bluuebunny/crossref_metadata_2025_split huggingface dataset:
The perceived impact of the Covid-19 pandemic on medical student education and training – an international survey
Authors:   TMS Collaborative, Wanigasooriya Kasun , Beedham William , Laloo Ryan , Karri Rama Santhosh , Darr Adnan , Layton Georgia R. , Logan Peter , Tan Yanyu , Mittapalli Devender , Patel Tapan , Mishra Vivaswan Dutt , Odeh Osama , Prakash Swathi , Elnoamany Salma , Peddinti Sri Ramya , Daketsey Elorm Adzoa , Gadgil Shardool , Bouhuwaish Ahmad Elmabri Mohammad , Ozair Ahmad , Bansal Sanchit , Elhadi Muhammed , Godbole Aditya Amit , Axiaq Ariana , Rauf Faateh Ahmad , Ashpak Ashna 
Published: November 2021

Abstract
Background
The Covid-19 pandemic led to significant changes and disruptions to medical education worldwide. We evaluated medical student perceived views on training, their experiences and changes to teaching methods during the pandemic.

Methods
An online survey of medical students was conducted in the Autumn of 2020. An international network of collaborators facilitated participant recruitment. Students were surveyed on their perceived overall impact of Covid-19 on their training and several exposure variables. Univariate analyses and adjusted multivariable analysis were performed to determine strengths in associations.

Results
A total of 1604 eligible participants from 45 countries took part in this survey and 56.3% (n = 860) of these were female. The median age was 21 (Inter Quartile Range:21–23). Nearly half (49.6%, n = 796) of medical students were in their clinical years. The majority (n = 1356, 84.5%) were residents of a low or middle income country. A total of 1305 (81.4%) participants reported that the Covid-19 pandemic had an overall negative impact on their training. On adjusted analysis, being 21 or younger, females, those reporting a decline in conventional lectures and ward based teaching were more likely to report an overall negative impact on their training (p ≤ 0.001). However, an increase in clinical responsibilities was associated with lower odds of participants reporting a negative impact on training (p < 0.001). The participant’s resident nation economy and stage of training were associated with some of the participant training experiences surveyed (p < 0.05).

Conclusion
An international cohort of medical students reported an overall significant negative impact of the Covid-19 pandemic on their undergraduate training. The efficacy of novel virtual methods of teaching to supplement traditional teaching methods warrants further research.
Determinants of research productivity during postgraduate medical education: a structured review
Authors: Laupland Kevin B. , Edwards Felicity , Dhanani Jayesh 
Published: November 2021

Abstract
Background
Although formal participation in research is an integral and often mandatory component of clinical training programs, resulting productivity is highly variable. The objective of this review was to identify determinants of successful research performance among graduate medical education trainees.

Methods
A structured review of the published literature was performed by searching PubMed, CINAHL, and EMBASE from inception through to 7 April, 2021. Articles examining graduate medical education trainee research productivity evidenced by publications in peer-reviewed journals were included.

Results
Eighty-five articles were included of which most (66; 78%) were reported from the USA or Canada (10; 12%). A wide range of disciplines were represented with the most common being general surgery, internal medicine, orthopedic surgery, and pediatrics. Themes (number of reports) included trainee characteristics (n = 24), project characteristics (n = 8), mentoring/supervision (n = 11), and programmatic aspects (n = 57). Although variable results were observed, research productivity tended to be higher with prior research experience, later years of training, male gender, and pursuit of a postgraduate degree. Few project related aspects of success were identified. Trainee publication was associated with mentors with higher rank, publication productivity, and supportive academic environments. Training programs with organised programs/curricula including protection of time for research were associated with increased productivity as were provision of incentives or rewards but not mandatory requirements.

Conclusion
This review identifies several trainee characteristics, project and mentor aspects, and programmatic aspects associated with increased productivity that may serve as a useful resource for trainees and graduate medical education training programs.
Examining gender differentials and determinants of private health insurance coverage in Zambia
Authors: Mulenga James , Mulenga Mulenga C. , Musonda Katongo M. C. , Phiri Chilizani 
Published: November 2021

AbstractBackgroundHealth insurance is an essential aspect of healthcare. This is because it enables the insured to acquire timely and essential healthcare services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and determinants of health insurance coverage in Zambia.MethodsThe data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data were analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses.ResultsThe study reveals that for women and men, age, wealth category, education, and professional occupation are positively associated with health insurance while being self-employed in the agricultural sector negatively influences health insurance coverage for both sexes. Other variables have gender-specific effects. For instance, being in marital union and having a clerical occupation increases the probability of having health insurance for women while being in the services, skilled, and unskilled manual occupations increases the probability of having health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men.ConclusionThe study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include enhancing education, job creation, diversifying insurance schemes, and gender consideration in the design of National Health Insurance Scheme.
The transposable element-rich genome of the cereal pest Sitophilus oryzae
Authors: Parisot Nicolas , Vargas-Chávez Carlos , Goubert Clément , Baa-Puyoulet Patrice , Balmand Séverine , Beranger Louis , Blanc Caroline , Bonnamour Aymeric , Boulesteix Matthieu , Burlet Nelly , Calevro Federica , Callaerts Patrick , Chancy Théo , Charles Hubert , Colella Stefano , Da Silva Barbosa André , Dell’Aglio Elisa , Di Genova Alex , Febvay Gérard , Gabaldón Toni , Galvão Ferrarini Mariana , Gerber Alexandra , Gillet Benjamin , Hubley Robert , Hughes Sandrine , Jacquin-Joly Emmanuelle , Maire Justin , Marcet-Houben Marina , Masson Florent , Meslin Camille , Montagné Nicolas , Moya Andrés , Ribeiro de Vasconcelos Ana Tereza , Richard Gautier , Rosen Jeb , Sagot Marie-France , Smit Arian F. A. , Storer Jessica M. , Vincent-Monegat Carole , Vallier Agnès , Vigneron Aurélien , Zaidman-Rémy Anna , Zamoum Waël , Vieira Cristina , Rebollo Rita , Latorre Amparo , Heddi Abdelaziz 
Published: November 2021

Abstract
Background
The rice weevil Sitophilus oryzae is one of the most important agricultural pests, causing extensive damage to cereal in fields and to stored grains. S. oryzae has an intracellular symbiotic relationship (endosymbiosis) with the Gram-negative bacterium Sodalis pierantonius and is a valuable model to decipher host-symbiont molecular interactions.

Results
We sequenced the Sitophilus oryzae genome using a combination of short and long reads to produce the best assembly for a Curculionidae species to date. We show that S. oryzae has undergone successive bursts of transposable element (TE) amplification, representing 72% of the genome. In addition, we show that many TE families are transcriptionally active, and changes in their expression are associated with insect endosymbiotic state. S. oryzae has undergone a high gene expansion rate, when compared to other beetles. Reconstruction of host-symbiont metabolic networks revealed that, despite its recent association with cereal weevils (30 kyear), S. pierantonius relies on the host for several amino acids and nucleotides to survive and to produce vitamins and essential amino acids required for insect development and cuticle biosynthesis.

Conclusions
Here we present the genome of an agricultural pest beetle, which may act as a foundation for pest control. In addition, S. oryzae may be a useful model for endosymbiosis, and studying TE evolution and regulation, along with the impact of TEs on eukaryotic genomes.
Prognostic impact of hypochromic erythrocytes in patients with pulmonary arterial hypertension
Authors: Xanthouli Panagiota , Theobald Vivienne , Benjamin Nicola , Marra Alberto M. , D’Agostino Anna , Egenlauf Benjamin , Shaukat Memoona , Ding Cao , Cittadini Antonio , Bossone Eduardo , Kögler Maria , Grünig Ekkehard , Muckenthaler Martina U. , Eichstaedt Christina A. 
Published: November 2021

Abstract
Background
Iron deficiency affects up to 50% of patients with pulmonary arterial hypertension (PAH) but iron markers such as ferritin and serum iron are confounded by several non-disease related factors like acute inflammation and diet. The aim of this study was to identify a new marker for iron deficiency and clinical outcome in PAH patients.

Methods
In this single-center, retrospective study we assessed indicators of iron status and clinical parameters specifying the time to clinical worsening (TTCW) and survival in PAH patients at time of initial diagnosis and at 1-year follow-up using univariable and multivariable analysis.

Results
In total, 150 patients were included with an invasively confirmed PAH and complete data on iron metabolism. The proportion of hypochromic erythrocytes > 2% at initial diagnosis was identified as an independent predictor for a shorter TTCW (p = 0.0001) and worse survival (p = 0.002) at initial diagnosis as well as worse survival (p = 0.016) at 1-year follow-up. Only a subset of these patients (64%) suffered from iron deficiency. Low ferritin or low serum iron neither correlated with TTCW nor survival. Severe hemoglobin deficiency at baseline was significantly associated with a shorter TTCW (p = 0.001).

Conclusions
The presence of hypochromic erythrocytes > 2% was a strong and independent predictor of mortality and shorter TTCW in this cohort of PAH patients. Thus, it can serve as a valuable indicator of iron homeostasis and prognosis even in patients without iron deficiency or anemia. Further studies are needed to confirm the results and to investigate therapeutic implications.
Functional pre-therapeutic evaluation by genome editing of variants of uncertain significance of essential tumor suppressor genes
Authors: Billaud Amandine , Chevalier Louise-Marie , Augereau Paule , Frenel Jean-Sebastien , Passot Christophe , Campone Mario , Morel Alain 
Published: November 2021

AbstractBackgroundTargeted therapies in oncology are promising but variants of uncertain significance (VUS) limit their use for clinical management and necessitate functional testing in vitro. UsingBRCA1andBRCA2variants, which have consequences on PARP inhibitor sensitivity, andPOLEvariants, potential biomarkers of immunotherapy response, we developed a rapid functional assay based on CRISPR-Cas9 genome editing to determine the functional consequences of these variants having potentially direct implications on patients’ access to targeted therapies.MethodsWe first evaluated the functional impact of 26BRCA1and 7BRCA2variants by editing and comparing NGS results between the variant of interest and a silent control variant. Ten of these variants had already been classified as benign or pathogenic and were used as controls. Finally, we extended this method to the characterization ofPOLEVUS.ResultsFor the 23 variants that were unclassified or for which conflicting interpretations had been reported, 15 were classified as functionally normal and 6 as functionally abnormal. Another two variants were found to have intermediate consequences, both with potential impacts on splicing. We then compared these scores to the patients’ responses to PARP inhibitors when possible. Finally, to prove the application of our method to the classification of variants from other tumor suppressor genes, we exemplified with threePOLEVUS. Among them, two were classified with an intermediate functional impact and one was functionally abnormal. Eventually, fourPOLEvariants previously classified in databases were also evaluated. However, we found evidence of a discordance with the classification, variant p.Leu424Val being found here functionally normal.ConclusionsOur new rapid functional assay can be used to characterize the functional implication ofBRCA1andBRCA2variants, giving patients whose variants were evaluated as functionally abnormal access to PARP inhibitor treatment. Retrospective analysis of patients’ responses to PARP inhibitors, where accessible, was consistent with our functional score evaluation and confirmed the accuracy of our protocol. This method could potentially be extended to the classification of VUS from all essential tumor suppressor genes and can be performed within a timeframe compatible with clinical applications, thereby having a direct theranostic impact.
Gummatous neurosyphilis in an elderly patient in the Australian outback: a case report
Authors: Devanand Nilesh Anand , Sundararajan Krishnaswamy 
Published: November 2021

Abstract
Introduction
Neurosyphilis is an infection caused by the spirochete Treponema pallidum, which causes infiltration and thickening of brain meninges. Despite being an Old World disease, the rates of infection continue to rise. This clinical challenge involves early and accurate diagnosis, as neurosyphilis masquerades with various clinical symptoms and is often missed during initial presentation to the hospital. A comprehensive history and clinical examination are essential to detect suspicious cases early for further cerebrospinal fluid examination and neuroimaging. Patients treated with benzylpenicillin for a specific duration often show promising clinical and cognitive improvement, thus emphasizing the need for constant vigilance in our day-to-day practice.

Case presentation
A 77-year-old Caucasian gentleman presented to our hospital repeatedly with multiple episodes of presyncope and cognitive impairment. He also demonstrated bilateral deafness, tabes dorsalis, and left sixth cranial nerve palsy. His cerebrospinal fluid examination showed a nonreactive venereal disease research laboratory test, and magnetic resonance imaging of the brain revealed a gumma.

Conclusion
The diagnosis of neurosyphilis in the elderly requires a combination of clinical vigilance and a high index of suspicion, along with multimodal investigations, including cerebrospinal fluid examination and brain imaging.
Clinical application of mesenchymal stem cells in rheumatic diseases
Authors: Wang Yajing , Ma Dan , Wu Zewen , Yang Baoqi , Li Rong , Zhao Xingxing , Yang Helin , Zhang Liyun 
Published: November 2021

AbstractMesenchymal stem cells (MSCs) are pluripotent stem cells derived from mesoderm during early development that are characterized by high self-renewal ability and multidirectional differentiation potential. These cells are present various tissues in the human body and can be cultured in vitro. Under specific conditions, MSCs can differentiate into osteoblasts, neuron-like cells, adipocytes and muscle cells and so on, therefore, have a great application value in cell replacement therapy and tissue repair. In recent years, the application of MSCs in rheumatic diseases has received increasing attention. On the one hand, MSCs have the ability to differentiate into bone and cartilage cells; on the other hand, these stem cells are also involved in immune regulation, resulting in the alleviation of inflammation and anti-fibrotic properties and the promotion of vascular repair, thus bringing new hope for the treatment of rheumatic diseases. This article reviews the clinical progress in MSC application for the treatment of rheumatic diseases.
Are wheezing, asthma and eczema in children associated with mother’s health during pregnancy? Evidence from an Australian birth cohort
Authors: Ahmad Kabir , Kabir Enamul , Ormsby Gail M. , Khanam Rasheda 
Published: November 2021

Abstract
Background
This study investigated the prevalence of wheezing, asthma, and eczema among Australian children using longitudinal data from birth to 15 years of age. This study also examined the association between maternal health status during pregnancy and their offspring’s respiratory and allergic morbidities using sex-segregated data.

Methods
This study used data from the Longitudinal Study of Australian Children (LSAC) where approximately 5000 children of a birth cohort across Australia were surveyed in 2004. These children were followed biennially in eight waves up to their age of 15 years until 2018. The status of the children’s wheezing, asthma, and eczema were reported by the mothers upon doctors’ diagnosis (for asthma) or self-assessment (for wheezing or eczema). Binomial logistic regression models were used to analyse associations between maternal health during pregnancy and their children’s health outcomes.

Results
Asthma prevalence among 0–1-year aged children was 11.7%, increased to 15.4% when the children were 10–11 years old, and then decreased to 13.6% when they were 14–15 years old. Wheezing and eczema were most prevalent when the children were 2–3 years old (26.0 and 17.8% respectively) and were least prevalent when the children were 14–15 years old (7.3 and 9.5% respectively). Maternal asthma, smoking during pregnancy, and pre-pregnancy obesity were significantly associated with an increased risk of wheezing and asthma in Australian children. Childhood eczema was associated only with maternal asthma. These associations were stronger among male children up to age 10–11 and during adolescence (12–15 years of age), female children were more prone to wheezing, asthma, and eczema.

Conclusion
This is a comprehensive longitudinal study of Australian children (0–15 years of age) to assess the prevalence (with sex-specific differences) of wheezing, asthma and eczema as well as the association between these respiratory and allergic morbidities and maternal health during pregnancy. The study findings suggest that careful medical and obstetric monitoring, improved specific age-sex wise risk factor prevention for children and health promotion for pregnant women would help protect child health.
Time to first antenatal care visit among pregnant women in Ethiopia: secondary analysis of EDHS 2016; application of AFT shared frailty models
Authors: Fentaw Kenaw Derebe , Fenta Setegn Muche , Biresaw Hailegebrael Birhan , Mulugeta Solomon Sisay 
Published: November 2021

Abstract
Background
The survival of pregnant women is one of great interest of the world and especially to a developing country like Ethiopia which had the highest maternal mortality ratios in the world due to low utilization of maternal health services including antenatal care (ANC). Survival analysis is a statistical method for data analysis where the outcome variable of interest is the time to occurrence of an event. This study demonstrates the applications of the Accelerated Failure Time (AFT) model with gamma and inverse Gaussian frailty distributions to estimate the effect of different factors on time to first ANC visit of pregnant women in Ethiopia.

Methods
This study was conducted by using 2016 EDHS data about factors associated with the time to first ANC visit of pregnant women in Ethiopia. A total of 4328 women from nine regions and two city administrations whose age group between 15 and 49 years were included in the study AFT models with gamma and inverse Gaussian frailty distributions have been compared using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) to select the best model.

Results
The factors residence, media exposure, wealth index, education level of women, education level of husband and husband occupation are found to be statistically significant (P-value < 0.05) for the survival time of time to first ANC visit of pregnant women in Ethiopia. Inverse Gaussian shared frailty model with Weibull as baseline distribution is found to be the best model for the time to first ANC visit of pregnant women in Ethiopia. The model also reflected there is strong evidence of the high degree of heterogeneity between regions of pregnant women for the time to first ANC visit.

Conclusion
The median time of the first ANC visit for pregnant women was 5 months. From different candidate models, Inverse Gaussian shared frailty model with Weibull baseline is an appropriate approach for analyzing time to first ANC visit of pregnant women data than without frailty model. It is essential that maternal and child health policies and strategies better target women’s development and design and implement interventions aimed at increasing the timely activation of prenatal care by pregnant women. The researchers also recommend using more powerful designs (such as cohorts) for the research to establish timeliness and reduce death.
Brass products in the coronet excavated from an M2-numbered Sui-Tang-dynasty tomb situated in Kun Lun Company in Xi'an, Shaanxi
Authors: Shao Yanbing , Jiang Fengrui , Du Jingnan , Yang Junchang , Zhang Quanmin 
Published: November 2021

Abstract
Ancient Chinese brass smelting technology has promoted the invention of zinc smelting, thus becoming an important part of the metallurgical history. However, the information concerning its origin and development is still controversial. In that regard, thorough analysis of composition and structure of the early brass is crucial for studying various stages of the ancient brass smelting technology history. This study aimed to investigate brass artifacts from Kunlun M2 tomb in Xi'an, Shaanxi, dating back during Sui to early Tang Dynasty (581–712 AD). The composition and metallographic characterization of the materials was performed using XRF, SEM–EDS and metallographic analysis. According to the results, brass was composed of 83 wt% of copper, 12 wt% of zinc, and 3 wt% of tin. Furthermore, its microstructure consisted of α-isometric single crystals with some slip lines and a few twinned grains. This indicated that brass was obtained by melting an appropriate mixture of zinc ores and copper ores at a temperature above 920 °C. Furthermore, brass support components were installed on the coronet after integral hot forging and partial cold shaping. Besides, the use of brass in the coronet was in conformity with the social hierarchy of that historical period, and also reflected the attention paid to the properties of materials.