bluuebunny/crossref_metadata_2025_split huggingface dataset:
Démilitariser Gaza, sans plus : un piège ?
Authors: Bistolfi Robert 
Published: October 2014

Alors que les ruines de Gaza fument encore, un premier bilan politique montre qu’Israël n’a pas atteint ses objectifs et que la Hamas a conforté son autorité sur fond d’impuissance de l’Autorité palestinienne. Même si ses appuis occidentaux demeurent, Israël connaît une profonde détérioration de son image sur le plan international. Un aggiornamento de la politique israélienne n’est cependant pas à attendre. L’intervention à Gaza visait d’abord et surtout à empêcher le rapprochement inter-palestinien qui se dessinait. Cet objectif de division de l’adversaire demeure central pour un gouvernement israélien qui poursuit sa politique de colonisation et refuse la « solution à deux Etats ». Le second objectif qui en découle pour lui est de parvenir à tout prix à une démilitarisation de Gaza, et ce qu’il n’a pu obtenir par les armes sera maintenant recherché à travers une intervention internationale qui sécuriserait Israël sans qu’il ait à payer le prix politique de la paix. S’il est de plus en plus évident qu’une solution du conflit conforme au droit international ne pourra qu’être imposée par la « communauté internationale », il ne faudrait pas que cette intervention ait pour objectif premier, sinon pour but unique, de réduire la capacité de résistance du Hamas. En d’autres termes, toute action concernant Gaza devrait avoir pour pendant des pressions fortes sur Israël, touchant à la colonisation et à l’enclenchement d’un vrai processus de négociation en vue d’une paix juste.
Un adolescent seul n'existe pas
Authors: Cabrol Guy 
Published: October 2014

Ce texte propose une réflexion sur les présupposés d’une possible institution de la crise adolescente. Ces réflexions ont été mises à l’épreuve, durant 20 ans, dans mon expérience de psychanalyste sans divan, à travers les références de la psychothérapie institutionnelle et des théories de la groupalité. Les enjeux de la subjectivation sont, entre destructivité et créativité, imprégnés du fantasme masturbatoire central et du nécessaire meurtre des objets œdipiens, sans endommager ses objets internes. Comment résoudre ce paradoxe de finir sans en finir ? La crise adolescente est l’expression d’une tentative de solution de ce dilemme dans des changements catastrophiques qui traversent aussi l’institution familiale, car un adolescent, toujours "grand prématuré," seul, n’existe pas. Peut-on jamais en finir avec la part adolescente de la personnalité ?
Moduler sa connexion : les enseignants-chercheurs aux prises avec leur courriel
Authors: Chaulet Johann , Datchary Caroline 
Published: October 2014

Cet article se propose d’appréhender la façon dont les enseignants-chercheurs tentent de résister à la norme de connexion permanente, en prêtant attention aux dispositifs qui équipent l’activité, en particulier la messagerie électronique. Si l’outil n’est pas jugé négativement par tous, il est malgré tout possible de dire que, dans la quasi-totalité des situations investiguées, le courriel pose problème dans le sens où il génère au mieux un questionnement, au pire une situation douloureuse. Nous questionnons ici la tension permanente entre, d’un côté, la maîtrise et le sentiment de liberté que renforce cet outil, et de l’autre, la perte de contrôle, voire l’aliénation dont il semble responsable. Dans les faits, les usagers oscillent alors entre deux modalités de gestion de leur connexion : le cloisonnement équipé et l’hyperconnexion maîtrisée. Les résultats de cette enquête permettent de fournir des bases à une réflexion sur les formes contemporaines d’entretien du lien et les modulations de connexions toujours plus nombreuses et présentes.
Images du territoire des indiens pueblos en Amérique du nord
Authors: Warburg Aby , Muller Sibylle 
Published: October 2014

Résumé	Ce texte est un extrait de la conférence de Aby Warburg sur son voyage en Amérique, inédite et pour la première fois traduite en français. Nous tenons à remercier Jean Clay des Éditions Macula pour nous avoir aimablement autorisé à le reproduire en avant-première dans nos pages.
Differential Efficacy of Human Mesenchymal Stem Cells Based on Source of Origin
Authors: Collins Erin , Gu Fei , Qi Maosong , Molano Ivan , Ruiz Phillip , Sun Lingyun , Gilkeson Gary S. 
Published: October 2014

Abstract
Mesenchymal stem cells (MSCs) are useful in tissue repair but also possess immunomodulatory properties. Murine and uncontrolled human trials suggest efficacy of MSCs in treating lupus. Autologous cells are preferable; however, recent studies suggest that lupus-derived MSCs lack efficacy in treating disease. Thus, the optimum derivation of MSCs for use in lupus is unknown. It is also unknown which in vitro assays of MSC function predict in vivo efficacy. The objectives for this study were to provide insight into the optimum source of MSCs and to identify in vitro assays that predict in vivo efficacy. We derived MSCs from four umbilical cords, four healthy bone marrows (BMs), and four lupus BMs. In diseased MRL/lpr mice, MSCs from healthy BM and umbilical cords significantly decreased renal disease, whereas lupus BM MSCs only delayed disease. Current in vitro assays did not differentiate efficacy of the different MSCs. However, differences in MSC efficacy were observed in B cell proliferation assays. Our results suggest that autologous MSCs from lupus patients are not effective in treating disease. Furthermore, standard in vitro assays for MSC licensing are not predictive of in vivo efficacy, whereas inhibiting B cell proliferation appears to differentiate effective MSCs from ineffective MSCs.
Burnout and Physical Activity in Minnesota Internal Medicine Resident Physicians
Authors: Olson Shawn M. , Odo Nnaemeka U. , Duran Alisa M. , Pereira Anne G. , Mandel Jeffrey H. 
Published: October 2014

Abstract

Background
Regular physical activity plays an important role in the amelioration of several mental health disorders; however, its relationship with burnout has not yet been clarified.

Objective
To determine the association between achievement of national physical activity guidelines and burnout in internal medicine resident physicians.

Methods
A Web-based survey of internal medicine resident physicians at the University of Minnesota and Hennepin County Medical Center was conducted from September to October 2012. Survey measures included the Maslach Burnout Inventory-Human Services Survey and the International Physical Activity Questionnaire.

Results
Of 149 eligible residents, 76 (51.0%) completed surveys, which were used in the analysis. Burnout prevalence, determined by the Maslach Burnout Inventory, was 53.9% (41 of 76). Prevalence of failure to achieve US Department of Health and Human Services physical activity guidelines was 40.8% (31 of 76), and 78.9% (60 of 76) of residents reported that their level of physical activity has decreased since they began medical training. Residents who were able to meet physical activity guidelines were less likely to be burned out than their fellow residents (OR, 0.38, 95% CI 0.147–0.99).

Conclusions
Among internal medicine resident physicians, achievement of national physical activity guidelines appears to be inversely associated with burnout. Given the high national prevalence of burnout and inactivity, additional investigation of this relationship appears warranted.
What Makes a Great Resident Teacher? A Multicenter Survey of Medical Students Attending an Internal Medicine Conference
Authors: Melvin Lindsay , Kassam Zain , Burke Andrew , Wasi Parveen , Neary John 
Published: October 2014

Abstract

Background
Residents have a critical role in the education of medical students and have a unique teaching relationship because of their close proximity in professional development and opportunities for direct supervision. Although there is emerging literature on ways to prepare residents to be effective teachers, there is a paucity of data on what medical students believe are the attributes of successful resident teachers.

Objective
We sought to define the qualities and teaching techniques that learners interested in internal medicine value in resident teachers.

Methods
We created and administered a resident-as-teacher traits survey to senior medical students from 6 medical schools attending a resident-facilitated clinical conference at McMaster University. The survey collected data on student preferences of techniques employed by resident teachers and qualities of a successful resident teacher.

Results
Of 90 student participants, 80 (89%) responded. Respondents found the use of clinical examples (78%, 62 of 80) and repetition of core concepts (71%, 58 of 80) highly useful. In contrast, most respondents did not perceive giving feedback to residents, or receiving feedback from residents, was useful to their learning. With respect to resident qualities, respondents felt that a strong knowledge base (80%, 64 of 80) and tailoring teaching to the learner's level (83%, 66 of 80) was highly important. In contrast, high expectations on the part of resident supervisors were not valued.

Conclusions
This multicenter survey provides insight into the perceptions of medical students interested in internal medicine on the techniques and qualities that characterize successful resident teachers. The findings may be useful in the future development of resident-as-teacher curricula.
Restoring Emphasis on Ambulatory Internal Medicine Training—The 3∶1 Model
Authors: Harrison Joshua W. , Ramaiya Astha , Cronkright Peter 
Published: October 2014

Abstract

Background
Resident dissatisfaction in ambulatory care training has prompted the need for new scheduling models that support a positive learning climate.

Intervention
We instituted a 3∶1 scheduling model for postgraduate year (PGY)–2 and PGY-3 residents. We hypothesized this model would provide a more structured ambulatory educational atmosphere, better continuity of care, and more exposure to subspecialty outpatient medicine. This model would also eliminate conflict with inpatient duties and contribute to enhance residents′ satisfaction with ambulatory medicine and their ambulatory education experience. The model used weeklong ambulatory blocks every fourth week, consisting of morning continuity clinic and afternoon subspecialty clinics. The PGY-1 residents maintained a traditional schedule.

Results
Residents were surveyed regarding their ambulatory experience, with an overall response rate of 73 of 80 (91%). The PGY-2 and PGY-3 responses were analyzed descriptively and compared with PGY-1 responses. Residents reported that the 3∶1 model positively affected their satisfaction with residency training in general, their satisfaction with outpatient/primary care training, and their outpatient/clinic educational experience. Residents in the 3∶1 model perceived improvements in continuity of care and in the quality of care they provided for patients. The experience in ambulatory subspecialty training was positive.

Conclusions
A 3∶1 scheduling model appears to mitigate some of the conflict between inpatient and outpatient duties. Residents agreed the new model promoted an improved ambulatory experience.
Exploring Clinical Reasoning Strategies and Test-Taking Behaviors During Clinical Vignette Style Multiple-Choice Examinations: A Mixed Methods Study
Authors: Heist Brian Sanjay , Gonzalo Jed David , Durning Steven , Torre Dario , Elnicki David Michael 
Published: October 2014

Abstract

Background
Clinical vignette multiple-choice questions (MCQs) are widely used in medical education, but clinical reasoning (CR) strategies employed when approaching these questions have not been well described.

Objectives
The aims of the study were (1) to identify CR strategies and test-taking (TT) behaviors of physician trainees while solving clinical vignette MCQs; and (2) to examine the relationships between CR strategies and behaviors, and performance on a high-stakes clinical vignette MCQ examination.

Methods
Thirteen postgraduate year–1 level trainees completed 6 clinical vignette MCQs using a think-aloud protocol. Thematic analysis employing elements of grounded theory was performed on data transcriptions to identify CR strategies and TT behaviors. Participants' CR strategies and TT behaviors were then compared with their US Medical Licensing Examination Step 2 Clinical Knowledge scores.

Results
Twelve CR strategies and TT behaviors were identified. Individuals with low performance on Step 2 Clinical Knowledge demonstrated increased premature closure and increased faulty knowledge, and showed comparatively less ruling out of alternatives or admission of knowledge deficits. High performers on Step 2 Clinical Knowledge demonstrated increased ruling out of alternatives and admission of knowledge deficits, and less premature closure, faulty knowledge, or closure prior to reading the alternatives.

Conclusions
Different patterns of CR strategies and TT behaviors may be used by high and low performers during high-stakes clinical vignette MCQ examinations.
A Clinical Process Change and Educational Intervention to Reduce the Use of Unnecessary Preoperative Tests
Authors: Richards Sarah E. , Shiffermiller Jason F. , Wells Adam D. , May Sara M. , Chakraborty Subhankar , Caverzagie Kelly J. , Beachy Micah W. 
Published: October 2014

Abstract

Background
Internal medicine residents receive limited training on how to be good stewards of health care dollars while preserving high-quality care.

Intervention
We implemented a clinical process change and an educational intervention focused on the appropriate use of preoperative diagnostic testing by residents at a Veterans Administration (VA) medical center.

Methods
The clinical process change consisted of reducing routine ordering of preoperative tests in the absence of specific indications. Residents received a short didactic session, which included algorithms for determining the appropriate use of perioperative diagnostic testing. One outcome was the average cost savings on preoperative testing for a continuous cohort of patients referred for elective knee or hip surgery. Resident knowledge and confidence prior to and after the intervention was measured by pre- and posttest.

Results
The mean cost of preoperative testing decreased from $74 to $28 per patient after the dual intervention (P &lt; .001). The bulk of cost savings came from elimination of unnecessary blood and urine tests, as well as reduced numbers of electrocardiograms and chest radiographs. Among residents who completed the pretest and posttest, the mean score on the pretest was 54%, compared with 80% on the posttest (P  =  .027). Following the educational intervention, 70% of residents stated they felt “very comfortable” ordering appropriate preoperative testing (P  =  .006).

Conclusions
This initiative required few resources, and it simultaneously improved the educational experience for residents and reduced costs. Other institutions may be able to adopt or adapt this intervention to reduce unnecessary diagnostic expenditures.
Survey of Residents' Attitudes and Awareness Toward Teaching and Student Feedback
Authors: Tuck Keiran K. , Murchison Charles , Flores Christine , Kraakevik Jeff 
Published: October 2014

Abstract

Background
Teaching medical students is an important component of residency; however, little is known about student feedback regarding resident teaching skills.

Objective
We sought to explore resident awareness of medical student feedback mechanisms and how feedback is obtained, and also identified attitudes about teaching more commonly found in residents who seek feedback.

Methods
We surveyed all resident physicians at a university-affiliated academic health center about awareness of student feedback regarding their teaching abilities, and their attitudes related to teaching that may impact whether residents seek feedback.

Results
Of 605 residents, 335 (55%) responded, with 72% (242 of 335) noting they did not formally review student feedback of their teaching with their advisor during regularly scheduled meetings, 42% (140 of 332) reporting they did not know of any formal feedback mechanisms, and 28.4% (95 of 334) reporting they had not received feedback from students in any format. Although only a quarter of residents solicit feedback always or often, more than half would like feedback always or often. Reported barriers to feedback included student apprehension, time constraints, and lack of a formal system. A majority of residents had positive attitudes toward teaching and felt that student feedback would help teaching ability and medical proficiency.

Conclusions
A large percentage of residents at 1 teaching institution reported not receiving feedback from students on their teaching abilities. Residents who did receive feedback were more likely to have actively solicited it. Overall, residents believe that this feedback from students would benefit their clinical and teaching performance.
Learning to Sing Again: A Gay Widower’s Journey
Authors: Taylor Donald 
Published: October 2014

Abstract
The purpose of this article was to report the author’s journey through grief and healing via a gay men’s chorus following the death of his husband from congestive heart failure. Research questions in this study were: In what ways did joining a gay men’s chorus affect the author’s grieving process? and How did singing with a gay men’s chorus affect the author’s sense of identity? Data drawn from field notes, reflections on Facebook postings, and program archives were collected from January to August 2012, representing the time the author joined the chorus until the ensemble’s performance at the 2012 GALA Festival in Denver, Colorado, which hosted over 6,000 singers from 130 LGBTQ choruses. Findings emerged into three themes: vulnerability, awakening, and healing. Implications are provided for music educators directing community ensembles.
Engineering Efficient Retinal Pigment Epithelium Differentiation From Human Pluripotent Stem Cells
Authors: Lane Amelia , Philip Lissa Rachel , Ruban Ludmila , Fynes Kate , Smart Matthew , Carr Amanda , Mason Chris , Coffey Pete 
Published: October 2014

Abstract
Human embryonic stem cells (hESCs) are a promising source of retinal pigment epithelium (RPE) cells: cells that can be used for the treatment of common and incurable forms of blindness, such as age-related macular degeneration. Although most hESC lines will produce a number of clusters of pigmented RPE cells within 30–50 days when allowed to spontaneously differentiate, the timing and efficiency of differentiation is highly variable. This could prove problematic in the design of robust processes for the large scale production of RPE cells for cell therapy. In this study we sought to identify, quantify, and reduce the sources of variability in hESC-RPE differentiation. By monitoring the emergence of pigmented cells over time, we show how the cell line, passaging method, passage number, and seeding density have a significant and reproducible effect on the RPE yield. To counter this variability, we describe the production of RPE cells from two cell lines in feeder-free, density controlled conditions using single cell dissociation and seeding that is more amenable to scaled up production. The efficacy of small molecules in directing differentiation toward the RPE lineage was tested in two hESC lines with divergent RPE differentiation capacities. Neural induction by treatment with a bone morphogenetic protein inhibitor, dorsomorphin, significantly enhanced the RPE yield in one cell line but significantly reduce it in another, generating instead a Chx10 positive neural progenitor phenotype. This result underlines the necessity to tailor differentiation protocols to suit the innate properties of different cell lines.
Effects of Shock-Absorbing Insoles During Transition from Natural Grass to Artificial Turf in Young Soccer Players
Authors: Kaalund Søren , Madeleine Pascal 
Published: October 2014

BackgroundPlaying soccer on artificial turf can provoke pain in young players. Using shock-absorbing insoles (SAIs) can result in decreased pain perception. We sought to investigate the pain and comfort intensity experienced during the switch from natural grass to third-generation artificial turf and with the use of SAIs on artificial turf during training in young soccer players.MethodsIn a prospective randomized controlled study, 75 players were included from the youth teams of U15, U17, and U19. Pain intensity and comfort were assessed after training on only grass turf for 3 months. Randomization stratified by team level and age was performed; the intervention group received SAIs, and the control group used their own insoles. Assessments were repeated after 3 weeks on artificial turf (baseline) and 3 more weeks (follow-up) on artificial turf with SAIs/usual insoles.ResultsPain intensity increased and comfort decreased significantly after 3 weeks of training on artificial grass compared with natural grass (P &lt; .05). The addition of SAIs resulted in significantly reduced pain intensity compared with the usual insoles (P &lt; .05).ConclusionsThe switch to artificial turf is associated with less comfort and more pain during training in young soccer players. The use of SAIs led to lower pain intensity, highlighting a protective role of the insoles after 6 weeks of training on artificial turf.
Description of Total Population Hospital Admissions for Morton's Metatarsalgia in Australia
Authors: Naraghi Reza , Bryant Alan , Slack-Smith Linda 
Published: October 2014

BackgroundMorton's metatarsalgia is a painful perineural fibroma of a plantar nerve, most commonly of the second or third intermetatarsal spaces of the forefoot. The aim of this study was to investigate hospital admissions with a diagnosis of Morton's metatarsalgia in the Australian population from 1998 to 2008.MethodsData regarding admissions with a diagnosis code of ICD-10 G57.6 were extracted from the Australian Institute of Health and Welfare databases of hospital morbidity from 1998 to 2008. The event of interest was an admission with ICD-10 G57.6 (Morton's metatarsalgia). The explanatory variables included sex and age group. Rates were calculated using the estimated resident population counts to determine denominators.ResultsMorton's metatarsalgia admissions were almost three-fold higher for women in the population compared to men. The rate of admissions for Morton's metatarsalgia was the highest for the total population in the 55- to 59-year-old age group. Among women admitted for Morton's metatarsalgia, the highest rate was in the 50- to 54-year-old age group; among men, the highest rate was in the slightly older 55- to 59-year-old age category.ConclusionsPopulation-level information on admissions for Morton's metatarsalgia show that admissions were three times higher among women compared to men. The highest admission rate was in the 50- to 55-year-old age group.