bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preceptor engagement in distributed medical school campuses
Authors: Piggott Thomas , Morris Cathy , Lee-Poy Michael 
Published: April 2020

Background: There is increasing interest in distributed medical campuses and engagement of physicians in these communities. To date, there has been suboptimal recruitment of physicians to participate in medical education at distributed campuses. The purpose of this project was to identify barriers to engagement in medical education by community physicians in the geographical catchment of the Waterloo Regional Campus of McMaster.Method: In-depth, semi-structured, qualitative interviews were conducted with physicians not involved in teaching. Interview recordings were transcribed and analyzed using a closed-loop, iterative coding methodology and thematic analysis was performed. Interviews were conducted until thematic saturation was achieved.Results: Six interviews were conducted and coded. Nine key themes emerged: academic centre versus distributed sites, interest in teaching, financial considerations, administrative barriers, medical experience and knowledge currency, practice environment and schedule, training on teaching, setting up systems for learners in distributed campus settings, and student engagement and medical learner level.Conclusions: Barriers to engagement in teaching primarily focused on differences in job structure in the community, administrative barriers both at the hospital and through the medical school, and lack of knowledge on how to teach. As medical schools look to expand the capacity of distributed campuses, misperceptions should be addressed and opportunities to improve engagement should be further explored.
Exploring social media and admissions decision-making – friends or foes?
Authors: Law Marcus , Mylopoulos Maria , Veinot Paula , Miller Daniel , Hanson Mark 
Published: April 2020

Background: Despite the ever-increasing use of social media (e.g., Facebook, Twitter) little is known about its use in medical school admissions. This qualitative study explores whether and how social media (SM) is used in undergraduate admissions in Canada, and the attitudes of admissions personnel towards such use.Methods: Phone interviews were conducted with admissions deans and nominated admissions personnel. A qualitative descriptive analysis was performed using iterative coding and comparing, and grouping data into themes.Results: Personnel from 15 of 17 Canadian medical schools participated. A sizeable proportion had, at some point, examined social media (SM) profiles to acquire information on applicants. Participants did not report using it explicitly to screen all applicants (primary use); however, several did admit to looking at SM to follow up on preliminary indications of misbehaviour (secondary use). Participants articulated concerns, such as validity and equity, about using SM in admissions. Despite no schools having existing policy, participants expressed openness to future use. Conclusions: While some of the 15 schools had used SM to acquire information on applicants, criteria for formulating judgments were obscure, and participants expressed significant apprehension, based on concerns for fairness and validity. Findings suggest participant ambivalence and ongoing risks associated with “hidden” selection practices.
Orbital Refinement and Stellar Properties for the HD 9446, HD 43691, and HD 179079 Planetary Systems
Authors: Hill Michelle L. , Močnik Teo , Kane Stephen R. , Henry Gregory W. , Pepper Joshua , Hinkel Natalie R. , Dalba Paul A. , Fulton Benjamin J. , Stassun Keivan G. , Rosenthal Lee J. , Howard Andrew W. , Howell Steve B. , Everett Mark E. , Boyajian Tabetha S. , Fischer Debra A. , Rodriguez Joseph E. , Beatty Thomas G. , James David J. 
Published: April 2020

Abstract
The Transit Ephemeris Refinement and Monitoring Survey is a project that aims to detect transits of intermediate-long period planets by refining orbital parameters of the known radial velocity planets using additional data from ground-based telescopes, calculating a revised transit ephemeris for the planet, then monitoring the planet host star during the predicted transit window. Here we present the results from three systems that had high probabilities of transiting planets: HD 9446 b and c, HD 43691 b, and HD 179079 b. We provide new radial velocity (RV) measurements that are then used to improve the orbital solution for the known planets. We search the RV data for indications of additional planets in orbit and find that HD 9446 shows a strong linear trend of 4.8σ. Using the newly refined planet orbital solutions, which include a new best-fit solution for the orbital period of HD 9446 c, and an improved transit ephemerides, we found no evidence of transiting planets in the photometry for each system. Transits of HD 9446 b can be ruled out completely and transits HD 9446 c and HD 43691 b can be ruled out for impact parameters up to b = 0.5778 and b = 0.898, respectively, due to gaps in the photometry. A transit of HD 179079 b cannot be ruled out, however, due to the relatively small size of this planet compared to the large star and thus low signal to noise. We determine properties of the three host stars through spectroscopic analysis and find through photometric analysis that HD 9446 exhibits periodic variability.
Karst and Cave Systems in Bosnek Region (Vitosha Mountain, Bulgaria) and Wintimdouine (High Atlas Mountain, Morocco)
Authors: Angelova Dora , Beloul M'hamed Alaeddine , Bouzid Sophia , Faik Farid 
Published: April 2020

The study of both endokarstic systems Bosnek (Vitosha Mountain, Bulgaria) and Wintimdouine (High Atlas Mountain, Morocco) is presented in this work. Both regions are standard for the study of geodynamic processes in Bulgaria and Morocco, and they could be used as geodynamic polygons in the Mediterranean region. The karst is developed in Triassic and Jurassic limestones. The karst processes in both endokarstic systems occur under the conditions of active Quaternary and recent tectonics. A typical structural karst is formed. The present work shows also the results of the comprehensive studies performed in the field of geology, tectonics, geomorpholody, hydrology, climatology, etc., of the karst. It is accented on the genesis and the evolution of the greatest cave systems in Bulgaria (Duhlata cave – more than 17 km) and Morocco (Wintimdouine cave – more than 19 km long). Both cave systems are situated in zones with high seismicity, with open surface and sud-surfase paleoseismic disruptions. The karst study and monitoring of its processes has great practical value in Bulgaria and Morocco because they are related to one of the largest urbanized territories ( Pernik and Sofia for Bulgaria, and Agadir for Morocco) and they are protected natural objectives as well. V prispevku so predstavljene raziskave jamskih sistemov Bosnek (Vitoša, Bolgarija) in Wintimdouine (Visoki Atlas, Maroko). To sta standardni območji za preučevanje geodinamičnih procesov v Bolgariji in Maroku in bi lahko služili kot geodinamični poligon za celotno Sredozemlje. Tamkajšnji kras je razvit v triasnih in jurskih apnencih. V obeh jamskih sistemih potekajo kraški procesi pod vplivom aktivne kvartarne in recentne tektonike. Izoblikovan je značilni strukturni kras. V članku so predstavljeni tudi izsledki podrobnih preučevanj krasa na področju geologije, tektonike, geomorfologije, hidrologije, klimatologije, itd. Osredotočen je na največja jamska sistema v Bolgariji (preko 17 km dolga jama Duhlata) in Maroku (preko 19 km dolga jama Wintimdouine). Oba sistema sta v območju močne seizmičnosti z odprtimi površinskimi in podpovršinskimi paleoseizmičnimi razpokami. Preučevanje in redno opazovanje krasa in kraških procesov je za Bolgarijo in Maroko velikega praktičnega pomena, saj so vezana tako na največja urabnizirana ozemlja (Pernik in Sofija v Bolgariji, Agadir v Maroku), kot so to tudi zavarovani naravni pojavi.
Naselbinska imena v Tikveški regiji
Authors: Jačeva-Ulčar Elka 
Published: April 2020

V prispevku je s semantičnega in besedotvornega vidika analiziranih in
klasificiranih 140 naselbinskih imen Tikveške regije, večjega območja v srednjem Povardarju. Klasifikacija ojkonimov je narejena po tisti, ki jo je v svoji doktorski disertaciji z naslovom Toponomastikata na Ohridsko‑prespanskiot bazen (Toponomastika Ohridsko‑prespanskega bazena) predstavil Poljak Włodzimierz Pianka. Analiza je pokazala, da se v ojkonimih Tikveške regije ohranjajo geografski apelativi, fitonimi, zoonimi in osebna imena. Poseben tip ojkonimov predstavljajo tisti, ki so enaki stanovniškim imenom in patronimikom. Z besedotvornega vidika
so ojkonimi s tega območja pretežno nastali s toponimizacijo apelativov ali pa s sufiksalno substantivizacijo. Precejšen del ojkonimov je eliptičnih, manjše število je zloženk in večbesednih imen. Glede izvora je najvišji odstotek ojkonimov slovanskega izvora, manjši pa turškega, grškega ali romanskega.
On Contradictions: The Architecture of Women’s Resistance and Emancipation in Early twentieth-Century Iran
Authors: Ziaee Armaghan 
Published: April 2020

The public spaces in Iran’s built environment were gendered sites of domination and subordination, yet also terrains of resistance and emancipation. Tracing the massive western-oriented project of modernization of public spaces issued by the Shah of Iran, Reza Shah Pahlavi (1925-1941), this article contextualizes the gendered language used to advance modernization, and examines examples of women’s experiences in major cities including Tehran, Shiraz, Qazvin, Rasht, and Bushehr. During this period, modern architecture and planning movements in Iran mainly followed the discourse instigated by ciam [International Congresses of Modern Architecture]. Urban street plans with an orthogonal network of roads, streets, and wide boulevards were favored over the vernacular system of narrow, twisting, partly-roofed alleys, based on pedestrian movements. The modern movement also attempted to desegregate and “democratize” public spaces through gender desegregation, arguing that streets needed to be aesthetically-pleasing spaces where both men and women could walk and socialize in mixed-sex gatherings, a phenomenon that was not common in public spaces in the history of Iran. It should be noted that in 1936, Reza Shah promulgated a ban on the use of the chador (the traditional Iranian veil) in public places, in favor of Western women’s fashion, i.e., European hats, coats, and gloves. Due to this ban, some women, particularly those from conservative, religious, lower-class backgrounds, resisted using public spaces and streets. In older neighborhoods, where houses were attached to each other, these women used the rooftops as gathering spaces and as a form of pedestrian pathway. Others, mainly elite, urban, upper-class women, accepted and appreciated the desegregated spatial practices, using them to free themselves from social and cultural taboos. Building on postcolonial and transnational feminist theories, including those of Chandra Talpade Mohanty (1984) and Inderpal Grewal and Caren Kaplan (1994), which critique modernity and modernization and emphasize the diversity of women’s experiences and the importance of contextualizing them, this article addresses how, in a political climate of enormous contradictions, architectures were (re)configured and (re)appropriated as physical tools of resistance against the coloniality of modernization of the built environment and state power for one group of women, yet simultaneously, were (re)envisioned as an apparatus of confrontation with cultural traditionalism and patriarchal ideologies for another group of women.
Patients’ Recollections of Therapeutic Paralysis in the Intensive Care Unit
Authors: Ballard Nancy , Robley Lois , Barrett Darcy , Fraser Danielle , Mendoza Inocencia 
Published: April 2020

• Background Neuromuscular blocking agents used for therapeutic purposes, such as facilitating mechanical ventilation and relieving life-threatening agitation, paralyze patients but leave them fully conscious. Aggressive sedation or analgesia is necessary to reduce awareness, relieve fear, produce comfort, decrease anxiety, induce unconsciousness, and minimize possible complications such as posttraumatic stress syndrome. Little information is available on the extent to which patients experience awareness during therapeutic paralysis.• Objectives To determine and describe the remembered experiences of critical care patients who were given neuromuscular blocking agents and sedatives and/or analgesics to facilitate mechanical ventilation, improve hemodynamic stability, and improve oxygenation.• Methods A phenomenological approach with in-depth interviews with 11 patients was used. Data were analyzed by using the constant comparative approach.• Results A total of 4 themes and 3 subthemes were identified. The first theme was back and forth between reality and the unreal, between life and death; the subtheme was having weird dreams. The second theme was loss of control; the 2 subthemes were (1) fighting or being tied down and (2) being scared. The third theme was almost dying, and the fourth theme was feeling cared for.• Conclusions Patients can remember having both negative and positive experiences during neuromuscular blockade. Steps to improve the experiences of patients receiving neuromuscular blockers include improving assessment parameters, developing and using sedation/analgesia guidelines, and investing in quality improvement programs to provide assessment of awareness during therapeutic paralysis and follow-up and referral as necessary. Ways to decrease the use of neuromuscular blockers would also be useful.
Clinical Comparison of Automatic, Noninvasive Measurements of Blood Pressure in the Forearm and Upper Arm With the Patient Supine or With the Head of the Bed Raised 45°: A Follow-Up Study
Authors: Schell Kathleen , Lyons Denise , Bradley Elisabeth , Bucher Linda , Seckel Maureen , Wakai Sandra , Carson Elizabeth , Waterhouse Julie , Chichester Melanie , Bartell Deborah , Foraker Theresa , Simpson E. Kathleen 
Published: April 2020

• Background Noninvasive measurement of blood pressure in the forearm is used when the upper arm is inaccessible and/or when available blood pressure cuffs do not fit a patient’s arm. Evidence supporting this practice is limited.
• Objective To compare noninvasive measurements of blood pressure in the forearm and upper arm of medical-surgical inpatients positioned supine and with the head of the bed raised 45°.
• Methods Cuff size was selected on the basis of forearm and upper arm circumference and manufacturers’ recommendations. With a Welch Allyn Vital Signs 420 Series monitor, blood pressures were measured in the forearm and then in the upper arm of 221 supine patients with their arms resting at their sides. Patients were repositioned with the head of the bed elevated 45° and after 2 minutes, blood pressures were measured in the upper arm and then the forearm. Starting position was alternated on subsequent subjects.
• ResultsPaired t tests revealed significant differences between systolic and diastolic blood pressures measured in the upper arm and forearm with patients supine and with the head of the bed elevated 45°. The Bland-Altman procedure revealed that the distances between the mean values and the limits of agreement were from 15 to 33 mm Hg for individual subjects.
• Conclusions Noninvasive measurements of blood pressure in the forearm and upper arm cannot be interchanged in medical-surgical patients who are supine or in patients with the head of the bed elevated 45°.
Validation of the Critical-Care Pain Observation Tool in Adult Patients
Authors: Gélinas Céline , Fillion Lise , Puntillo Kathleen A. , Viens Chantal , Fortier Martine 
Published: April 2020

• Background Little research has been conducted to validate pain assessment tools in critical care, especially for patients who cannot communicate verbally.• Objective To validate the Critical-Care Pain Observation Tool.• Methods A total of 105 cardiac surgery patients in the intensive care unit, recruited in a cardiology health center in Quebec, Canada, participated in the study. Following surgery, 33 of the 105 were evaluated while unconscious and intubated and 99 while conscious and intubated; all 105 were evaluated after extubation. For each of the 3 testing periods, patients were evaluated by using the Critical-Care Pain Observation Tool at rest, during a nociceptive procedure (positioning), and 20 minutes after the procedure, for a total of 9 assessments. Each patient’s self-report of pain was obtained while the patient was conscious and intubated and after extubation.• Results The reliability and validity of the Critical-Care Pain Observation Tool were acceptable. Interrater reliability was supported by moderate to high weighted κ coefficients. For criterion validity, significant associations were found between the patients’ self-reports of pain and the scores on the Critical-Care Pain Observation Tool. Discriminant validity was supported by higher scores during positioning (a nociceptive procedure) versus at rest.• Conclusions The Critical-Care Pain Observation Tool showed that no matter their level of consciousness, critically ill adult patients react to a noxious stimulus by expressing different behaviors that may be associated with pain. Therefore, the tool could be used to assess the effect of various measures for the management of pain.
Psychosocial Issues for Patients with Ventricular Assist Devices: A Qualitative Pilot Study
Authors: Chapman Elizabeth , Parameshwar Jayan , Jenkins David , Large Stephen , Tsui Steven 
Published: April 2020

• Background Surgical implantation of a ventricular assist device is being used increasingly in patients in the United Kingdom, yet few studies have focused on patients’ experiences from a phenomenological (psychological) perspective.
• Objective To explore, through a pilot study, the impact of implantation of a ventricular assist device on patients’ bodies and lives.
• Methods This qualitative retrospective study included 6 patients (4 men and 2 women) and 3 of these patients’ relatives. Patients were from 17 to 50 years old and had used Thoratec, Heartmate, or VentrAssist devices.
• Results The participants’ accounts clustered around a number of themes, 2 of which are reported here: (1) body and self and (2) trust. Each theme comprised several subthemes: body and self had sub-themes of shock, restrictions, scarring, and infection; trust had subthemes of keeping me alive, device failure, and confidence.
• Conclusions The ventricular assist device has a considerable effect on a patient’s body and sense of self. This effect is often accommodated without much difficulty, but some patients and their families need additional psychological support during and after use of a ventricular assist device. Assessment before implantation of such a device can sometimes reveal this need, but such assessment may not be possible in emergency procedures. Trusting the new heart or the native recovered heart may be difficult for some patients. Further research is needed to understand this phenomenon.
PANDEMIE E VIRUS EMERGENTI: NUOVE SFIDE E ANTICHE PAURE
Authors: Maga Giovanni 
Published: April 2020

The epidemics of AIDS, SARS, avian flu, MERS-CoV and SARS-CoV2 are examples of viral infections which, starting from local outbreaks, spread in many different countries or even became pandemics. Reports of novel viruses emerging from remote areas of the world and able to infect the human population, are not anymore confined to medical bulletins, but are being found everyday in newspapers and public media. This, because it is now well understood that every outbreak, small and remote it may be, can rapidly evolve into a worldwide health emergency. Dealing with such situations requires high forecasting ability starting from the available data and deep knowledge of the many factors influencing the spread of a viral outbreak. In turn, such ability stems from the study of the life cycle and pathogenetic mechanisms of the viruses. Understanding the biology of viruses and the relationships between emerging viral pathogens and the anthropic influences on the environment is the key to develop new drugs and vaccines, but also to genetically manipulate viruses for gene therapy applications.
Flood trends in Europe: are changes in small and big floods different?
Authors: Bertola Miriam , Viglione Alberto , Lun David , Hall Julia , Blöschl Günter 
Published: April 2020

Abstract. Recent studies have revealed evidence of trends in the median or mean flood discharge in Europe over the last 5 decades, with clear and coherent
regional patterns. The aim of this study is to assess whether trends in flood discharges also occurred for larger return periods, accounting for
the effect of catchment scale. We analyse 2370 flood discharge records, selected from a newly available pan-European flood database, with record
length of at least 40 years over the period 1960–2010 and with contributing catchment area ranging from 5 to 100 000 km2. To estimate
regional flood trends, we use a non-stationary regional flood frequency approach consisting of a regional Gumbel distribution, whose median and
growth factor can vary in time with different strengths for different catchment sizes. A Bayesian Markov chain Monte Carlo (MCMC) approach is used
for parameter estimation. We quantify regional trends (and the related sample uncertainties), for floods of selected return periods and for
selected catchment areas, across Europe and for three regions where coherent flood trends have been identified in previous studies. Results show
that in northwestern Europe the trends in flood magnitude are generally positive. In small catchments (up to 100 km2), the 100-year flood
increases more than the median flood, while the opposite is observed in medium and large catchments, where even some negative trends appear,
especially in northwestern France. In southern Europe flood trends are generally negative. The 100-year flood decreases less than the median flood,
and, in the small catchments, the median flood decreases less compared to the large catchments. In eastern Europe the regional trends are negative
and do not depend on the return period, but catchment area plays a substantial role: the larger the catchment, the more negative the trend.
Gender, Race, and Nation in Tableau Representing Great Britain and Her Colonies
Authors: Contogouris Ersy 
Published: April 2020

Le 15 février 1900 avait lieu à Dawson au Yukon un concert bénéfice pour venir en aide aux familles de soldats canadiens morts pendant la Guerre d’Afrique du Sud. Pendant ce concert fut présenté un tableau vivant mettant en scène environ trente-cinq femmes, hommes et enfants, costumés et en blackface, qui incarnaient la Grande-Bretagne et ses colonies. Cet article propose une première lecture détaillée de ce tableau vivant pris en photo par le duo de photographes Larss et Duclos. L’analyse de ce double objet d’étude (le tableau vivant et la photo du tableau vivant) démontre que ce qui peut paraître à première vue comme une représentation anodine et quelque peu excentrique d’une performance amateure au Yukon au tournant du XXe siècle se révèle au contraire comme un marqueur et un vecteur des processus liés de la colonisation du nord-ouest du Canada et de la construction nationale du jeune pays, et que les femmes jouèrent un rôle central dans ces processus liés.