bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Study of Asymmetric Versus Non-asymmetric Intrastromal Corneal Ring Segments for the Management of Keratoconus
Authors: Barugel Raphaël , David Clémentine , Kallel Sofiene , Borderie Marie , Cuyaubère Roxane , Goemaere Isabelle , Borderie Vincent , Bouheraoua Nacim 
Published: August 2021

PURPOSE:
To compare the outcomes obtained with models of asymmetric and non-asymmetric intracorneal ring segments (ICRS) in keratoconic eyes with asymmetric topo-graphic patterns.

METHODS:
In this prospective observational study, ICRS were implanted alternately in patients with the same tomographic patterns of keratoconus assigned to four groups. Patients with the “duck” phenotype received one asymmetric or non-asymmetric ICRS and patients with the “snowman” pheno-type received two asymmetric or non-asymmetric ICRS. Visual, refractive, astigmatism, keratometric, and corneal aberrometry changes were evaluated over a 6-month follow-up period.

RESULTS:

Sixty-eight eyes were analyzed. No significant difference was observed between the use of one asymmetric and one non-asymmetric ICRS in duck phenotypes. In snowman keratoconus, the inferior-superior index decreased significantly (
P
= .03) with asymmetric but not with non-asymmetric ICRS implantation. Total corneal higher order aberrations and coma rates were lower, but not significantly so, after the implantation of two asymmetric ICRS in snowman phenotypes (2.85 ± 0.89 to 2.60 ± 0.91 µm,
P
= .20 and 2.64 ± 0.93 to 2.39 ± 0.98 µm,
P
= .21), and significantly higher after the implantation of two non-asymmetric ICRS (2.56 ± 1.28 to 3.08 ± 1.62 µm,
P
= .02 and 2.34 ± 1.27 to 2.84 ± 1.62 µm,
P
= .02).

CONCLUSIONS:
Asymmetric ICRS did not improve the outcomes of ICRS implantation in duck keratoconus. However, the implantation of two asymmetric ICRS was more effective than that of two non-asymmetric ICRS for decreasing vertical asymmetry and preventing increases in corneal aberration in the snowman phenotype of keratoconus.

[
J Refract Surg
. 2021;37(8):552–561.]
Th22 Cells Are a Major Contributor to the Mycobacterial CD4+ T Cell Response and Are Depleted During HIV Infection
Authors: Bunjun Rubina , Omondi Fidilia M A , Makatsa Mohau S , Keeton Roanne , Wendoh Jerome M , Müller Tracey L , Prentice Caryn S L , Wilkinson Robert J , Riou Catherine , Burgers Wendy A 
Published: August 2021

Abstract
HIV-1 infection substantially increases the risk of developing tuberculosis (TB). Mechanisms such as defects in the Th1 response to Mycobacterium tuberculosis in HIV-infected persons have been widely reported. However, Th1-independent mechanisms also contribute to protection against TB. To identify a broader spectrum of defects in TB immunity during HIV infection, we examined IL-17A and IL-22 production in response to mycobacterial Ags in peripheral blood of persons with latent TB infection and HIV coinfection. Upon stimulating with mycobacterial Ags, we observed a distinct CD4+ Th lineage producing IL-22 in the absence of IL-17A and IFN-γ. Mycobacteria-specific Th22 cells were present at high frequencies in blood and contributed up to 50% to the CD4+ T cell response to mycobacteria, comparable in magnitude to the IFN-γ Th1 response (median 0.91% and 0.55%, respectively). Phenotypic characterization of Th22 cells revealed that their memory differentiation was similar to M. tuberculosis–specific Th1 cells (i.e., predominantly early differentiated CD45RO+CD27+ phenotype). Moreover, CCR6 and CXCR3 expression profiles of Th22 cells were similar to Th17 cells, whereas their CCR4 and CCR10 expression patterns displayed an intermediate phenotype between Th1 and Th17 cells. Strikingly, mycobacterial IL-22 responses were 3-fold lower in HIV-infected persons compared with uninfected persons, and the magnitude of responses correlated inversely with HIV viral load. These data provide important insights into mycobacteria-specific Th subsets in humans and suggest a potential role for IL-22 in protection against TB during HIV infection. Further studies are needed to fully elucidate the role of IL-22 in protective TB immunity.
Upper-Pole Infra-Costal Access for Supine Percutaneous Nephrolithotomy
Authors: Kontos Stylianos , Smyth Niamh , Papatsoris Athanasios , Nalagatla Sarath K 
Published: August 2021

Objective:
There are still disagreements in choosing a better approach to establish a percutaneous tract for percutaneous nephrolithotomy (PCNL), between supine and prone positions. The aim of this study is to investigate the safety, efficacy, and practicability of treating upper-pole renal stones, using an infra-costal puncture in both prone and supine positions.

Materials and Methods:
Fifteen patients underwent infra-costal puncture for the percutaneous treatment of upper-pole stones at our institution over a 3-year period. Seven patients underwent a prone procedure and six had a supine PCNL. All punctures were undertaken by two consultant urologists. Stone clearance was assessed with a plain X-ray kidney-ureter-bladder on postoperative day 1. We retrospectively analyzed our prospectively maintained database to assess stone clearance, complications, and length of stay of these patients.

Results:
The overall stone-free rate was 93.3% (all but one patient). One hundred percentage of the prone group were stone free following the procedure. Nearly 87.5% of the supine group had a complete clearance. Complications and length of stay were comparable for both groups. Almost 25% of the supine group and 14% of the prone group required transfusion. The postoperative pyrexia rates were similar for both groups. The overall complication rate was 26.7% (n = 4) – one case of sepsis and three patients required blood transfusion. There were no thoracic complications.

Conclusions:
Upper-pole renal stones can be safely and effectively treated percutaneously using direct upper-pole puncture via an infra-costal approach in supine position, as well as in prone position.
Enhancing the Teaching Environment: 3-Year Follow-Up of a Resident-Led Residents-as-Teachers Program
Authors: Ratan Bani M. , Johnson Grace J. , Williams Amanda C. , Greely Jocelyn T. , Kilpatrick Charlie C. 
Published: August 2021

ABSTRACT

Background
Previous faculty-driven residents-as-teachers (RAT) models have had limited efficacy and sustainability.

Objective
To evaluate the acceptability and effects of a resident-led RAT program on resident teaching.

Methods
In October 2016, obstetrics and gynecology (OB/GYN) residents at a large academic institution implemented a resident-led RAT program, consisting of a steering committee of peer-selected residents with 2 faculty mentors who planned education-focused resident didactics and journal clubs, organized resident involvement in clerkship activities, and recognized residents who excelled in teaching as Distinguished Educators (DEs). From July 2016 through June 2019, using the Kirkpatrick Model, we evaluated the program with annual resident surveys assessing self-perception of 13 teaching skills (5-point Likert scale) and value of RAT program, institutional end-of-clerkship student evaluations of resident teaching, and resident participation in DE award.

Results
Annual resident survey response rates ranged from 63% to 88%. Residents' self-reported teaching skills improved significantly in 11 of 13 domains from 2016 to 2018 (improvements ranging from 0.87–1.42; 5-point Likert scale; P &lt; .05). Of the 2018 respondents, 80% agreed that the resident-led RAT program added value to the residency. For 2017–2018 and 2018–2019 academic years, 47% and 48% of medical students (100% response rate) strongly agreed that residents provided effective teaching compared to 30% in 2016–2017 (P &lt; .05). Ten residents have graduated as DEs during this time period.

Conclusions
A resident-led RAT program increased residents' self-reported teaching skills, improved medical student perceptions of teaching quality, and was sustainable and acceptable over a 3-year period.
A Transitional Year Residency Program Provides Innovative Solutions for Unmatched Medical Students
Authors: Gathright Molly M. , Hankins Jennifer , Siddiqui Mohammad Zia , Thrush Carol R. , Atkinson Tim 
Published: August 2021

ABSTRACT

Background
The transition to residency is competitive with more medical students applying for residency positions than slots available, and some will face challenges securing a position in their desired specialty. Our institution created a transitional year (TY) residency program in 2016 to help meet the needs of our medical students who did not initially secure a position in the main residency Match.

Objective
This report provides a brief overview of the TY program and analysis of the program's value from the inaugural 3 years (2017–2020).

Methods
The TY program is based at a midsized, urban, academic health center and features a tailorable curriculum emphasizing preparation for residents' specialty career plans. We used participatory action research and appreciative inquiry strategies as part of the annual program evaluation to examine TY residents' perceptions of the program's value. Stakeholder perceptions were also elicited from a purposive selection of 4 program directors and 2 key medical school education leaders.

Results
Internal evaluations revealed a high rate of resident satisfaction with the TY program and self-reported benefits such as increased confidence, clinical proficiency, and professional enculturation. Stakeholders valued the program as a potential pipeline for increasing physicians in the state and providing valuable direction to students' career trajectories.

Conclusions
Creating a TY residency program to meet the needs of unmatched medical students was feasible to implement, acceptable to residents in meeting their academic and career needs, and provided a sustainable institutional solution with benefits to multiple stakeholders.
Training Residents in Advance Care Planning: A Task-Based Needs Assessment Using the 4-Component Instructional Design
Authors: Fassier Thomas , Rapp Amandine , Rethans Jan-Joost , Nendaz Mathieu , Bochatay Naïke 
Published: August 2021

ABSTRACT

Background
Residents may learn how to perform advance care planning (ACP) through informal curriculum. Task-based instructional designs and recent international consensus statements for ACP provide opportunities to explicitly train residents, but residents' needs are poorly understood.

Objective
We assessed residents' training needs in ACP at the Geneva University Hospitals in Geneva, Switzerland.

Methods
Qualitative data were collected and analyzed iteratively between December 2017 and September 2019. Transcripts were coded using both a deductive content analysis based on the 4-Component Instructional Design (4C/ID) model and an inductive thematic analysis.

Results
Out of 55 individuals contacted by email, 49 (89%) participated in 7 focus groups and 10 individual interviews, including 19 residents, 18 fellows and attending physicians, 4 nurses, 1 psychologist, 1 medical ethics consultant, 3 researchers, and 3 patients. Participants identified 3 tasks expected of residents (preparing, discussing, and documenting ACP) and discussed why training residents in ACP is complex. Participants described knowledge (eg, prognosis), skills (eg, clinical and ethical reasoning), and attitudes (eg, reflexivity) that residents need to become competent in ACP and identified needs for future training. In terms of the 4C/ID, these needs revolved around: (1) learning tasks (eg, workplace practice, simulated scenarios); (2) supportive information (eg, videotaped worked examples, cognitive feedback); (3) procedural information (eg, ACP pocket-sized information sheet, corrective feedback); and (4) part-task practice (eg, rehearsal of communication skills, simulation).

Conclusions
This study provides a comprehensive description of tasks and competencies to train residents in ACP.
Unheard Voices: A Qualitative Study of Resident Perspectives on Remediation
Authors: Krzyzaniak Sara M. , Kaplan Bonnie , Lucas Daniella , Bradley Elizabeth , Wolf Stephen J. 
Published: August 2021

ABSTRACT

Background
Remediation is an important component of residency training that ensures residents are progressing toward competency and unsupervised practice. There is literature describing educators' attitudes about remediation; however, little is known about residents' perspectives regarding peers who are struggling and remediation. Understanding this perspective is critical to supporting struggling residents and developing successful remediation programs.

Objective
The objective of this study was to describe residents' perspectives on peers who are struggling and remediation processes within graduate medical education programs.

Methods
In 2015, we conducted focus groups of residents in a multi-institutional exploratory qualitative study designed to investigate resident perspectives on remediation. Focus groups included questions on identification of residents who are struggling, reasons residents face difficulty in training, attitudes toward remediation, and understanding of the remediation process. Using conventional content analysis, we analyzed the focus group data to discover common themes.

Results
Eight focus groups were performed at 3 geographically distinct institutions. A total of 68 residents participated, representing 12 distinct medical specialties. Four major themes emerged from the participants' discussion: lack of transparency, negative stigma, overwhelming emotions, and a need for change.

Conclusions
Resident perspectives on remediation are affected by communication, culture, and emotions. The resident participants called for change, seeking greater understanding and transparency about what it means to struggle and the process of remediation. The residents also believed that remediation can be embraced and normalized.
Leer literatura: un recurso para la enseñanza de las lenguas en la Universidad
Authors: Torres Calzadilla. Zaydelys Lucrecia , Armentero Reboredo Alejandro , López Rodríguez del Rey María Magdalena , Domínguez Pouyot Lisandra 
Published: August 2021

La formación humanística de los estudiantes universitarios no solo es una exigencia académica o una concepción de aprendizaje asociada al crecimiento cognitivo, es también una prioridad de formación afectiva y social.
Legitimar esta idea, implica primero: ser conscientes de las potencialidades desarrolladoras de la lectura literaria en el pregrado y segundo: concebir la implementación de su práctica como un recurso educativo orientado al aprendizaje de las lenguas materna y extranjera.
Al asumir que la lectura literaria es determinante en el proceso de formación del estudiante universitario, se confirma que su práctica no solo deberá estar asociada a los aprendizajes curriculares o profesionales, sino que además llega a ser una vía de socialización, en tanto, se convierte en un espacio para el desarrollo integral de la personalidad. En este sentido, la universidad se identifica como una comunidad lectora, cuyos significados y sentidos de la lectura literaria están mediados por prácticas sociales e intercambios comunicativos, que giran alrededor de la producción, recepción y uso social de los textos literarios en función del conocimiento plural.
Médecine et philosophie au cœur du soin
Authors: Benaroyo Lazare 
Published: August 2021

À l’heure où la pratique de la médecine est soumise à des impératifs techniques et biopolitiques qui suscitent une (bio)éthique défensive, il est essentiel de revivifier les dimensions éthiques du soin au cœur même de la clinique, pour redonner sens à la responsabilité morale qui l’habite. Cette contribution cherche à relever ce défi en puisant aux ressources anthropologiques, épistémologiques et éthiques des travaux de Viktor von Weizsäcker, de Georges Canguilhem, de Paul Ricœur et d’Emmanuel Lévinas, dont les recherches ont ouvert, dès le milieu du XXe siècle, la voie d’une anthropologie clinique qui pose les jalons d’une éthique de responsabilité propre à l’exercice de la médecine. À la lumière de ces recherches, où médecine et philosophie se nourrissent mutuellement, cette étude propose une éthique du soin qui contribue à maintenir vivants les liens unissant éthique et médecine.
UN ANÁLISIS EN TORNO A LA EDUCACIÓN PARA LA CIUDADANÍA Y LA IDEOLOGÍA DE GÉNERO
Authors: RUIZ RESA JOSEFA DOLORES 
Published: August 2021

La introducción y el desarrollo curricular en nuestro sistema educativo
de las asignaturas de Educación para la Ciudadanía no han estado exentos
de polémica, y su rechazo se ha traducido en la proliferación de demandas interpuestas
por numerosos padres y también por muchas madres. En ellas se ha solicitado
la anulación de ciertas partes del desarrollo reglamentario de las asignaturas,
y/o el reconocimiento de un hipotético derecho a la objeción de conciencia
respecto a las mismas. Dado que estas impugnaciones se refieren a aspectos relacionados
con la comprensión y aplicación del principio de igualdad de mujeres y
hombres, como la noción de género, se ha hecho necesario analizar las sentencias
que los resuelven. Y a ofrecer este análisis se dirige el siguiente trabajo.
Herritartasunerako hezkuntzako irakasgaiak gure hezkuntza sisteman
sartzeak eta curriculumean garatzeak polemika ekarri du, eta, horren erakusle,
guraso askok helegiteak jarri dituzte kontra daudela agertzeko. Helegite horietan
irakasgaiak araudiari jarraiki garatzearen zenbait alderdi ezeztatzea edo/eta,
horien harira, kontzientzia eragozpenerako eskubide hipotetikoa aitortzea eskatzen
da. Aurka egite horiek gizon eta emakumeen arteko berdintasun printzipioa ulertzearekin
eta aplikatzearekin lotutako alderdiei buruzkoak direnez, genero nozioa
kasu, beharrezkoa bilakatu da ebazten dituzten epaiak aztertzea. Aipatutakoa egiten
du, bada, hurrengo lanak.
The introduction and development of the subjects of education for
citizenship in our educational system have provoked controversy, and this rejection
has resulted in the proliferation of numerous lawsuits and appeals filed by
parents. They claimed the annulment of certain parts of the regulatory development
of the subjects, and the recognition of a hypothetical right to conscientious
objection to them. As these challenges are related to the understanding and application
of the principle of equality between women and men, like for example,
the concept of gender, it has become necessary to consider the judgments that resolved
these claims. This work addresses to offer an analysis of these judgments.
Measurement and improvement of efficiency of Library by mathematical modelling and finding reliability
Authors: Bahl Yakshi , Garg Tarun Kumar 
Published: August 2021

Here in this paper we have developed the mathematical model of the library server using Markov birth – death process assuming that library system server system is based on exponential distribution. The model so developed by victimisation Chapman Kolmogorov differential equation and is solved by using Mathematica. The solution so obtained is analysed for various rates of failures and repair. The finding so obtained are discussed with the concerned authorities of the library to boost the efficiency of the library.
Electrochemical preparation of graphene from waste battery-electrodes directed to organic dyes removal in aqueous solution
Authors: Tran Thi Thu Huyen  , Duong Thi Ngan  , Hoang Thanh Ly  , Phi Thi Thuy Hong  , Tran Vinh Hoang  
Published: August 2021

In this research, we present a new method for preparation of graphene from waste zinc carbon battery (ZCB) electrodes using electrochemically exfoliation via a intercalating of sulfate ions into the graphitic layers at different D.C. voltages and optimized conditions (i.e., electrolyte medium and applied voltage). The synthesized graphene was characterized by X-ray diffraction (XRD), Raman spectroscopy and Scanning/Transmission electron microcopy (SEM/TEM). The synthesized graphene has been used as the adsorbents for efficient removal of methylene blue (MB) as a cationic dye from aqueous solutions to test their qualities. Results shown that the equilibrium adsorption capacity (qe) of prepared graphene samples are from 92.32 mg.g-1 to 99.73 mg.g-1 which are extremly higher than that of the pristine waste graphite electrode (5.03 mg.g-1) or powdered waste electrode graphite (40.05 mg.g-1). These obtaned results indicated that the graphene can be produced from waste graphite electrodes by electrochemical method, which can be considered as an eco-friendly method not only for production of quality graphene but also for reuse of waste graphite electrodes.
Gas–particle partitioning of polyol tracers at a suburban site in Nanjing, east China: increased partitioning to the particle phase
Authors: Qin Chao , Gou Yafeng , Wang Yuhang , Mao Yuhao , Liao Hong , Wang Qin'geng , Xie Mingjie 
Published: August 2021

Abstract. Gas–particle partitioning of water-soluble organic compounds plays a significant role in influencing the formation, transport, and lifetime of
organic aerosols in the atmosphere, but is poorly characterized. In this work, gas- and particle-phase concentrations of isoprene oxidation products
(C5-alkene triols and 2-methylterols), levoglucosan, and sugar polyols were measured simultaneously at a suburban site of the western Yangtze River
Delta in east China. All target polyols were primarily distributed into the particle phase (85.9 %–99.8 %). Given the uncertainties in
measurements and vapor pressure predictions, a dependence of particle-phase fractions on vapor pressures cannot be determined. To explore the impact
of aerosol liquid water on gas–particle partitioning of polyol tracers, three partitioning schemes (Cases 1–3) were proposed based on
equilibriums of gas vs. organic and aqueous phases in aerosols. If particulate organic matter (OM) is presumed as the only absorbing phase
(Case 1), the measurement-based absorptive partitioning coefficients (Kp,OMm) of isoprene oxidation products and levoglucosan were more than 10 times greater than predicted values (Kp,OMt). The agreement between
Kp,OMm and Kp,OMt was substantially improved when solubility in a separate aqueous phase was
included, whenever water-soluble and water-insoluble OM partitioned into separate (Case 2) or single (Case 3) liquid phases,
suggesting that the partitioning of polyol tracers into the aqueous phase in aerosols should not be ignored. The measurement-based effective Henry's
law coefficients (KH,em) of polyol tracers were orders of magnitude higher than their predicted values in pure water
(KH,wt). Due to the moderate correlations between log⁡(KH,em/KH,wt) and
molality of sulfate ions, the gap between KH,em and KH,wt of polyol tracers could not be fully
parameterized by the equation defining “salting-in” effects and might be ascribed to mechanisms of reactive uptake, aqueous phase reaction,
“like-dissolves-like” principle, etc. These study results also partly reveal the discrepancy between observation and modeling of organic
aerosols.