament share the same everyday experiences as they do. It further explores the relationship between these perceptions and indicators of specific and diffuse political support. We show that British citizens generally say that politicians are less affected by social and economic conditions and less reliant on public services than they are. The size of this perceived ‘discommunion’ affects voting behaviour and satisfaction with democracy.
Traumatic bifrontal extradural haematoma resulting from superior sagittal sinus injury: case report
Authors: Bimpis Alexios , Marcus Hani J , Wilson Mark H
Published: May 2015

Lesson

Traumatic bilateral extradural haematoma resulting from injury to the superior sagittal sinus is rare; in such cases, early surgical evacuation of the haematoma and control of bleeding from the sinus can achieve an excellent patient outcome.
Follow Them, Closely
Authors: Domingo David
Published: May 2015

The ability to gather millions of data snippets of social media interactions offers a fascinating glimpse of the dynamics of the (digital) public sphere, a wealth of data asking for interpretations. This article pleas researchers not to rely solely on algorithms, but to resort to ethnographic methods to follow the citizens behind the social media users.
Deceptively Simple: Unpacking the Notion of “Sharing”
Authors: Lampinen Airi
Published: May 2015

This essay approaches social media by addressing the deceptively simple notion of “sharing.” While “sharing” is central to how activities taking place on social media get discussed, the word does not necessarily help us get our analytical work about social media done. It is at risk of turning into one of those words that mean little because we try to make them mean too many things at once. While it remains relevant to address and analyze discourses surrounding the notion of “sharing,” it is important to be critical about them. Sharing is not a monolith. Sharing is diverse. Sharing serves the economic interests of big corporations. Perhaps most importantly, referring to activities as “sharing” is political and value-laden.
Social Media Governance
Authors: Flew Terry
Published: May 2015

This short article proposes an institutional framework for understanding questions of social media governance, based around the four axes of formal and informal institutions, national and supranational governance, public and private, and large-scale and smaller scale governance.
On Stickers and Communicative Fluidity in Social Media
Authors: Lim Sun Sun
Published: May 2015

Social media platforms provide the key affordance of “communicative fluidity”, where communication can be more seamless because of the multiple channels users can tap to express themselves. Besides just text therefore, users can communicate via photographs, videos, emoji, and stickers, on top of voice and video calls. The visual richness of social media enables users to make explicit feelings that cannot be articulated in words, while graphical representations such as stickers can lend messages an air of interpretability. Users can strategically and dynamically choose the best means by which to express their emotions, opinions, and intentions to attain communicative fluidity. However, the rigid scripting that underpins the vocabulary of social media can also compel users to communicate in ways that they find forced and inauthentic.
Which Social Media? A Call for Contextualization
Authors: Dahlberg Lincoln
Published: May 2015

This essay briefly reflects upon digital social media in the mid-1990s in order to encourage: first, investigation of pre-twenty first century social media, towards the identification of lessons and resources for present-day research, practice, policy, and activism; and, second, the discursive and socio-historical contextualization of today’s social media.
Mapped, Measured, and Mined: The Social Graph and Colonial Visuality
Authors: Shepherd Tamara
Published: May 2015

This manifesto argues that the social graph and its associated contemporary surveillance economies might be situated within a longstanding colonial tradition of harnessing visuality for control and profit.
Counting to Nowhere: Social Media Adoption and Use as an Opportunity for Public Scholarship and Engagement
Authors: Pearce Katy E.
Published: May 2015

Counting social media site users is popular yet fraught with challenges. Scholars can help illuminate public discussion of social media use. An open access journal like Social Media + Society provides a platform for scholarly public engagement. This essay highlights some of the challenges of understanding social media adoption and suggests opportunities for scholars to become part of public deliberation.
“Meaning” in Social Media
Authors: Lomborg Stine
Published: May 2015

Researchers of social media struggle to stay up to speed: empirical findings are most often very context- and time-specific and quickly become outdated because the object of study changes. By extension, previously solid and well-tested methods and tools may be rendered obsolete, for instance, as social media services change their application programming interfaces (APIs). The stabilizing component in social media research is arguably good theory—about the communicative patterns and bit trails of use, the actions that social media channel and mobilize, the interplay between social and other media, and, of course, the implications of social media for sociality, privacy, and society at large. In this essay, the concept and study of meaning is proposed as a key concern for social media research. “Meaning” highlights the generative process by which users negotiate the communicative potentials and constraints of a text or a medium vis-a-vis the individuals’ preexisting mental models, expectations, and intentions in context.
Polymedia and Ethnography: Understanding the Social in Social Media
Authors: Madianou Mirca
Published: May 2015

In this essay I argue that social media need to be understood as part of complex environments of communicative opportunities which I conceptualize as polymedia. This approach shifts our attention from social media as discrete platforms to the ways users navigate environments of affordances in order to manage their social relationships. Ethnography emerges as the most appropriate method to capture the relational dynamics that underpin social media practices within polymedia.
The Limits of Social Media: What Social Media Can Be, and What We Should Hope They Never Become
Authors: Srauy Sam
Published: May 2015

Social media are among many tools that people use to articulate culture. However, it must be remembered that social media are websites that afford community building regardless of the morality, social benefit, or social detriment of the communities that get built. At their core, social media sites are products created by their respective corporations with the intent of monetizing the labor of their users. The values that these sites might offer are dependent on the users and the users’ ability to claim some social benefit. In this regard, the author argues that social media can be beneficial spaces where society articulates and records culture “only if” users can maintain that use despite corporate actors’ efforts to monetize users’ labor.
Comparing to Prepare: Suggesting Ways to Study Social Media Today—and Tomorrow
Authors: Larsson Anders Olof
Published: May 2015

While the two currently most popular social media services – Twitter and Facebook – are different in terms of technical and end-user details, this paper suggests that a series of similarities can also be found regarding different modes of communication offered by both services. These modes are labeled as Broadcasting, Redistributing, Interacting and Acknowledging. The argument is put forward that such synthesis of communication modes across platform could prove useful for longitudinal and comparative research efforts.
Why I Joined Facebook and Still Regret It
Authors: Jordan Tim
Published: May 2015

This article argues for a particular understanding of identity and sociality in social media. While there is considerable insightful research about the sociality and subjectivity produced in social media, it is also important to see that such identity and sociality is about creating and maintaining public-private boundaries online that can be different to those divisions of public and private that are lived offline.
The Networked Democratic Spectator
Authors: Kreiss Daniel
Published: May 2015

In this brief essay, I argue that the idea of “social media” is symbolically powerful in the political domain precisely because political actors conflate it broadly with “social relations” and, even more, “public opinion.” To do so, I draw on two recent empirical studies I conducted that analyze social media and contemporary media events. These studies reveal that social media platforms provide unprecedented opportunities for people to participate in political discourse. I argue that political actors see the discourse on social media that develops around media events as a representation of public opinion (even though this is problematic as an empirical matter). I conclude by suggesting that especially at extraordinary moments, public narratives about social media articulate the normative democratic ideal that these platforms create a collective social space for, and public representation of, the “people.”
Social Media and Symbolic Violence
Authors: Recuero Raquel
Published: May 2015

On this essay, I briefly discuss by means of a few examples how social media is used to reproduce and legitimate violent discourses, focusing on the concept of symbolic violence.
My So-Called Social Media Life
Authors: Shade Leslie Regan
Published: May 2015

This short essay offers a personal reflection on social media and some of the challenges related to corporate ownership and policy issues of privacy and surveillance.
Games Are Social/Media(ted)/Technology Too . . .
Authors: O’Donnell Casey , Consalvo Mia
Published: May 2015

In this manifesto, we argue that social media research needs to take the broader field of game studies in the exploration and understanding of social media. Many of the results, theories, and concepts developed in the study of games has significant implications for the study of all social media. Of course, game studies should be paying attention to social media research too.
Social Media and the Struggle for Society
Authors: Baym Nancy K.
Published: May 2015

This piece argues that all communication media are inherently social. The term “social media” emerged at the time that companies began harnessing what people were already doing online, turning socializing into revenue streams for venture capitalists and the people who run internet companies. The paper critiques the conversion of social interaction into wealth for the few and argues that we need to fight for media that help build better societies rather than those that view people as data profiles to be sold to advertisers.
What Is the Impact of Online Training in Mind–Body Skills?
Authors: Kemper Kathi J. , Lynn Joanne , Mahan John D.
Published: May 2015

Background.

Mind–body skills (MBS) training is popular, but in-person training can be inconvenient and costly. We assessed the impact of online MBS training on clinicians’ and trainees’ stress, mindfulness, and confidence in providing calm, compassionate care.

Methods.

This was a prospective cohort trial. Trainees entering medical school; graduate programs in nursing, social work, and dietetics; and residencies in family medicine and pediatrics at a large Midwestern academic health center were invited to complete online surveys before and 12 weeks after enrolling in online elective integrative health courses on MBS training or not. The elective offered no course credit and had no mandated deadlines for completion.

Results.

At baseline, the 60 who engaged in MBS training were similar to the 43 who did not in terms of profession, gender, perceived stress levels, mindfulness, resilience, and compassion. MBS participants engaged in a median of 3 of 12 available modules with a bimodal distribution peaking at 1 to 2 and 12 modules. Twelve weeks later, those who participated in MBS showed significantly greater improvements in measures of stress, mindfulness, and confidence in providing calm, compassionate care than those who did not.

Conclusions.

Online elective training offers a feasible strategy to improve mindfulness, stress, and confidence in providing calm, compassionate care. Additional studies are needed to determine the impact of required versus elective courses, the optimal dosage and content of training, and the costs and benefits of online versus in-person training.
Arthroscopic Findings After Traumatic Shoulder Instability in Patients Older Than 35 Years
Authors: Robinson Elisabeth C. , Thangamani Vijay B. , Kuhn Michael A. , Ross Glen
Published: May 2015

Background:

Shoulder instability in the older patient traditionally has received less attention in the literature than in the younger patient population. However, when traumatic dislocation does occur, these patients often still have frequent pain, disability, and even continued instability.

Purpose:

To characterize the pathoanatomy of traumatic anterior shoulder instability in the older patient population and to discuss the correlating symptoms that ultimately led to operative treatment.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients with a history of an initial traumatic anterior shoulder instability event occurring after the age of 35 years who underwent arthroscopic surgical intervention were prospectively enrolled. Exclusion criteria included posterior instability, major fractures of the shoulder girdle, and multidirectional instability. All patients initially underwent a period of nonoperative rehabilitation. Operative treatment was performed if a patient continued to have pain and/or instability. Operative reports and arthroscopic pictures were reviewed for pathoanatomical findings.

Results:

A total of 27 patients (28 shoulders) met the inclusion criteria and were analyzed in this study (22 men and 5 women; mean age, 55 years; age range, 35-74 years). Surgical intervention was performed for recurrent instability in 7 patients, pain for 8 patients, and pain with instability for 13 patients. Arthroscopic findings demonstrated 18 rotator cuff tears (RCTs) (64.3%) and 18 Bankart lesions (64.3%). Nine patients had both an RCT combined with a Bankart lesion (32.1%). Three humeral avulsion of the glenohumeral ligament (HAGL) lesions (10.7%) and 2 anterior labral periosteal sleeve avulsion (ALPSA) lesions (7.1%) were found. All shoulders demonstrated Hill-Sachs lesions of various size and depth.

Conclusion:

Traumatic shoulder instability in the older patient may result in a wide array of pathologic findings as well as a diversity of clinical presentations. These findings suggest that the clinical diagnostician should maintain a high index of suspicion for RCT, Bankart lesions, and HAGL lesions in older patients who remain symptomatic after traumatic anterior shoulder instability.
Absorption mechanisms of Cu2+ on a biogenic bixbyite-like Mn2O3 produced by Bacillus CUA isolated from soil
Authors: Zhang Zhijun , Lai Jing , Yin Hui , Feng Xionghan , Tan Wenfeng , Liu Fan
Published: May 2015

Background

Although most reported biogenic Mn oxides are hexagonal birnessites, other types of biogenic Mn oxides also commonly occur in the environment. However, sorption characteristics and underlying mechanisms of the adsorption of heavy-metal ions on these biogenic Mn oxides are still rarely addressed. In this study, the sorption mechanisms of Cu(II) on a low valence biogenic Mn oxide, poorly crystallized bixbyite-like Mn2O3(α-Mn2O3), were investigated.

Results

The maximum adsorption capacity of Cu(II) onto this biogenic Mn oxide at pH 6.00 was 796 mmol/kg (0.45 mol Cu mol−1Mn). The complex structure of adsorbed Cu(II) was constrained using Cu extended X-ray absorption fine structure (EXAFS) analysis, combined with structural parameters of the biogenic Mn oxide with alternately arranged regular and distorted MnO6octahedra obtained through multiple-FEFF fitting of Mn EXAFS data. The sorbed Cu(II) was found to coordinate with the biogenic Mn oxide particle edges as inner-sphere complexes. At a relatively low Cu2+loading (233 mmol/kg, pH 6.00), Cu(II) adsorbed onto the biogenic Mn oxide with two types of coordinated complexes, i.e., (1) coordinated with one regular/distorted MnO6octahedron as a monodentate-mononuclear complex and (2) with two adjacent MnO6octahedra as a bidentate-binuclear complex. While, at a relatively high Cu2+loading (787 mmol/kg, pH 6.00), only one type of coordinated complex was constrained, the adsorbed Cu(II) coordinated with one regular/distorted MnO6octahedron as a monodentate-mononuclear complex.

Conclusions

This research extends further insight into the bacterial Mn(II) oxidation in the environment and serves as a good reference for understanding the interactions between metal ions and biogenic low valence Mn oxides, which are still poorly explored either theoretically or practically.
Central venous-to-arterial carbon dioxide difference as a prognostic tool in high-risk surgical patients
Authors: Robin Emmanuel , Futier Emmanuel , Pires Oscar , Fleyfel Maher , Tavernier Benoit , Lebuffe Gilles , Vallet Benoit
Published: May 2015

Introduction

The purpose of this study was to evaluate the clinical relevance of high values of central venous-to-arterial carbon dioxide difference (PCO2gap) in high-risk surgical patients admitted to a postoperative ICU. We hypothesized that PCO2gap could serve as a useful tool to identify patients still requiring hemodynamic optimization at ICU admission.

Methods

One hundred and fifteen patients were included in this prospective single-center observational study during a 1-year period. High-risk surgical inclusion criteria were adapted from Schoemaker and colleagues. Demographic and biological data, PCO2gap, central venous oxygen saturation, lactate level and postoperative complications were recorded for all patients at ICU admission, and 6 hours and 12 hours after admission.

Results

A total of 78 (68%) patients developed postoperative complications, of whom 54 (47%) developed organ failure. From admission to 12 hours after admission, there was a significant difference in mean PCO2gap (8.7 ± 2.8 mmHg versus 5.1 ± 2.6 mmHg;P = 0.001) and median lactate values (1.54 (1.1-3.2) mmol/l versus 1.06 (0.8-1.8) mmol/l;P = 0.003) between patients who developed postoperative complications and those who did not. These differences were maximal at admission to the ICU. At ICU admission, the area under the receiver operating characteristic curve for occurrence of postoperative complications was 0.86 for the PCO2gap compared to Sequential Organ Failure Assessment score (0.82), Simplified Acute Physiology Score II score (0.67), and lactate level (0.67). The threshold value for PCO2gap was 5.8 mmHg. Multivariate analysis showed that only a high PCO2gap and a high Sequential Organ Failure Assessment score were independently associated with the occurrence of postoperative complications. A high PCO2gap (≥6 mmHg) was associated with more organ failure, an increase in duration of mechanical ventilation and length of hospital stay.

Conclusion

A high PCO2gap at admission in the postoperative ICU was significantly associated with increased postoperative complications in high-risk surgical patients. If the increase in PCO2gap is secondary to tissue hypoperfusion then the PCO2gap might be a useful tool complementary to central venous oxygen saturation as a therapeutic target.
Cardiac Monitoring During Adjuvant Trastuzumab-Based Chemotherapy Among Older Patients With Breast Cancer
Authors: Chavez-MacGregor Mariana , Niu Jiangong , Zhang Ning , Elting Linda S. , Smith Benjamin D. , Banchs Jose , Hortobagyi Gabriel N. , Giordano Sharon H.
Published: May 2015

Purpose

Patients treated with adjuvant trastuzumab require adequate cardiac monitoring. We describe the patterns of cardiac monitoring and evaluate factors associated with adequate monitoring in a large population-based study of older patients with breast cancer.

Patients and Methods

Patients age 66 years or older with full Medicare coverage, diagnosed with stage I to III breast cancer between 2005 and 2009, and treated with adjuvant trastuzumab-based chemotherapy were identified in the SEER-Medicare and the Texas Cancer Registry-Medicare databases. The adequacy of cardiac monitoring was determined. Chemotherapy, trastuzumab use, cardiac monitoring, and comorbidities were identified by using International Classification of Diseases, 9th revision and Healthcare Common Procedure Coding System codes. Prescribing physician characteristics were also evaluated. Analyses included descriptive statistics and multilevel logistic regression models.

Results

In all, 2,203 patients were identified; median age was 72 years. Adequate monitoring was identified in only 36.0% of the patients (n = 793). In the multivariable model, factors associated with optimal cardiac monitoring included a more recent year of diagnosis (hazard ratio [HR], 1.83; 95% CI, 1.32 to 2.54), anthracycline use (HR, 1.39; 95% CI, 1.14 to 1.71), female prescribing physician (HR, 1.37; 95% CI, 1.10 to 1.70), and physician graduating after 1990 (HR, 1.66; 95% CI, 1.29 to 2.12). The presence of cardiac comorbidities was not a determinant for cardiac monitoring. Of the variance in the adequacy of cardiac monitoring, 15.3% was attributable to physician factors and 5.2% to measured patient factors.

Conclusion

A large proportion of patients had suboptimal cardiac monitoring. Physician characteristics had more influence than measured patient-level factors in the adequacy of cardiac monitoring. Because trastuzumab-related cardiotoxicity is reversible, efforts to improve the adequacy of cardiac monitoring are needed, particularly in vulnerable populations.
Yes—yet—hegel’s Oracle
Authors: Mendicino Kristina
Published: May 2015

This article proposes a reading of Hegel’s Phenomenology of Spirit as a translation project akin to that of Luther’s Bible and Voss’s Homer, following Hegel’s own placement of his work within this lineage of major Ger-man translations. Different from his predecessors, however, Hegel does not translate a canonical text from the Western tradition, but rather strives to translate a theological-philosophical language that does not yet exist. In this orientation toward a language that is not yet, his first major philosophical work—and translation project—is oracular in ways that have yet to be explored in Hegel scholarship. By attending closely to his explicit discussion of the oracle in the Phenomenology of Spirit, one of the most underexamined passages of the text, this article shows that Hegel’s book is. foremost, a prophecy of language that would speak against the overwhelming systematic tendency of his thought.
With Expressions We Traffic
Authors: Dennis Marissa Kantor
Published: May 2015

This piece is an interpretation of an interpretation of an interpretation. The setting is a clinical encounter between a Spanish-speaking patient, an English-speaking doctor, and a Spanish medical interpreter on the inpatient psychiatric floor of a New York–area hospital. The typesetting is also an interpretation: the piece is written in three columns to evoke some of the questions surrounding the practice of medical interpretation as well as the interpretation of literature and lived experience. By framing the clinical encounter in such a way, I hope to show the connections between language, interpretation, and desire, as well as their disconnects. The piece also questions the uninterpretable and asks, particularly with respect to psychosis: what does it mean to be situated somewhere outside of the bounds of interpretation?
In the Absence of Reliable Ghosts: Sexuality, Historiography, South Asia
Authors: Arondekar Anjali
Published: May 2015

Sexuality endures as an object of historical recovery through a poetics of melancholia, an irresolvable longing for loss that refuses all forms of consolation. My meditations call upon a historiography of sexuality in South Asia that pushes against the binding energies of such melancholic historicism. To fix sexuality primarily within such an arbitrary arsenal of loss (while politically exigent) is to refuse alternative histories of emergence. At its most ambitious, my essay ruminates instead on more imaginative histories of sexuality, full of intrepid archives and acts of invention. To do so, I engage the emergence of a Devadasi collectivity in Portuguese India and pose two broad and vulgar questions: What happens if we abandon the historical language of search and rescue and focus instead on sexuality as a site of radical abundance, even futurity? How do collectivities in South Asia wrestle with the evidentiary forms that such models of loss demand, and in doing so, how do they assemble historical archives that anticipate the compensatory gains that such losses should or will produce?
The influence of motion quality on responses towards video playback stimuli
Authors: Ware Emma , Saunders Daniel R. , Troje Nikolaus F.
Published: May 2015

Visual motion, a critical cue in communication, can be manipulated and studied using video playback methods. A primary concern for the video playback researcher is the degree to which objects presented on video appear natural to the non-human subject. Here we argue that the quality of motion cues on video, as determined by the video's image presentation rate (IPR), are of particular importance in determining a subject's social response behaviour. We present an experiment testing the effect of variations in IPR on pigeon (Columbia livia) response behaviour towards video images of courting opposite sex partners. Male and female pigeons were presented with three video playback stimuli, each containing a different social partner. Each stimulus was then modified to appear at one of three IPRs: 15, 30 or 60 progressive (p) frames per second. The results showed that courtship behaviour became significantly longer in duration as IPR increased. This finding implies that the IPR significantly affects the perceived quality of motion cues impacting social behaviour. In males we found that the duration of courtship also depended on the social partner viewed and that this effect interacted with the effects of IPR on behaviour. Specifically, the effect of social partner reached statistical significance only when the stimuli were displayed at 60 p, demonstrating the potential for erroneous results when insufficient IPRs are used. In addition to demonstrating the importance of IPR in video playback experiments, these findings help to highlight and describe the role of visual motion processing in communication behaviour.
Local homeoprotein diffusion can stabilize boundaries generated by graded positional cues
Authors: Quiñinao Cristóbal , Prochiantz Alain , Touboul Jonathan
Published: May 2015

Boundary formation in the developing neuroepithelium decides on the position and size of compartments in the adult nervous system. In this study, we start from the French Flag model proposed by Lewis Wolpert, in which boundaries are formed through the combination of morphogen diffusion and of thresholds in cell responses. In contemporary terms, a response is characterized by the expression of cell-autonomous transcription factors, very often of the homeoprotein family. Theoretical studies suggest that this sole mechanism results in the formation of boundaries of imprecise shapes and positions. Alan Turing, on the other hand, proposed a model whereby two morphogens that exhibit self-activation and reciprocal inhibition, and are uniformly distributed and diffuse at different rates lead to the formation of territories of unpredictable shapes and positions but with sharp boundaries (the ‘leopard spots’). Here, we have combined the two models and compared the stability of boundaries when the hypothesis of local homeoprotein intercellular diffusion is, or is not, introduced in the equations. We find that the addition of homeoprotein local diffusion leads to a dramatic stabilization of the positioning of the boundary, even when other parameters are significantly modified. This novel Turing/Wolpert combined model has thus important theoretical consequences for our understanding of the role of the intercellular diffusion of homeoproteins in the developmental robustness of and the changes that take place in the course of evolution.