bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic diversity analysis of Chinese Leishmania isolates and development of L. donovani complex-specific markers by RAPD
Authors: Yuan Dongmei , Qin Hanxiao , Chen Dali , Chen Jianping 
Published: May 2021

Abstract
Background
Leishmaniasis is one of the most neglected tropical diseases in the world and remains endemic in some underdeveloped regions, including western China. The phylogeny and classification of Chinese Leishmania has not been completely clarified to date, especially within the Leishmania (L.) donovani complex, although phylogenetic analyses based on a series of gene markers have been performed. More analytic methods and data are still needed. Random amplified polymorphic DNA (RAPD) technology can sensitively identify slight intraspecific differences, and it is a powerful tool to seek species-specific markers. This work attempted to identify Chinese Leishmania isolates from diverse geographic regions at the genomic level. Meanwhile, specific markers of the L. donovani complex were also developed by RAPD.

Methods
RAPD was applied to 14 Chinese Leishmania isolates from diverse geographic regions and 3 WHO reference strains. The polymorphic sites of amplification were transformed into a data matrix, based on which genetic similarity was calculated, and a UPGMA dendrogram was constructed to analyse the genetic diversity of these Leishmania isolates. Meanwhile, the specific amplification loci of the L. donovani complex were TA-cloned, sequenced and converted into sequence characterized amplified region (SCAR) markers, which were validated preliminarily in 17 available Leishmania strains in this study and analysed by bioinformatics.

Results
The cluster analyses showed that the three Leishmania sp. isolates SC10H2, SD and GL clustered together and apart from others, the strains of the L. donovani complex clearly divided into two clades, and the three isolates Cy, WenChuan and 801 formed a subclade. Three specific SCAR markers of the L. donovani complex, i.e., 1-AD17, 2-A816 and 3-O13, were successfully obtained and validated on 17 available Leishmania strains in this study. Through bioinformatic analyses, Marker 1-AD17 may have more specificity for PCR detection of VL, and Marker 3-O13 has the potential to encode a protein.

Conclusions
The RAPD results verified that the undescribed Leishmania species causing visceral leishmaniasis (VL) in China was a unique clade distinguished from L. donovani and revealed that there was genetic differentiation among Chinese L. donovani. The identification of L. donovani-specific markers may help to provide a foundation for future research attempting to develop new specific diagnostic markers of VL and identify specific gene functions.
“What do you think about nephrology?” A national survey of internal medicine residents
Authors: Nakhoul Georges N. , Mehdi Ali , Taliercio Jonathan J. , Arrigain Susana , Schold Jesse D. , Spencer Abby , Greenfield Jessica , Diwakar Amit , Snyder Grace , O’Toole John , Nally Joseph V. , Sedor John R. , Kao Patricia F. , Bierer S. Beth 
Published: May 2021

AbstractBackgroundInterest in nephrology has been declining among internal medicine residents but the reasons behind this observation are not well characterized. Our objective was to evaluate factors influencing residents’ choice of subspecialty.MethodsThis is a mixed-method QUAL-QUAN design study that used the results of our previously published qualitative analysis on residents’ perception of nephrology to create and pilot a questionnaire of 60 questions. The final questionnaire was distributed to 26 programs across the United States and a total of 1992 residents. We calculated response rates and tabulated participant characteristics and percentage of participant responses. We categorized choice of fellowship into 2 medical categories (Highly Sought After vs. Less Sought After) and fitted a logistic regression model of choosing a highly vs. less sought after fellowship.ResultsFour hundred fifteen out of 1992 (21%) US residents responded to the survey. Of the 268 residents planning to pursue fellowship training, 67 (25%) selected a less sought after fellowship. Female sex was associated with significantly higher odds of selecting a less sought after fellowship (OR = 2.64, 95% CI: 1.47, 4.74). Major factors deterring residents from pursuing nephrology were perception of inadequate financial compensation, broad scope of clinical practice and complexity of patient population. We observed a decline in exposure to nephrology during the clinical years of medical school with only 35.4% of respondents rotating in nephrology versus 76.8% in residency. The quality of nephrology education was rated less positively during clinical medical school years (median of 50 on a 0–100 point scale) compared to the pre-clinical years (median 60) and residency (median 75).ConclusionOur study attempts to explain the declining interest in nephrology. Results suggest potential targets for improvement: diversified trainee exposure, sub-specialization of nephrology, and increased involvement of nephrologists in the education of trainees.
Seven-year retrospective study understanding the latent TB infection treatment cascade of care among adults in a low incidence country
Authors: Sullivan K. , Pease C. , Zwerling A. , Mallick R. , Van Dyk D. , Mulpuru S. , Allen C. , Alsdurf H. , Alvarez G. G. 
Published: May 2021

Abstract
Background
Prevention of TB is paramount to achieving elimination targets as recommended by the World Health Organization’s action framework for low incidence countries striving to eliminate TB. Although the rates of TB in Canada are low, understanding the latent TB infection (LTBI) cascade is paramount to identifying gaps in care and treatment barriers, thereby increasing the effectiveness of preventive strategies. The purpose of this study was to examine the LTBI cascade of care and identify barriers to treatment completion in adults referred from primary care to a regional tertiary care TB clinic in Ottawa, Canada.

Methods
Electronic medical records between January 2010 and December 2016 were reviewed retrospectively and an LTBI cascade of care was constructed from The Ottawa Hospital TB clinic and surrounding primary care clinics. A cohort of 2207 patients with untreated LTBI was used to ascertain the associations between demographic and clinical factors for both treatment non-initiation and non-completion using log-binomial univariable and multivariable regression models.

Results
Of 2207 patients with untreated LTBI who were seen in the clinic during the study period, 1771 (80.2%) were offered treatment, 1203 (67.9% of those offered) started treatment, and 795 (66.1% of those started) completed treatment. In multivariable analysis, non-initiation of treatment was associated with older age (adjusted risk ratio [aRR] 1.06 per 5-year increase, 95% CI: 1.03–1.08) and female gender (aRR 1.28, 95% CI: 1.11–1.47). Non completion of treatment was associated with referral from the TB Clinic back to the primary care team following initial consult (aRR 1.62, 95% CI: 1.35–1.94) and treatment with the standard of 9 months of Isoniazid (9H) compared to 4 months of Rifampin (4R) (aRR 1.45, 95% CI:1.20–1.74).

Conclusions
LTBI treatment completion was significantly decreased among patients who were referred back to primary care from the TB clinic. The 4R regimen resulted in more people completing LTBI treatment compared to 9H in keeping with a recently published RCT. Improved education, communication, and collaboration between tertiary care TB clinics and primary care teams may improve treatment completion rates and address the TB burden in low incidence communities in Canada.
Differential impact of non-pharmaceutical public health interventions on COVID-19 epidemics in the United States
Authors: Liu Xiaoshuang , Xu Xiao , Li Guanqiao , Xu Xian , Sun Yuyao , Wang Fei , Shi Xuanling , Li Xiang , Xie Guotong , Zhang Linqi 
Published: May 2021

Abstract
Background
The widespread pandemic of novel coronavirus disease 2019 (COVID-19) poses an unprecedented global health crisis. In the United States (US), different state governments have adopted various combinations of non-pharmaceutical public health interventions (NPIs), such as non-essential business closures and gathering bans, to mitigate the epidemic from February to April, 2020. Quantitative assessment on the effectiveness of NPIs is greatly needed to assist in guiding individualized decision making for adjustment of interventions in the US and around the world. However, the impacts of these approaches remain uncertain.

Methods
Based on the reported cases, the effective reproduction number (Rt) of COVID-19 epidemic for 50 states in the US was estimated. Measurements on the effectiveness of nine different NPIs were conducted by assessing risk ratios (RRs) between Rt and NPIs through a generalized linear model (GLM).

Results
Different NPIs were found to have led to different levels of reduction in Rt. Stay-at-home contributed approximately 51% (95% CI 46–57%), wearing (face) masks 29% (15–42%), gathering ban (more than 10 people) 19% (14–24%), non-essential business closure 16% (10–21%), declaration of emergency 13% (8–17%), interstate travel restriction 11% (5–16%), school closure 10% (7–14%), initial business closure 10% (6–14%), and gathering ban (more than 50 people) 7% (2–11%).

Conclusions
This retrospective assessment of NPIs on Rt has shown that NPIs played critical roles on epidemic control in the US in the past several months. The quantitative results could guide individualized decision making for future adjustment of NPIs in the US and other countries for COVID-19 and other similar infectious diseases.
Real time surveillance of COVID-19 space and time clusters during the summer 2020 in Spain
Authors: Rosillo Nicolás , Del-Águila-Mejía Javier , Rojas-Benedicto Ayelén , Guerrero-Vadillo María , Peñuelas Marina , Mazagatos Clara , Segú-Tell Jordi , Ramis Rebeca , Gómez-Barroso Diana 
Published: May 2021

Abstract
Background
On June 21st de-escalation measures and state-of-alarm ended in Spain after the COVID-19 first wave. New surveillance and control strategy was set up to detect emerging outbreaks.

Aim
To detect and describe the evolution of COVID-19 clusters and cases during the 2020 summer in Spain.

Methods
A near-real time surveillance system to detect active clusters of COVID-19 was developed based on Kulldorf’s prospective space-time scan statistic (STSS) to detect daily emerging active clusters.

Results
Analyses were performed daily during the summer 2020 (June 21st – August 31st) in Spain, showing an increase of active clusters and municipalities affected. Spread happened in the study period from a few, low-cases, regional-located clusters in June to a nationwide distribution of bigger clusters encompassing a higher average number of municipalities and total cases by end-August.

Conclusion
STSS-based surveillance of COVID-19 can be of utility in a low-incidence scenario to help tackle emerging outbreaks that could potentially drive a widespread transmission. If that happens, spatial trends and disease distribution can be followed with this method. Finally, cluster aggregation in space and time, as observed in our results, could suggest the occurrence of community transmission.
Selection of the fusion and fixation range in the intervertebral surgery to correct thoracolumbar and lumbar tuberculosis: a retrospective clinical study
Authors: Yang Zongqiang , Liu Changhao , Niu Ningkui , Tang Jing , Shi Jiandang , Wang Zili , Ding Huiqiang 
Published: May 2021

Abstract
Background
To compare the diseased verses the non-diseased intervertebral surgery used in the treatment of thoracolumbar and lumbar spinal tuberculosis and to explore the best choice of fusion of fixation range.

Methods
Two hundred twenty-one patients with thoracolumbar and lumbar tuberculosis were categorized into two groups. One hundred eighteen patients underwent the diseased intervertebral surgery (lesion vertebral pedicle fixation, Group A) and 103 patients underwent the non-diseased intervertebral surgery (1 or 2 vertebral fixation above and below the affected vertebra, group B). Spinal tuberculosis diagnosis was confirmed in both groups of patients before lesion removal, bone graft fusion, and internal fixation. Clinical data and efficacy of the two surgical methods were then evaluated.

Results
The mean follow-up duration for both procedures was 65 months (50–68 months range). There were no significant differences in laboratory examinations, VAS scores, and the Cobb angle correction rate and the angle loss. However, significant differences existed in the operation time, blood loss, serosanguineous drainage volume, and blood transfusion requirement between the two groups. The diseased intervertebral surgery group performed significantly better than the non-diseased intervertebral surgery group in all of these areas. In both cases, the bone graft fused completely with the normal bone by the last follow-up, occuring at 50–86 months post surgery.

Conclusion
The diseased intervertebral surgery is a safe and feasible option for the treatment of thoracolumbar and lumbar tuberculosis. It effectively restores the physiological curvature of the spine and reduces the degeneration of adjacent vertebral bodies in the spinal column.
Self-worth and bonding emotions are related to well-being in health-care providers: a cross-sectional study
Authors: Weilenmann Sonja , Schnyder Ulrich , Keller Nina , Corda Claudio , Spiller Tobias R. , Brugger Fabio , Parkinson Brian , von Känel Roland , Pfaltz Monique C. 
Published: May 2021

Abstract
Background
Interacting with patients can elicit a myriad of emotions in health-care providers. This may result in satisfaction or put providers at risk for stress-related conditions such as burnout. The present study attempted to identify emotions that promote provider well-being. Following eudaimonic models of well-being, we tested whether certain types of emotions that reflect fulfilment of basic needs (self-worth, bonding with patients) rather than positive emotions in general (as suggested by hedonic models) are linked to well-being. Specifically, we hypothesized that well-being is associated with positive emotions directed at the self, which reflect self-worth, and positive as well as negative emotions (e.g., worry) directed at the patient, which reflect bonding. However, we expected positive emotions directed at an object/situation (e.g., curiosity for a treatment) to be unrelated to well-being, because they do not reflect fulfilment of basic needs.

Methods
Fifty eight physicians, nurses, and psychotherapists participated in the study. First, in qualitative interviews, they reported their emotions directed at the self, the patient, or an object/situation during distressing interactions with patients. These emotions were categorised into positive emotions directed towards the self, the patient, and an object/situation, and negative emotions directed towards the patient that reflect bonding. Second, providers completed questionnaires to assess their hedonic and eudaimonic well-being. The well-being scores of providers who did and did not experience these emotions were compared.

Results
Providers who experienced positive emotions directed towards the self or the patient had higher well-being than those who did not. Moreover, for the first time, we found evidence for higher well-being in providers reporting negative patient-directed emotions during distressing interactions. There was no difference between providers who did and did not experience positive object/situation-directed emotions.

Conclusions
These findings may point towards the importance of “eudaimonic” emotions rather than just positive emotions in interactions with patients. Emotions such as contentment with oneself, joy for the patient’s improvement, and, notably, grief or worry for the patient may build a sense of self-worth and strengthen bonding with the patient. This may explain their association with provider well-being.
Does organizational vision really matter? An empirical examination of factors related to organizational vision integration among hospital employees
Authors: Slåtten Terje , Mutonyi Barbara Rebecca , Lien Gudbrand 
Published: May 2021

AbstractBackgroundThere seems to be a consensus that a vision for an organization is a valuable thing for organizations to have. However, research on organizational vision has predominantly been studied from a leadership perspective. In contrast to previous research, organizational vision in this paper takes an employee perspective. Specifically, the purpose is to examine factors associated with the integration of organizational vision among employees in hospital organizations. Consequently, it focuses on a relatively neglected domain within health services research.MethodsA conceptual model, centred on the concept of organizational vision integration, was developed and tested on a sample (N = 1008) consisting of hospital employees. Partial least-squares structural equation modelling (PLS-SEM) was used to test the hypotheses, using SmartPLS 3 software. Furthermore, a bootstrapping test was used to inspect potential mediating effects. Specifically, the test assessed whether the proposed direct and indirect effects were statistically significant, and at the same time revealed the nature of the mediation effect.ResultsThe results from the empirical study reveal three key findings: i) organizational vision integration among employees is directly and positively related to creative performance in their respective work role (β= 0.16). Organizational vision integration and employees’ psychological capital explains almost 40% (R2= 0.36) in employees’ creative performance, ii) psychological capital and employees’ perception of organizational attractiveness are directly and positively related to employees’ organizational vision integration (β= 0.19 andβ= 0.40, respectively) and explains about 30% (R2= 0.29) of employees’ organizational vision integration, iii) employees’ organizational vision integration mediates the relationship between employees’ psychological capital, perception of organizational attractiveness and employees’ creative performance.ConclusionsTaking an employee perspective, this study contributes to revealing whether and how organizational vision matters and its impact on hospital employees’ work performance. To achieve organizational vision integration among hospital employees successfully, this study shows that it is important for hospital leaders to be aware of the pattern of impact of both personal as well as environmental-related factors.
Development and validation of the medical professionals resilience scale
Authors: Rahman Mardhati Ab , Yusoff Muhamad Saiful Bahri , Roslan Nurhanis Syazni , Mohammad Jamilah Al-Muhammady , Ahmad Anisa 
Published: May 2021

Abstract
Purpose
Most of the resilience scales were developed for the non-medical population, therefore the purpose of this study was developing and validating a resilience scale for medical professionals – namely Medical Professionals Resilience Scale (MeRS).

Methods
A questionnaire development and validation study was conducted. The resilience domains and items were identified and generated through a literature review. The content validation was carried out by content experts and the content validity index (CVI) was calculated. The face validation was performed by medical officers and the face validity index (FVI) was calculated. The final MeRS was administered to 167 medical officers, exploratory factor analysis (EFA) and reliability analysis were performed to assess MeRS’s factorial structure and internal consistency.

Results
Four domains with 89 items of medical professionals’ resilience were developed. Following that, the content and face validation was conducted, and a total of 41-items remained for construct validation. EFA extracted four factors, namely growth, control, involvement, and resourceful, with a total of 37 items. The items’ CVI and FVI values were more than 0.80. The final MeRS’s items had factor loading values ranged from 0.41 to 0.76, and the Cronbach’s alpha values of the resilience domains ranged from 0.72 to 0.89.

Conclusions
MeRS is a promising scale for measuring medical professionals’ resilience as it showed good psychometric properties. This study provided validity evidence in terms of content, response process, and internal structure that supported the validity of MeRS in the measurement of resilience domains among medical professionals.
The identification of novel gene mutations for degenerative lumbar spinal stenosis using whole-exome sequencing in a Chinese cohort
Authors: Jiang Xin , Chen Dong 
Published: May 2021

Abstract
Background
Degenerative lumbar spinal stenosis (DLSS) is a common lumbar disease that requires surgery. Previous studies have indicated that genetic mutations are implicated in DLSS. However, studies on specific gene mutations are scarce. Whole-exome sequencing (WES) is a valuable research tool that identifies disease-causing genes and could become an effective strategy to investigate DLSS pathogenesis.

Methods
From January 2016 to December 2017, we recruited 50 unrelated patients with symptoms consistent with DLSS and 25 unrelated healthy controls. We conducted WES and exome data analysis to identify susceptible genes. Allele mutations firstly identified potential DLSS variants in controls to the patients’ group. We conducted a site-based association analysis to identify pathogenic variants using PolyPhen2, SIFT, Mutation Taster, Combined Annotation Dependent Depletion, and Phenolyzer algorithms. Potential variants were further confirmed using manual curation and validated using Sanger sequencing.

Results
In this cohort, the major classification variant was missense_mutation, the major variant type was single nucleotide polymorphism (SNP), and the major single nucleotide variation was C > T. Multiple SNPs in 34 genes were identified when filtered allele mutations in controls to retain only patient mutations. Pathway enrichment analyses revealed that mutated genes were mainly enriched for immune response-related signaling pathways. Using the Novegene database, site-based associations revealed several novel variants, including HLA-DRB1, PARK2, ACTR8, AOAH, BCORL1, MKRN2, NRG4, NUP205 genes, etc., were DLSS related.

Conclusions
Our study revealed that deleterious mutations in several genes might contribute to DLSS etiology. By screening and confirming susceptibility genes using WES, we provided more information on disease pathogenesis. Further WES studies incorporating larger DLSS patient cohorts are required to comprehend the genetic landscape of DLSS pathophysiology fully.