bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Resident-Performed FS-LASIK for Myopia and Myopic Astigmatism
Authors: Yu Eun Jin , Nejad Mitra , Miller Kevin M. 
Published: August 2021

PURPOSE:
To evaluate the outcomes of resident-performed femtosecond laser–assisted in situ keratomileusis (FS-LASIK).

METHODS:
Records of 138 eyes of 69 patients treated by residents for myopia or myopic astigmatism between March 2018 and June 2020 were reviewed. All preoperative visits, procedures, and postoperative visits were supervised by attending physicians. Follow-up examinations were performed 1 day and 1 month postoperatively. Complications and enhancements were noted. Outcome measures included postoperative uncorrected distance visual acuity (UDVA), refractive accuracy, and complications.

RESULTS:
Eighteen residents performed FS-LASIK on a median of 8 eyes (interquartile range: 1.75). Fifty-nine patients (118 eyes) returned for a 1-month postoperative examination. UDVA was 20/40 or better in 117 eyes (99%) and 20/20 or better in 108 eyes (92%). The mean preoperative spherical equivalent (SE) refractive error was −4.01 ± 1.82 diopters (D) in 138 eyes, decreasing to −0.12 ± 0.35 D at 1 month after surgery in the 102 eyes that were refracted. The SE was ±1.00 D in 100 eyes (98%) and ±0.50 D in 94 eyes (93%). The CDVA change was within one line in 100% of eyes. Intraoperative complications occurred in 5 eyes (3.62%), enhancements were performed in 3 eyes (2.17%), and postoperative complications developed in 3 eyes (2.17%).

CONCLUSIONS:
Resident-performed FS-LASIK is relatively safe and effective in comparison to published U.S. Food and Drug Administration premarket approval studies. Early resident experience performing LASIK can improve the training of ophthalmic surgeons while simultaneously increasing patient access to laser vision correction.

[
J Refract Surg
. 2021;37(8):545–551.]
Protracted yet Coordinated Differentiation of Long-Lived SARS-CoV-2-Specific CD8+ T Cells during Convalescence
Authors: Ma Tongcui , Ryu Heeju , McGregor Matthew , Babcock Benjamin , Neidleman Jason , Xie Guorui , George Ashley F , Frouard Julie , Murray Victoria , Gill Gurjot , Ghosn Eliver , Newell Evan W , Lee Sulggi A , Roan Nadia R 
Published: August 2021

Abstract
CD8+ T cells can potentiate long-lived immunity against COVID-19. We screened longitudinally-sampled convalescent human donors against SARS-CoV-2 tetramers and identified a participant with an immunodominant response against residues 322 to 311 of nucleocapsid (Nuc322–331), a peptide conserved in all variants of concern reported to date. We conducted 38-parameter cytometry by time of flight on tetramer-identified Nuc322–331–specific CD8+ T cells and on CD4+ and CD8+ T cells recognizing the entire nucleocapsid and spike proteins, and took 32 serological measurements. We discovered a coordination of the Nuc322–331–specific CD8+ T response with both the CD4+ T cell and Ab pillars of adaptive immunity. Over the approximately six month period of convalescence monitored, we observed a slow and progressive decrease in the activation state and polyfunctionality of Nuc322–331–specific CD8+ T cells, accompanied by an increase in their lymph node–homing and homeostatic proliferation potential. These results suggest that following a typical case of mild COVID-19, SARS-CoV-2–specific CD8+ T cells not only persist but continuously differentiate in a coordinated fashion well into convalescence into a state characteristic of long-lived, self-renewing memory.
Exploring the Effort-Reward Structure of University Work Focusing on Perceived Overall Stress, Self-Reported Health, and Musculoskeletal Disorders
Authors: Verpeléti Bence , Horváth Edina , Dobi-Ágoston Gordana , Ágoston Gergely , Bérces Kitti , Molnár Regina , Mátó Veronika , Varga Albert , Paulik Edit 
Published: August 2021

Background The effort-reward imbalance (ERI) model by Siegrist encouraged numerous scientific investigations that reported particular ties between psychosocial risks and poor self-reported health (SRH), while psychosocial work-related stress has also been linked to musculoskeletal disorders (MSDs). The aim of this study was to examine the health status and the perceived levels of occupational stress of university employees and to analyse the findings according to the employees’ effort and reward structure of work, perceived overall stress, SRH and the presence of MSDs. Design and methods 398 employees – including healthcare professionals, academic personnel and workers with administrative or other jobs – employed at the University of Szeged, Faculty of Medicine were investigated with a self-administered questionnaire including the Effort-Reward Imbalance Questionnaire (ERIQ) and Perceived Stress Scale 4 (PSS-4). Results More than half of the investigated subjects (54.8%) reported some forms of MSDs. Low self-reported health (P<0.001) and presence of MSDs (P=0.015) were significantly associated with the level of perceived stress and effort-reward imbalance (ERI), moreover increased level of perceived stress was independently associated with the likelihood of MSDs (AOR=1.13) and low self-reported health (AOR=1.30). ERI well predicted low self-reported health (AOR=2.05) as well. Increased level of perceived stress positively correlated with high workrelated effort (r=0.247, P<0.001) and over-commitment (r=0.387, P<0.001) while with work-related reward (r=-0.181, P=0.011) perceived stress showed a negative connection. Conclusion Our results suggest that addressing the burden of effort-reward imbalance and MSDs would likely lessen employees’ perceived level of overall stress and affect their self-reported overall state of health.
Do Orthopaedic Residency Programs Have the Least Time Between Invitation and Interview?
Authors: Ruckle David , Wongworawat Montri Daniel 
Published: August 2021

ABSTRACT

Background
The cost and stress of applying to residency programs are increasing. Planning for interviews with limited lead time can cause additional burden to residency applicants.

Objective
We sought to determine if the specialty of orthopaedics was affording the same lead time between interview invitation and interview dates as its surgical and medical counterparts.

Methods
Dates for the first interview invitation and last possible interview were gathered for each program in orthopaedic surgery, general surgery, otolaryngology, vascular surgery, plastic surgery, neurological surgery, internal medicine, psychiatry, pediatrics, and family medicine. Interview lead time was calculated for each specialty. Mann–Whitney U and independent sample Kruskal-Wallis tests were used for nonparametric data with P &lt; .05 considered as significant.

Results
Orthopaedic surgery lead time is significantly different when compared individually and pairwise to other specialties (P &lt; .05 for all comparisons), with a median lead time of 57 days. The next lowest lead time specialty is otolaryngology with a 70-day lead time. The specialty with the longest is pediatrics (median 106 days).

Conclusions
Residency programs (orthopaedic surgery in particular) vary widely in the amount of lead time given to schedule and attend interviews. The authors propose that interview invitations be extended into mid-October.
Preliminary Evidence Supporting a Novel 10-Item Clinical Learning Environment Quick Survey (CLEQS)
Authors: Simpson Deborah , McDiarmid Matthew , La Fratta Tricia , Salvo Nicole , Bidwell Jacob L. , Moore Lawrence , Irby David M. 
Published: August 2021

ABSTRACT

Background
The clinical learning environment (CLE) is a priority focus in medical education. The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review's (CLER) recent addition of teaming and health care systems obligates educators to monitor these areas. Tools to evaluate the CLE would ideally be: (1) appropriate for all health care team members on a specific unit/project; (2) informed by contemporary learning environment frameworks; and (3) feasible/quick to complete. No existing CLE evaluation tool meets these criteria.

Objective
This report describes the creation and preliminary validity evidence for a Clinical Learning Environment Quick Survey (CLEQS).

Methods
Survey items were identified from the literature and other data sources, sorted into 1 of 4 learning environment domains (personal, social, organizational, material) and reviewed by multiple stakeholders and experts. Leaders from 6 interprofessional graduate medical education quality improvement/patient safety teams distributed this voluntary survey to their clinical team members (November 2019–mid-January 2021) using electronic or paper formats. Validity evidence for this instrument was based on the content, response process, internal structure, reliability, relations to other variables, and consequences.

Results
Two hundred one CLEQS responses were obtained, taking 1.5 minutes on average to complete with good reliability (Cronbach's α ≥ 0.83). The Cronbach alpha for each CE domain with the overall item ranged from 0.50 for personal to 0.79 for social. There were strong associations with other measures and clarity about improvement targets.

Conclusions
CLEQS meets the 3 criteria for evaluating CLEs. Reliability data supports its internal consistency, and initial validity evidence is promising.
Gait Characteristics in Youth With Transverse Myelitis
Authors: Hwang Miriam , Flanagan Ann , Graf Adam , Kruger Karen M. , Scullion Nancy , Tayne Samantha , Altiok Haluk 
Published: August 2021

Background:
Transverse myelitis (TM) in childhood is a rare disorder characterized by the presence of spinal cord inflammation. Gait difficulty in children with TM is common; however, there is a paucity of literature regarding quantitative assessment of gait in children and adolescents with TM.

Objectives:
To characterize gait patterns in a cohort of ambulatory children with TM and age-matched, typically developing peers in order to better understand the functional mobility of patients diagnosed with childhood TM.

Methods:
This was a retrospective study of 26 ambulatory pediatric patients with a confirmed diagnosis of TM who had undergone three-dimensional, instrumented gait analysis (3D-IGA) at 3 years of age or older. A group of 38 typically developing children served as a control group.

Results:
Gait in children with TM was characterized by moderate kinematic deviations as measured by the Gait Deviation Index (GDI) and a crouched gait pattern (p &lt; .001), increased anterior pelvic tilt (p &lt; .001), decreased motion at the knees (p &lt; .001), and a wider base of support (foot progression angle, p &lt; .001). The TM group had a slower walking speed (p &lt; .001), shorter strides (p &lt; .001), and an increased stance phase compared to controls.

Conclusion:
Our study results showed moderate kinematic deviations quantified by the GDI. Overall, the gait pattern in the TM population tested had greater hip and knee flexion with wider foot progression angle. Identification of gait characteristics in children with TM is the first step in predicting changes in gait pattern as they mature over time, which may ultimately allow for targeted intervention to maintain their ambulatory function.
Inertial Measurement Unit–Derived Ergonomic Metrics for Assessing Arm Use in Manual Wheelchair Users With Spinal Cord Injury: A Preliminary Report
Authors: Jahanian Omid , Van Straaten Meegan G. , Goodwin Brianna M. , Cain Stephen M. , Lennon Ryan J. , Barlow Jonathan D. , Murthy Naveen S. , Morrow Melissa M. B. 
Published: August 2021

Background:
Individuals with spinal cord injury (SCI) who use manual wheelchairs (MWCs) have a higher rate of rotator cuff pathology progression than able-bodied individuals.

Objectives:
This study aimed to test the ability of risk and recovery metrics of arm use to differentiate between (1) MWC users with SCI and matched able-bodied participants (cross-sectional matched-sample study) and (2) MWC users with rotator cuff pathology progression over 1 year from those without pathology progression (longitudinal study).

Methods:
Thirty-four MWC users and 34 age- and sex-matched able-bodied individuals were recruited. Upper arm risk (humeral elevation &gt;60°) and recovery (static ≥5 seconds and humeral elevation &lt;40°) metrics were calculated from wireless inertial measurement units (IMUs) worn on the upper arms and torso in the free-living environment. Two separate magnetic resonance imaging studies were completed and assessed for a subset of 16 MWC users approximately 1 year apart.

Results:
The frequency of risk events (p = .019), summated duration of recovery events (p = .025), and duration of each recovery event (p = .003) were higher for MWC users than able-bodied participants. The summated duration of risk events (p = .047), frequency of risk events (p = .027), and risk to recovery ratio (p = .02) were higher and the summated duration of recovery events (p = .036) and frequency of recovery events (p = .047) were lower for MWC users with rotator cuff pathology progression (n = 5) compared to those without progression (n = 11).

Conclusion:
IMU-derived metrics quantifying arm use at postures &gt;60° and risk to recovery ratios may provide insights of potential risk factors for rotator cuff pathology progression.
Ideological bases of Foreign Political Positioning of Republic of Tajikistan
Authors: Bulvinskyi A. 
Published: August 2021

In the article there has been made the analyzes of reflection ideological bases of foreign political and governmental positioning of Tajikistan in its’ doctrine documents. The main blocks of our analyzes was historical bases of Tajik statehood; the place and a role of Tajikistan in the world history, the place of the country in the modern world and features of understanding of the world trends of development; the place of water diplomacy in foreign political positioning of Tajikistan.
It was found, that important part of official ideological concept of Tajikistan was the appeal in way of Aryan origin of Tajiks, the heritage of government of the Samanids and the losses of the “original” Tajik’s territories. It was state that during 1990s until 2010s, doctrine understanding of Tajikistan about their place in the evolutionary region in the spot of the mission of historical civilization of Tajik’s nation regarding to other population of the region.
Important elements of the ideology of Tajikistan’s foreign policy positioning in the 1990s were the secular nature of the development of this Muslim state, elected during the 1992-1997 civil war, and the need for international assistance due to the country’s poverty and underdevelopment. In the doctrinal documents of the first half of the 2000s, the provision on poverty was combined with the thesis of the injustice of world development, which is dominated by the West, and the negative impact of globalization, which fuels the confrontation of civilizations. Since the mid-2000s, there has been a doctrinal rethinking of the role and place of Central Asia in the world - from a backward and troubled region to a clash of global interests and an economically important region of the world, dominance of great powers. By proclaiming a multi-vector open door policy in 2002, Tajikistan has doctrinally broadened its horizons of engagement with the world, going beyond the discourse of cooperation only with neighboring Muslim countries and Russia.
Features of the Formation of the Foundations of the Foreign Policy of the Republic of Kazakhstan
Authors: Demenko O. 
Published: August 2021

The article analyzes the foundations of the formation of the foreign policy of the Republic of Kazakhstan, which, first of all, are influenced by the traditions of the historical development of this country, its geopolitical location in the center of the Eurasian continent, transport and communication potential and the presence of large reserves of natural resources. It is emphasized that in modern Kazakhstan there is still no holistic perception of many historical events and processes, in particular those that were hushed up during the imperial and Soviet periods. At the same time, in the scientific discourse of the country, there is a rethinking of national history through criticism of the previous historical experience. It is noted that after the formation in the middle of the fifteenth century. In the Kazakh Khanate, the progressive development of statehood was replaced by a period of struggle against foreign invaders – first the Dzungars, and then the Russian Empire. It ended with the loss of statehood, the struggle for the restoration of which is presented in the form of a teleologically constructed narrative of the heroic struggle for independence, which includes a number of historical events and periods. The process of modern nation-state building in Kazakhstan is based on the consolidating role of the titular nation, which contributes to the growth of interest in historical issues and is accompanied by a gradual loss of the influence of Soviet-Russian narratives in political and historical discourse. A feature of the foreign policy of the Republic of Kazakhstan is a multi-vector approach, which has developed historically and is designed to ensure a balance between various geopolitical centers of power.
The priorities of Kazakhstan’s foreign policy are determined: the development of allied relations with the Russian Federation, a comprehensive strategic partnership with the PRC, an expanded strategic partnership with the United States, strategic relations with the Central Asian states, an expanded partnership and cooperation with the European Union.
La santé et la maladie dans la pensée de Georges Canguilhem et d’Oliver Sacks
Authors: Moinat Frédéric 
Published: August 2021

Cet article a pour but de montrer la proximité importante de deux auteurs, a priori très différents, au sujet de la question de la santé et de la maladie : Georges Canguilhem et Oliver Sacks. Ils se sont tous deux efforcés de critiquer une conception naturaliste et objectiviste de la santé et de la maladie, le premier en forgeant et en travaillant le concept de norme vitale, le deuxième en décrivant des patients atteints de troubles neurologiques. Ils se rejoignent pour soutenir que la maladie n’est pas une réalité antinaturelle ou aberrante, mais une façon de vivre, une forme d’équilibre physiologique. Toutefois, leurs façons de concevoir la santé vont s’avérer très différentes, pour ne pas dire antinomiques. Canguilhem se reconnaît très influencé par Nieztsche : la santé, c’est la grande santé, la capacité à surmonter les maladies et les épreuves. Il s’ensuit un dualisme entre les héros de la grande santé et la vie plus faible et plus fragile de tous les autres, un dualisme que Sacks remet radicalement en cause lorsqu’il montre que la maladie est aussi une expérience qui nous ouvre à des possibilités nouvelles. Le dialogue qui peut s’ouvrir entre ces deux penseurs permet de problématiser des enjeux essentiels de la question de la santé et de la maladie.
EL PRINCIPIO DE PROPORCIONALIDAD EN LA RESTAURACIÓN URBANÍSTICA ¿UN CABALLO DE TROYA EN LA SEGURIDAD JURÍDICA
Authors: CONDE ANTEQUERA JESÚS 
Published: August 2021

La trascendencia de la actividad urbanística no deja lugar a dudas
sobre la necesidad de la intervención administrativa disciplinaria. Pero tal intervención
ha de estar orientada por los principios que informan la actuación administrativa,
de los que, concretamente, resaltamos ahora los de legalidad, seguridad
jurídica y proporcionalidad. La aplicación del principio de proporcionalidad
en el ámbito restaurador urbanístico puede servir para dotar de racionalidad y justicia
a la actuación administrativa frente a la estricta aplicación de la norma y dar
solución a situaciones complejas en la práctica, pero es necesaria una mejor regulación
de los supuestos y requisitos para su aplicación a fin de evitar que la seguridad
jurídica se vea resentida y que sea utilizado como instrumento para justificar
ilegalidades.
Hirigintza-jardueraren garrantziak argi erakusten du administrazioaren
diziplinazko esku-hartzea beharrezkoa dela. Baina esku-hartze hori administrazioaren
jardueraren berri ematen duten printzipioek bideratu behar dute.
Printzipioon artean legaltasunekoak, segurtasun juridikokoak eta proportzionaltasunekoak
nabarmenduko ditugu jarraian. Proportzionaltasun printzipioa hirigintzako
zaharberritze arloan aplikatzeak balio dezake administrazioaren jarduera
arrazionaltasunez eta justiziaz hornitzeko arauaren aplikazio zorrotzen aurrean,
baita praktikan konplexuak diren egoerak konpontzeko ere. Baina beharrezkoa da
hori aplikatzeko suposizioak eta eskakizunak hobeto arautzea, segurtasun juridikoa
ez dadin ahuldu eta ez dadin erabili legez kontrako jarduerak justifikatzeko tresna
gisa.
The importance of town-planning activity is beyond doubt about
the need of the disciplinary administrative intervention. But that intervention has
to be directed by the principles which rule the administrative action, among which,
we specifically highlight the principle of legality, legal certainty and proportionality.
The application of the principle of proportionality in the town-planning urban
sphere can be suitable for providing the administrative action with rationality and
fairness against the strict application of the norm and so give answer to complex
situations, but it is necessary a better regulation of the facts and conditions for its
application so as to avoid to damage legal certainty and that it is used as a tool for
justifying illegalities.
ALGUMAS DIFICULDADES DA INFLUÊNCIA CLIMÁTICA NO VÔLEI DE PRAIA NA CIDADE DE MARATAÍZES – ES
Authors: Santos de Oliveira Weverton 
Published: August 2021

Neste artigo, vou dar ênfase na influência do Vento no Vôlei de Praia, além de mostrar algumas dificuldades encontradas no treinamento do vôlei de praia na cidade de Marataízes – ES, devido a grande influência climática, que vão oferecer uma base metodológica para adolescentes que com os treinos e adaptações ao clima poderão realizar a prática esportiva melhor, no vento, na chuva e com os olhos exposto aos raios solares, além de incrementar o artigo com alguns princípios do treinamento esportivo como: Conceitos, Definições, Possíveis Aplicações e Novos Olhares sobre o Vôlei de Praia em Marataízes/ES. Não posso falar sobre Vôlei de praia e a influência climática sem abordar neste trabalho também os principais objetivos dos Princípios do Treinamento Esportivo, seus conceitos e definições, e possíveis aplicações sob novas perspectivas, já que a pesquisa foi realizada através de uma coleta de conteúdo e revisão de literatura. Sobre o modelo de estudo, esse artigo pode ser tipificado como descritivo, qualitativo, tendo a análise de conteúdo o seu procedimento e característica principal. Atualmente, o vôlei de praia é um esporte muito praticado no Brasil, e tem uma grande legião de apaixonados e adeptos em cada canto do País. Isso ocorre devido à grande facilidade de ser praticado, por ter uma sensação de liberdade, além de não ter barreiras sociais e conta com grandes ídolos nacionais. Estimular atividade física em adolescentes e promover o pleno desenvolvimento físico e mental a cultura corporal de movimento utilizando a modalidade de Vôlei de Praia.