bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Rural Physician Associate Program: The Value of Immersion Learning for Third‐Year Medical Students
Authors: Zink Therese , Halaas Gwen W. , Finstad Deborah , Brooks Kathleen D. 
Published: September 2008

ABSTRACT:
Context: Changes in health care and new theories of learning have prompted significant changes in medical education. Some US medical schools employ immersion learning in rural communities to increase the number of physicians who choose to practice in these areas. Founded in 1971, the rural physician associate program (RPAP) is a longitudinal immersion learning experience for students during their third year of medical school. Students are assigned to a primary care preceptor(s) in a rural community ranging in population from 1,000 to 30,000 for 36 weeks. Purpose: To describe students' perceived value of this immersion learning experience. Methods: Data from 3 classes (2004, 2005, 2006) of students (n = 95) were analyzed, including final essays that reflect on their experiences and logs of their patient encounters and procedures. Themes from students' essays related to the hands‐on learning experience are presented. Frequencies of ambulatory encounters and procedures were calculated and compared with those of metropolitan area colleagues where possible. Findings: The continuity experience allows for one‐to‐one mentoring and long‐term relationships. Students see physicians, clinic/hospital staff, and patients as their teachers. The environment is nurturing, but nudges them outside their comfort zone. Students gain increasing competence with their skills and do best if they are independent and seek out learning opportunities. They report more hands‐on experience, more confidence and autonomy than their peers in the metropolitan area. Conclusions: The RPAP experience provides a nurturing, longitudinal, immersion learning experience that facilitates the gradual but steady development of clinical skills alongside a personal and professional mentor.
The Physician Pipeline to Rural and Underserved Areas in Pennsylvania
Authors: Schwartz Myron R. 
Published: September 2008

ABSTRACT:
Context: An implicit objective of a state's investments in medical education is to promote in‐state practice of state educated physicians. Purpose: To present a tool for evaluating this objective by analyzing the “pipeline” from medical education to patient care, primary care, rural areas, and underserved areas in Pennsylvania. Methods: AMA Masterfile data (2004) including all physicians with a Pennsylvania address or who received medical education in Pennsylvania were analyzed. These data were combined with local physician supply data. Results: About 36% of Pennsylvania medical school graduates provide patient care in the Commonwealth, 16% primary care, 7% rural care, 4% rural primary care, and 0.5% primary care in a rural underserved area. Fifty‐four percent of physicians who received both undergraduate and graduate medical education in‐state are retained. Conclusions: These retention rates have developed within the context of a middle‐of‐the‐road educational pipeline policy. If Pennsylvania policy makers consider that further pipeline development is advisable, there is room to amend current policy to that end. Conditions are favorable for other states to consider similar policy amendments.
Access to Cancer Services for Rural Colorectal Cancer Patients
Authors: Baldwin Laura‐Mae , Cai Yong , Larson Eric H. , Dobie Sharon A. , Wright George E. , Goodman David C. , Matthews Barbara , Hart L. Gary 
Published: September 2008

ABSTRACT:
Context: Cancer care requires specialty surgical and medical resources that are less likely to be found in rural areas. Purpose: To examine the travel patterns and distances of rural and urban colorectal cancer (CRC) patients to 3 types of specialty cancer care services—surgery, medical oncology consultation, and radiation oncology consultation. Methods: Descriptive cross‐sectional study using linked Surveillance, Epidemiology, and End Results (SEER) cancer registry and Medicare claims data for 27,143 individuals ages 66 and older diagnosed with stages I through III CRC between 1992 and 1996. Findings: Over 90% of rural CRC patients lived within 30 miles of a surgical hospital offering CRC surgery, but less than 50% of CRC patients living in small and isolated small rural areas had a medical or radiation oncologist within 30 miles. Rural CRC patients who traveled outside their geographic areas for their cancer care often went great distances. The median distance traveled by rural cancer patients who traveled to urban cancer care providers was 47.8 miles or more. A substantial proportion (between 19.4% and 26.0%) of all rural patients bypassed their closest medical and radiation oncology services by at least 30 miles. Conclusions: Rural CRC patients often travel long distances for their CRC care, with potential associated burdens of time, cost, and discomfort. Better understanding of whether this travel investment is paid off in improved quality of care would help rural cancer patients, most of whom are elderly, make informed decisions about how to use their resources during their cancer treatment.
Impact of Critical Access Hospital Conversion on Beneficiary Liability
Authors: Gilman Boyd H. 
Published: September 2008

ABSTRACT:
Context: While the Medicare Critical Access Hospital (CAH) program has improved the financial viability of small rural hospitals and enhanced access to care in rural communities, the program puts beneficiaries at risk for paying a larger share of the cost of services covered under the Medicare part B benefit. Purpose: This paper examines the impact of hospital conversion to CAH status on beneficiary out‐of‐pocket coinsurance payments for hospital outpatient services. Methods: The study is based on a retrospective observational design using administrative data from Medicare hospital cost reports and fee‐for‐service beneficiary claims from 1999 to 2003. The study compares changes in beneficiary co‐payments before versus after CAH conversion with payment trends among small rural non‐converting hospitals over the same period. Findings: Conversion to CAH status is associated with an increase in beneficiary coinsurance payments per outpatient visit of $17.19, equivalent to 34% of the sample average. However, CAH designation had no significant effect on the share of outpatient costs paid by the beneficiary. Most of the increase in beneficiary liability associated with conversion is attributable to the provision of more services per outpatient visit. Conclusions: While this and other studies show that conversion to CAH status results in more intensive outpatient care, CAH conversion does not appear to inadvertently create financial barriers to accessing ambulatory services in remote rural communities by forcing beneficiaries to pay a higher share of their Medicare part B costs.
Spontaneous reversion of complete A‐V block to sinus rhythm in the dog
Authors: DEAR M. G. 
Published: September 2008

ABSTRACTA case of complete atrioventricular block in a dog is reported. Emphasis is placed upon the spontaneous reversion of the dysrhythmia to sinus rhythm. The clinical veterinary literature on complete block is reviewed with particular reference to the incidence of the condition, the aetiology of complete block, the aetiology of Stokes—Adams attacks, the clinical features of the latter and the nature of the block, whether acquired or congenital. Comparative features with the human analogue of the dysrhythmia are discussed.Résumé.On rapporte le cas d'un bloc atrio‐ventriculaire complet chez un chien. On souligne la reversion spontanée de la dysrythmie en rythme sinusal. La littérature vétérinaire clinique sur le bloc complet du ceur est passée en révue et on souligne particulièrement la fréquence relative de cet état, l'étiologie du bloc complet et celle des accès de Stokes—Adams. Le tableau clinique de ce dernier syndrome et la nature du bloc atrioventriculaire acquis ou congénital sont décrits. On discute les analogies entre Ie cas de dysrythmie présenté ici et l'affection analogue dans l'espèce humaine.Zusammenfassung.Es wird über einen Fall von vollständigem atrioventrikularem Block bei einem Hund berichtet. Hervorgehoben wird die spontane Rückkehr von der Dysrhythmie zum Sinusrhythmus. Die tierärztliche klinische Literatur über den vollständigen Block wird besonders hinsichtlich der Häufigkeit des Zustands, der Ätiologie des vollständigen Blocks, der Ätiologie der Stokes—Adams‐Anfälle, ihrer klinischen Merkmale und des Charakters des Blocks, ob erworben oder kongenital, betrachtet. Vergleichbare Merkmale der analogen Dysrhythmie beim Menschen werden besprochen.
An unusual combination of congenital cardiac anomalies in a cat
Authors: DEAR M. G. 
Published: September 2008

ABSTRACTA case of a congenital cardiac anomaly in a cat is described. The anomaly includes a patent ductus arteriosus, an interatrial septal defect, an interventricular septal defect and tricuspid insufficiency. An umbilical hernia was present also. Emphasis is placed on the relationship of the auscultatory, radiographic and electrocardiographic features and the pathological findings.Résumé. On décrit un cas d'anomalie cardiaque congénitale chez un chat; cette anomalie comprenait la présence d'un carnal artériel, d'une communication inter‐auriculaire septale, d'une communication inter‐ventriculaire septale et d'une insuffisance tricuspidienne. L'animal était atteint aussi d'une hernie ombilicale. On souligne les rapports entre les données de l'auscultation, de la radiographie, de l'électro‐cardiographie et les lésions anatomopathologiques.Zusammenfassung. Ein Fall einer kongenitalen Herzanomalie bei einer Katze wird beschrieben. Zu der Anomalie gehören ein Ductus arteriosus apertus, ein interatrialer Septumdefekt, ein interventrikularer Septumdefekt und Tricuspidalinsuffizienz. Ausserdem lag ein Nabelbruch vor. Besonderes Gewicht wird auf die Beziehung der Auskultation, Radiographie und Elektrokardiographie zum pathologischen Befund gelegt.
Eurasian blackbird predated by wildRhinopithecus roxellanain the Qinling Mountains, China
Authors: ZHAO Dapeng , WANG Xiaowei , WATANABE Kunio , LI Baoguo 
Published: September 2008

AbstractAlthough there are some reports that have described primates eating animals, it is unknown whether predation on vertebrates exists in herbivorous leaf‐eating primates. We have witnessed firsthand wild Sichuan snub‐nosed monkeys (Rhinopithecus roxellana) preying on and consuming Eurasian blackbirds (Turdus meruld) in the Qinling Mountains of China. This event suggests thatR. roxellana, which has previously been described as a herbivorous leaf‐eating primate, may be partially carnivorous and the correct classification of this species would be omnivorous. Furthermore, food‐share behavior among higher‐ranked members occurs in a one‐male unit when vertebrate prey is hunted by this species.
A rare autosomal recessive condition, congenital erythropoietic porphyria, found in the canefield rat Rattus sordidus Gould 1858
Authors: RIVERA Dario F. , LEUNG Luke K.‐P. 
Published: September 2008

AbstractCongenital erythropoietic porphyria (CEP) is a rare autosomal recessive condition that has been reported in humans and in some animals, in which uroporphyrin 1 is deposited in the bones, teeth and urine, resulting in pink coloration and fluorescence of the tissues and urine under long‐wave ultraviolet (UV) light. We observed red teeth in nine of 450 canefield rats (Rattus sordidus) captured in a small, isolated patch of sugarcane in Tully, north Queensland, Australia. The skeletons of these animals were excised and were found to be bright red under normal day light. Under UV light, the skeleton had a bright red fluorescence. It is plausible that the canefield rat population in this isolated patch of sugarcane is small and inbreeding might have occurred, resulting in incidences of the autosomal recessive genes that cause CEP. The canefield rat can be used as an animal model for research into porphyria.
Effect of frugivorous birds on the establishment of a naturally regenerating population of Chinese yew in ex situ conservation
Authors: LU Changhu , ZHU Qiongqiong , DENG Qingshan 
Published: September 2008

AbstractThe Chinese yew (Taxus chinensis) is catalogued as an endangered species in China because of the small size and senescent status of most populations. Its lack of natural regeneration is the most important reason for its endangered status. We investigated the regeneration of an ex‐situ conservation population, which was introduced into the Nanjing Botanical Garden Memorial Sun Yat‐Sen in the 1950s, and evaluated the role of frugivorous birds on the establishment of this regenerating population. Two hundred and thirteen individual yew seedlings and saplings were found on the hillside in 2006, and the nearest seedling was found more than 10 m away from mother trees. The spatial pattern of all seedlings and saplings occurred as a clumped distribution, which is typical for vertebrate‐dispersed plants. Six bird species were seen ingesting whole “fruits” at yew trees in the present study and 745 visits by avian frugivores were recorded. Red‐billed blue magpie (Urocissa erythrorhyncha), Chinese bulbul (Pycnonotus sinensis) and azure‐winged magpie (Cyanopica cyana) were the most frequent visitors over the two years of the study. Comparing the flights of departure and perching habitats of the three main bird species, we inferred that U. erythrorhyncha would be the most important disperser. This regeneration population has had good development over the past 20 or more years; frugivorous birds have removed seeds to the hillside every year until now, and seed germination and seedling growth continue to develop well under natural conditions. We suggest that the conservation system of the Chinese yew should be composed of yews, avian dispersers and habitats for seed germination and seedling growth.
Global potential distribution of an invasive species, the yellow crazy ant (Anoplolepis gracilipes) under climate change
Authors: CHEN Youhua 
Published: September 2008

AbstractChanges to the Earth's climate may affect the distribution of countless species. Understanding the potential distribution of known invasive species under an altered climate is vital to predicting impacts and developing management policy. The present study employs ecological niche modeling to construct the global potential distribution range of the yellow crazy ant (Anoplolepis gracilipes) using past, current and future climate scenarios. Three modeling algorithms, GARP, BioClim and Environmental Distance, were used in a comparative analysis. Output from the models suggest firstly that this insect originated from south Asia, expanded into Europe and then into Afrotropical regions, after which it formed its current distribution. Second, the invasive risk of A. gracilipes under future climatic change scenarios will become greater because of an extension of suitable environmental conditions in higher latitudes. Third, when compared to the GARP model, BioClim and Environmental Distance models were better at modeling a species' ancestral distribution. These findings are discussed in light of the predictive accuracy of these models.
Karyotypes of three shrew species (Soriculus nigrescens, Episoriculus caudatus and Episoriculus sacratus) from Nepal
Authors: MOTOKAWA Masaharu , HARADA Masashi , MEKADA Kazuyuki , SHRESTHA Krishna C. 
Published: September 2008

AbstractThe karyotypes of three shrew species (Mammalia, Soricomorpha, Soricidae) from Nepal were examined for the first time. Based on the karyotypes and overall differences in skull size, the current Episoriculus caudatus appeared to include two distinct species: the larger E. caudatus and the smaller Episoriculus sacratus. Episoriculus sacratus has three subspecies, E. s. soluensis in Nepal and Sikkim, E. s. umbrinus in Assam, Myanmar and the Yunnan Province of China, and E. s. sacratus in the Sichuan Province of China. Soriculus nigrescens had a diploid chromosome number (2n) and fundamental number (FN), including two X chromosomes, of 64 and 92, respectively, consisting of 11 metacentric or submetacentric, two subtelocentric and 18 acrocentric pairs of autosomes, a metacentric X and an acrocentric Y chromosome. Episoriculus sacratus soluensis had 2n = 74 and FN = 126, consisting of 12 metacentric or submetacentric, 13 subtelocentric and 11 acrocentric pairs of autosomes, a submetacentric X and an acrocentric Y chromosome. Episoriculus caudatus had 2n = 60 and FN = 118, consisting of 19 metacentric or submetacentric, nine subtelocentric and one acrocentric pair of autosomes, a subtelocentric X and an acrocentric Y chromosome. The karyotypes of these three species are characterized by their large 2n and FN values compared with other Soricidae.
Comparative morphometrics of two populations of giant river catfish (Mystus seenghala) from the Indus river system
Authors: SAINI Archana , DUA Anish , MOHINDRA Vindhya 
Published: September 2008

AbstractGiant river catfish (Mystus seenghala) from the Beas river were compared with a population in the Sutlej river of the Indus river system using 28 morphometric characters. Discriminant analyses and a univariate anova were used to explore these data. Allometric transformation of each measurement was done to eliminate correlations with size. The stepwise discriminant analysis retained nine variables that significantly discriminated the Beas samples from the Sutlej samples. Using these variables, 91.2% (original) and 89.0% (cross validated) of fish were classified into their correct samples. Misclassification was higher for the Sutlej samples (12.5%) than for the Beas samples (6.3%). The results of the discriminant analyses showed that variability in the Beas samples was more homogeneous and provided a more characteristic picture of the group than the Sutlej samples. The univariate ANOVA revealed significant differences between the means of the two populations for 12 of the 28 transformed morphometric measurements.
Applications of graph theory to landscape genetics
Authors: Garroway Colin J. , Bowman Jeff , Carr Denis , Wilson Paul J. 
Published: September 2008

AbstractWe investigated the relationships among landscape quality, gene flow, and population genetic structure of fishers (Martes pennanti) in ON, Canada. We used graph theory as an analytical framework considering each landscape as a network node. The 34 nodes were connected by 93 edges. Network structure was characterized by a higher level of clustering than expected by chance, a short mean path length connecting all pairs of nodes, and a resiliency to the loss of highly connected nodes. This suggests that alleles can be efficiently spread through the system and that extirpations and conservative harvest are not likely to affect their spread. Two measures of node centrality were negatively related to both the proportion of immigrants in a node and node snow depth. This suggests that central nodes are producers of emigrants, contain high‐quality habitat (i.e., deep snow can make locomotion energetically costly) and that fishers were migrating from high to low quality habitat. A method of community detection on networks delineated five genetic clusters of nodes suggesting cryptic population structure. Our analyses showed that network models can provide system‐level insight into the process of gene flow with implications for understanding how landscape alterations might affect population fitness and evolutionary potential.
Segmental vitiligo as the possible expression of cutaneous somatic mosaicism: implications for common non‐segmental vitiligo
Authors: Taïeb Alain , Morice‐Picard Fanny , Jouary Thomas , Ezzedine Khaled , Cario‐André Muriel , Gauthier Yvon 
Published: September 2008

SummaryClinical findings in vitiligo challenge the widely accepted organ specific autoimmune pathomechanisms. We draw the attention to the fact that the distribution of segmental vitiligo (SV) fits in at least a subset of patients a pattern usually associated with cutaneous mosaicism. The association of SV to non‐segmental vitiligo (NSV) now confirmed by several observations indicates a continuum between the two subsets with shared predisposing genetic factors, including genes operating specifically in the skin. Some pedigrees associating SV and NSV further suggest a mechanism of loss of heterozygosity for a dominant gene controlling part of the cutaneous phenotype. The mosaic hypothesis applies only to SV and to the rare SV‐NSV association, but suggests that predisposing genetic factors in common NSV should also be searched directly in the skin. SV would be a good candidate disease to explore as a proof of principle of a new gene discovery strategy useful for multigenic disorders with organ specificity, applicable in priority to chronic inflammatory skin disorders.
Gouverner l'innovation, entre sciences dures et arts plastiques: le consortium interuniversitaire Hexagram (Montréal, Canada)*
Authors: FOURMENTRAUX JEAN‐PAUL 
Published: September 2008

In the academic stream of technological arts, the national systems of innovation are involved in a reconfiguration of research and development organizations, which are aimed at marketing hybrid products that are now concurrently oriented towards artistic presentation, technology transfer and an application in both the commercial and industrial sense. This article provides an initial analysis of the motives and organizational pressures involved in these attempts to integrate and articulate academic research, artistic creation and industrial production in a perspective of competitiveness in innovation. It draws on the results of a survey conducted with artist‐researchers who created a Canadian organizational prototype of these partnerships: the Hexagram inter‐university consortium (Montréal, Canada).Les ← systèmes d'innovation nationaux → engagent dans la filière universitaire des arts technologiques une reconfiguration des organisations de recherche et de création. Ces dernières visent la mise sur le marché de produits hybrides orientés désormais concurremment vers une exposition artistique, une valorisation scientifique et une application au sens commercial et industriel du terme. L'article propose une première analyse des ressorts et tensions organisationnelles de ces tentatives d'intégration et d'articulation de la recherche universitaire, de la création artistique et de la production industrielle dans une perspective de concurrence à l'innovation. Il mobilise les résultats d'une enquête menée auprès de chercheurs‐créateurs d'un prototype canadien d'organisation de ces rapprochements: le consortium interuniversitaire Hexagram (Montréal, Canada).