bluuebunny/crossref_metadata_2025_split huggingface dataset:
Language is a ‘Beautiful Creature’, not an ‘Old Fridge’
Authors: Bogetić Ksenija 
Published: August 2017

Abstract
Direct metaphor has been widely studied from the cognitive perspective, but its functions in the communicative dimension (Steen, 2011) remain less well understood. This study investigates direct metaphor as a tool of metaphorical framing (Ottati et al., 2014; Ritchie & Cameron, 2014) in discourse, by examining a corpus of British newspaper texts on the topic of language and language change. The analysis of direct metaphors is sufficient to point to major ideologies of language and communication in the observed media context, which echo broader anxieties over social change, social organization and control. Most notably, unlike the meanings stressed in existing studies, the vast majority of direct metaphors are here found to serve the specific role of relational argumentation. This function is achieved through a kind of ‘corrective framing’, which explicitly juxtaposes two conflicting representations through an ‘A is B and not C’ type of metaphor. The findings are discussed with respect to deliberateness, metaphorical framing and rhetorical goals in discourse. It is hypothesized that corrective framing is among the major functions of direct metaphor in public discourse, which can influence public opinion in ways different from other metaphorically created representations.
From metaphor to allegory
Authors: Cornevin Vanessa , Forceville Charles 
Published: August 2017

AbstractAfuganisu-tanis an online manga by Timaking, published in English online in 2005, that presents selected historical events of modern Afghanistan in a series of 29 episodes plus an appendix. An episode consists of a four-panel micro-narrative in which Afghanistan and the countries with which its history is intertwined are consistently personified as young girls. Each manga episode is accompanied by a short, textual ‘memo’ describing historical events in a neutral, factual way. In this paper, we (1) propose that the extended personification of Afghanistan and other countries in this manga can be understood in terms of ‘allegory’; (2) sketch and evaluate how the manga part affects the construal of the country’s history; (3) consider some of the consequences of combining the manga part with memo text for the informative and educational value ofAfuganisu-tan.
Analysing metaphor in the family register through scripted sitcom conversations
Authors: Skorczynska Hanna , Giménez-Moreno Rosa 
Published: August 2017

AbstractThis study looks into the patterns of metaphor use in the family register of scripted sitcom conversations. Previous studies of metaphor in conversation adopted different approaches to the concept of register, resulting in a rich but complex picture (Cameron, 2003,2007,2008;Deignan, Littlemore & Semino, 2013;Kaal, 2012). This research attempts to reduce such complexity by using an approach to register based on closely defining communicative settings and the participants’ roles (Giménez-Moreno, 2006). In this way, we were able to focus on the register used by family members and close friends and the contexts of private oral communication, as opposed to other possible registers characteristic of professional conversations or those between friends. The study provides data on the frequency, typology, grammatical form and function of the metaphors used in the fictional dialogues between family members and close friends from two British sitcoms, “Gavin & Stacey” and “The Royle Family”. The findings, in general, confirm the patterns of metaphor use in naturally-occurring (UK) conversation, but show lower frequency ranges than other more purpose-oriented contexts. The main contribution of this study is the evaluation of metaphor as an ‘appraisal resource’ (Martin & White, 2005) and its frequent use in assessing the participants’ attitudes. The study suggests that defining register in terms of communicative setting and participants’ roles can help to provide comparable data on metaphor variation.
Comprehensive process model of clinical information interaction in primary care: results of a “best-fit” framework synthesis
Authors: Veinot Tiffany C , Senteio Charles R , Hanauer David , Lowery Julie C 
Published: August 2017

AbstractObjectiveTo describe a new, comprehensive process model of clinical information interaction in primary care (Clinical Information Interaction Model, or CIIM) based on a systematic synthesis of published research.Materials and MethodsWe used the “best fit” framework synthesis approach. Searches were performed in PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Library and Information Science Abstracts, Library, Information Science and Technology Abstracts, and Engineering Village. Two authors reviewed articles according to inclusion and exclusion criteria. Data abstraction and content analysis of 443 published papers were used to create a model in which every element was supported by empirical research.ResultsThe CIIM documents how primary care clinicians interact with information as they make point-of-care clinical decisions. The model highlights 3 major process components: (1) context, (2) activity (usual and contingent), and (3) influence. Usual activities include information processing, source-user interaction, information evaluation, selection of information, information use, clinical reasoning, and clinical decisions. Clinician characteristics, patient behaviors, and other professionals influence the process.DiscussionThe CIIM depicts the complete process of information interaction, enabling a grasp of relationships previously difficult to discern. The CIIM suggests potentially helpful functionality for clinical decision support systems (CDSSs) to support primary care, including a greater focus on information processing and use. The CIIM also documents the role of influence in clinical information interaction; influencers may affect the success of CDSS implementations.ConclusionThe CIIM offers a new framework for achieving CDSS workflow integration and new directions for CDSS design that can support the work of diverse primary care clinicians.
Magnetically advected winds
Authors: Contopoulos I. , Kazanas D. , Fukumura K. 
Published: August 2017

Abstract
Observations of X-ray absorption lines in magnetically driven disc winds around black hole binaries and active galactic nuclei yield a universal radial density profile ρ ∝ r−1.2 in the wind. This is in disagreement with the standard Blandford and Payne profile ρBP ∝ r−1.5 expected when the magnetic field is neither advected nor diffusing through the accretion disc. In order to account for this discrepancy, we establish a new paradigm for magnetically driven astrophysical winds according to which the large-scale ordered magnetic field that threads the disc is continuously generated by the Cosmic Battery around the inner edge of the disc and continuously diffuses outward. We obtain self-similar solutions of such magnetically advected winds (MAW) and discuss their observational ramifications.
Nasopharyngeal Pneumococcal Density Is Associated With Viral Activity but Not With Use of Improved Stoves Among Young Andean Children
Authors: Howard Leigh M , Fan Roger , Zhu Yuwei , Griffin Marie R , Edwards Kathryn M , Hartinger Stella , Williams John V , Vidal Jorge E , Klugman Keith P , Gil Ana I , Lanata Claudio F , Grijalva Carlos G 
Published: August 2017

AbstractBackgroundIndoor smoke exposure is common in developing countries and may influence nasopharyngeal (NP) pneumococcal colonization density and risk of acute respiratory illness. We compared colonization density among Andean children living in households previously enrolled in a randomized controlled trial of a home intervention package including improved stoves to reduce smoke, kitchen sinks, and water disinfection.MethodsWe enrolled 260 children aged &lt;3 years and made weekly household visits to assess for acute respiratory illness (ARI) and collect nasal swabs for respiratory virus polymerase chain reaction (PCR) testing during ARI. At monthly intervals, NP swabs were collected to determine pneumococcal colonization density through quantitative lytA PCR. We used linear quantile mixed-effects models to compare median log-transformed colonization densities among children in households randomized to the control (n = 129) versus intervention (n = 131) in sequential time points, accounting for random effects of multiple samples from individual children. Other covariates included age, sex, month, antibiotic exposure, and timing of sample collection relative to ARI with and without viral detection.ResultsAge and sociodemographic characteristics were similar between groups. Although no differences were observed in densities between groups, colonization density varied significantly over time in both groups, with highest densities coinciding with spring months. Time during and after virus-associated ARI was also associated with higher pneumococcal colonization density than time remote from ARIs.ConclusionsA home intervention package, including improved stoves, was not associated with changes in pneumococcal densities in young Andean children. However, increasing pneumococcal density was observed with spring season and viral-associated ARIs.
Transgender and Gender Nonconforming Patient Experiences at a Family Medicine Clinic
Authors: Hinrichs Amanda , Link Carrie , Seaquist Lea , Ehlinger Peek , Aldrin Stephanie , Pratt Rebekah 
Published: August 2017

Purpose
Transgender and gender nonconforming (TGNC) patients have a wide array of often negative experiences when accessing health care, and may encounter insensitive or subcompetent care; thus, the authors conducted a qualitative study with patients at one family medicine residency clinic to assess how primary care clinics can improve care for TGNC patients.

Method
In 2015, the authors held three separate focus groups at Smiley’s Family Medicine Clinic in Minneapolis, Minnesota. They invited diverse TGNC participants who have accessed TGNC-related and/or primary care at Smiley’s. The authors analyzed and coded data using a grounded theory approach with NVivo10 (QSR). The authors also administered short demographic questionnaires and analyzed the results with REDCap.

Results
Twenty-three patients participated in the focus groups, and 22 completed the survey. Gender identities among the participants were diverse. Four main themes emerged: (1) shared negative experiences with health care, (2) the need for sensitive and inclusive primary care, (3) defining TGNC-sensitive care, and (4) the challenges of mainstreaming TGNC-competent care into primary care settings.

Conclusions
Providing sensitive and competent primary care to TGNC patients involves allowing patients to self-identify, respecting the gender identities of every patient, and focusing on the whole person—not the trans status of the patient. Education and training on TGNC care at a clinic-wide level is needed.
The Road to Rural Primary Care: A Narrative Review of Factors That Help Develop, Recruit, and Retain Rural Primary Care Physicians
Authors: Parlier Anna Beth , Galvin Shelley L. , Thach Sarah , Kruidenier David , Fagan Ernest Blake 
Published: August 2017

Purpose
To examine the literature documenting successes in recruiting and retaining rural primary care physicians.

Method
The authors conducted a narrative review of literature on individual, educational, and professional characteristics and experiences that lead to recruitment and retention of rural primary care physicians. In May 2016, they searched MEDLINE, PubMed, CINAHL, ERIC, Web of Science, Google Scholar, the Grey Literature Report, and reference lists of included studies for literature published in or after 1990 in the United States, Canada, or Australia. The authors identified 83 articles meeting inclusion criteria. They synthesized results and developed a theoretical model that proposes how the findings interact and influence rural recruitment and retention.

Results
The authors’ proposed theoretical model suggests factors interact across multiple dimensions to facilitate the development of a rural physician identity. Rural upbringing, personal attributes, positive rural exposure, preparation for rural life and medicine, partner receptivity to rural living, financial incentives, integration into rural communities, and good work–life balance influence recruitment and retention. However, attending medical schools and/or residencies with a rural emphasis and participating in rural training may reflect, rather than produce, intention for rural practice.

Conclusions
Many factors enhance rural physician identity development and influence whether physicians enter, remain in, and thrive in rural practice. To help trainees and young physicians develop the professional identity of a rural physician, multifactorial medical training approaches aimed at encouraging long-term rural practice should focus on rural-specific clinical and nonclinical competencies while providing trainees with positive rural experiences.
A Long-term Follow-up of Young Adults With Idiopathic Clubfoot: Does Foot Morphology Relate to Pain?
Authors: Graf Adam N. , Kuo Ken N. , Kurapati Nikhil T. , Krzak Joseph J. , Hassani Sahar , Caudill Angela K. , Flanagan Ann , Harris Gerald F. , Smith Peter A. 
Published: August 2017

Background:
Individuals with clubfoot, treated in infancy with either the Ponseti method or comprehensive clubfoot release, often encounter pain as adults. Multiple studies have characterized residual deformity after Ponseti or surgical correction using physical exam, radiographs and pedobarography; however, the relationship between residual foot deformity and pain is not well defined. The purpose of the current study was 2-fold: (1) to evaluate the relationship between foot morphology and pain for young adults treated as infants for idiopathic clubfoot and (2) to describe and compare pedobarographic measures and outcome measures of pain and morphology among surgically treated, Ponseti treated, and typically developing feet.

Methods:
We performed a case-control study of individuals treated for clubfoot at 2 separate institutions with either the Ponseti method or comprehensive clubfoot release between 1983 and 1987. All subjects (24 treated with comprehensive clubfoot release, 18 with Ponseti method, and 48 controls) were evaluated using the International Clubfoot Study Group (ICFSG) morphology scoring, dynamic pedobarography, and foot function index surveys. During pedobarography, we collected the subarch angle and arch index as well as the center of pressure progression (COPP) on all subjects.

Results:
Foot morphology (ICFSG) scores were highly correlated with foot function index pain scores (r=0.43; P<0.001), although the difference in pain scores between the surgical and Ponseti group did not reach significance. The surgical group exhibited greater subarch angle and arch indexes than the Ponseti group, demonstrating a significant difference in morphology, a flatter foot. Finally, we found more abnormalities in foot progression, decreased COPP in the forefoot and increased COPP in the midfoot and hindfoot, in the surgical group compared with controls.

Conclusions:
Measures of foot morphology were correlated with pain among all treated for clubfoot. Compared with Ponseti method, comprehensive surgical release lead to greater long-term foot deformity, flatter feet and greater hindfoot loading time.

Level of Evidence:
Level III—Therapeutic.
Fat Graft and Bone Wax Interposition Provides Better Functional Outcomes and Lower Reossification Rates Than Extensor Digitorum Brevis After Calcaneonavicular Coalition Resection
Authors: Masquijo Javier , Allende Victoria , Torres-Gomez Armando , Dobbs Matthew B. 
Published: August 2017

Background:
Calcaneonavicular coalitions are the most common form of tarsal coalitions. The prefered treatment for symptomatic coalitions is surgical resection; however, there are no published studies that directly compare different interposition techniques. The purpose of the present study was to retrospectively compare pain relief, functional outcomes, and complications of children and adolescents who had a resection of a symptomatic calcaneonavicular coalition with interposition of fat graft, bone wax, or extensor digitorum brevis (EDB).

Methods:
In total, 48 patients (56 ft) underwent calcaneonavicular coalition resection-interposition at 3 institutions from July 2008 to July 2015. There were 23 feet in group 1 (fat graft), 18 feet in group 2 (bone wax), and 15 feet in group 3 (EDB). Patient demographic characteristics were similar between all groups for age, sex, coalition type, and symptoms onset. Data concerning clinical and radiographic features, surgical technique, and postoperative complications were obtained from all available medical records. Radiographs were evaluated at last follow-up to determine coalition regrowth. Preoperative and postoperative pain was assessed with the visual analog scale, and function was assessed with use of the American-Orthopaedic-Foot and Ankle Society (AOFAS) score.

Results:
Pain improved to an average of 0.5 in the first group (range, 0 to 6), 0 in group 2, and 1.7 in group 3 (range, 0 to 5) (P=0.033). The average AOFAS score improved from 59 (range, 33 to 71 points) to 98 points (range, 62 to 100 points) in the fat graft group, from 50 (range, 34 to 62 points) to 98 points (range, 88 to 100 points) in the bone wax group, and from 48 (range, 30 to 60 points) to 75 points (range, 70 to 95 points) in the EDB group (P<0.001). Eight feet had regrowth of the coalition on the postoperative radiographs: 1 in group 1 (4%), 1 in group 2 (6%), and 6 in group 3 (40%) (P=0.004). Five feet from the third group developed progressive symptoms.

Conclusions:
In our study, autogenous fat graft and bone wax interposition techniques provided better pain relief, gave better functional scores, and avoided more effectively coalition reossification than EDB technique. Further studies are required to evaluate safety of bone wax as an interposition material.

Level of Evidence:
Level III—therapeutic.
Redefining Optimal Nail to Medullary Canal Diameter Ratio in Stainless Steel Flexible Intramedullary Nailing of Pediatric Femur Fractures
Authors: Shaha James S. , Cage Jason M. , Black Sheena R. , Wimberly Robert L. , Shaha Steven H. , Riccio Anthony I. 
Published: August 2017

Purpose:
The ideal canal fill for flexible intramedullary fixation of pediatric femoral shaft fractures is considered to be 80% based upon relatively few clinical studies. The purpose of this study is to assess the relationship between the summed nail to intramedullary canal diameter (ND/MCD) ratio and alignment at radiographic union following flexible intramedullary nailing (FIMN) of pediatric femoral shaft fractures.

Methods:
An Internal Review Board approved, retrospective review of a consecutive series of patients who sustained a femoral shaft fracture treated by retrograde, stainless steel FIMN was performed at a single level 1 pediatric trauma center from 2005 to 2012. Preoperative radiographs were analyzed to determine fracture pattern, location, and isthmic canal diameter. ND/MCD ratio was calculated using the sum of the known nail diameters and the measured isthmic diameter. Radiographs at bony union were reviewed to measure shortening, coronal angulation, and sagittal angulation. ND/MCD ratio was analyzed to determine correlative factors with final radiographic outcomes.

Results:
In total, 261 children underwent retrograde FIMN at an average age of 8.2 years (range, 2.2 to 17.0 y). ND/MCD ratio of ≥80% was seen in 108 (41.4%) patients. When compared with those with <80% ND/MCD ratio, there were no significant differences in age (8.8 vs. 8.0 y), sex (76.9% vs. 71.0% males), or body mass index (18.5 vs. 17.2 kg/m2). There were significantly more length unstable fractures in the <80% ND/MCD ratio group (49.4% vs. 29.7%; P<0.01). Radiographic outcome was no different with respect to coronal angulation (2.7 vs. 3.0 degrees), sagittal angulation (3.0 vs. 3.2 degrees), or shortening (2.5 vs. 4.1 mm). ND/MCD ratio of ≥70% was seen in 176 (67.4%) patients and, when compared with the <70% ND/MCD ratio group, there were no differences in shortening (3.3 vs. 3.9 mm), coronal angulation (2.8 vs. 3.0 degrees), or sagittal angulation (3.0 vs. 3.4 degrees). Finally, 6.9% of the population (18 patients) had ND/MCD ratios <60% and did not demonstrate a significant increase in shortening, coronal, or sagittal angulation compared with groups with higher ND/MCD ratios. No group had an increased rate of infection, implant removal, nonunion, or need for reoperation.

Conclusions:
In a large series of consecutive patients treated with retrograde stainless steel FIMN there does not appear to be any correlation between the ND/MCD ratio and radiographic outcome. Stainless steel flexible IM nails seem to maintain fracture alignment without an increase in complications at lower ND/MCD ratios than previously reported as “optimal.”

Level of Evidence:
Level III.
Elastic Intramedullary Nailing Versus Open Reduction Internal Fixation of Pediatric Tibial Shaft Fractures
Authors: Pennock Andrew T. , Bastrom Tracey P. , Upasani Vidyadhar V. 
Published: August 2017

Background:
The optimal fixation strategy for unstable pediatric tibia fractures is unclear with some favoring elastic intramedullary nails (EIN) and others favoring plate and screws [open reduction internal fixation (ORIF)]. The purpose of this study was to compare outcomes and complications of skeletally immature patients undergoing surgical stabilization of the tibia with either EIN or ORIF.

Methods:
A retrospective review was performed on all patients undergoing EIN or ORIF of a diaphyseal fracture at a single pediatric level I trauma center between 2010 and 2016. Patients were included if they had open growth plates, no intra-articular or physeal involvement, and radiographic follow-up until union. Patient demographic, injury, radiographic, and surgical data were recorded. Outcome measures included achievement of union, time to healing, residual deformity, complications, need for additional procedures, and return to sport. Statistical analysis was performed with alpha set at P<0.05.

Results:
A total of 70 patients met inclusion, 44 underwent EIN and 26 underwent ORIF. There were no significant differences between demographics or injury variables between groups other than ORIF patients having more distal fractures (44% vs. 32%; P=0.006). At a mean follow-up of 1.4 years, 97% of fractures healed and there was no difference in healing rates between groups. The mean time to union was 15 weeks. ORIF patients had a shorter cast duration (7 vs. 10 wk; P<0.001), less angular deformities >5 degrees (15% vs. 41%; P=0.03), and lower rates of subsequent surgery (35% vs. 91%; P<0.001), but trended toward longer operating room times (69 vs. 59 min; P=0.06), and higher rates of wound complications (23% vs. 9%; P=0.10). Regardless of surgical technique, nearly all patients returned to full activities with no significant deficits.

Conclusions:
Surgical stabilization of unstable pediatric tibia fractures with ORIF or EIN constructs lead to predictable healing in the majority of patients. Complications can occur and differ based on surgical approach. ORIF led to more anatomic reductions and lower rates of second surgeries, but trended toward higher rates of wound-related complications and slightly longer operating room times.

Level of Evidence:
Level III—therapeutic study.