bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in the pursuit of multiple orthopedic surgery fellowships among orthopedic trainees in Saudi Arabia
Authors: Alomar Abdulaziz Z. 
Published: January 2022

Abstract
Background
The increase in the enrollment of orthopedic surgery residents in multiple fellowship programs has gained considerable interest. Different factors may determine the specialty and number of fellowships trainees enroll in. This study aimed to elucidate these factors and determinants among orthopedic trainees.

Methods
This is a descriptive cross-sectional study, which was conducted among orthopedic surgical trainees (residency and fellowship training programs) in Saudi Arabia, between March 2021 and May 2021. The data were obtained through an online anonymous questionnaire aiming to clarify the most influential factors that determine the number of fellowships trainees choose, as well as to compare the choice of single fellowships with those of multiple ones.

Results
Two hundred and fifty orthopedic trainees (201 (80%) males and 49 (20%) females) completed the survey. Among them, 216 (86%) and 34 (14%) were residents and fellows, respectively, and 81% (n = 203) of the trainees preferred multiple fellowship training, and 22% (n = 47) preferred a single fellowship specialty. Notably, the male trainees preferred multiple fellowships to a single one (85% vs. 62%, p-value = 0.001), while the female trainees preferred single fellowships to multiple ones (38% vs. 15%, p-value = 0.001). The expected rate of income (17% vs. 9%), job opportunities in the private sector (17% vs. 9%), and availability and guarantee of jobs (33% vs. 23%) were the most significant factors that influenced the choices of the participants toward enrolling in multiple fellowships (p-values = 0.001, 0.001, and 0.004, respectively).

Conclusions
The study demonstrated that most of the orthopedic trainees in Saudi Arabia prefer the pursuits of multiple fellowship programs. Further, the female trainees preferred single fellowships, whereas the male ones preferred multiple fellowships. The main influencing factors for pursuing multiple fellowships were determined to be private job opportunities, financial gains, and job guarantees.
Loss of RPS27a expression regulates the cell cycle, apoptosis, and proliferation via the RPL11-MDM2-p53 pathway in lung adenocarcinoma cells
Authors: Li Hongyan , Zhang Hong , Huang Guomin , Bing Zhitong , Xu Duling , Liu Jiadi , Luo Hongtao , An Xiaoli 
Published: January 2022

Abstract
Background
Depletion of certain ribosomal proteins induces p53 activation, which is mediated mainly by ribosomal protein L5 (RPL5) and/or ribosomal protein L11 (RPL11). Therefore, RPL5 and RPL11 may link RPs and p53 activation. Thus, this study aimed to explore whether RPs interact with RPL11 and regulate p53 activation in lung adenocarcinoma (LUAD) cells.

Methods
The endogenous RPL11-binding proteins in A549 cells were pulled down through immunoprecipitation and identified with a proteomics approach. Docking analysis and GST-fusion protein assays were used to analyze the interaction of ribosomal protein S27a (RPS27a) and RPL11. Co-immunoprecipitation and in vitro ubiquitination assays were used to detect the effects of knockdown of RPS27a on the interaction between RPS27a and RPL11, and on p53 accumulation. Cell cycle, apoptosis, cell invasion and migration, cell viability and colony-formation assays were performed in the presence of knockdown of RPS27a. The RPS27a mRNA expression in LUAD was analyzed on the basis of the TCGA dataset, and RPS27a expression was detected through immunohistochemistry in LUAD samples. Finally, RPS27a and p53 expression was analyzed through immunohistochemistry in A549 cell xenografts with knockdown of RPS27a.

Results
RPS27a was identified as a novel RPL11 binding protein. GST pull-down assays revealed that RPS27a directly bound RPL11. Knockdown of RPS27a weakened the interaction between RPS27a and RPL11, but enhanced the binding of RPL11 and murine double minute 2 (MDM2), thereby inhibiting the ubiquitination and degradation of p53 by MDM2. Knockdown of RPS27a stabilized p53 in an RPL11-dependent manner and induced cell viability inhibition, cell cycle arrest and apoptosis in a p53-dependent manner in A549 cells. The expression of RPS27a was upregulated in LUAD and correlated with LUAD progression and poorer prognosis. Overexpression of RPS27a correlated with upregulation of p53, MDM2 and RPL11 in LUAD clinical specimens. Knockdown of RPS27a increased p53 activation, thus, suppressing the formation of A549 cell xenografts in nude mice.

Conclusions
RPS27a interacts with RPL11, and RPS27a knockdown enhanced the binding of RPL11 and MDM2, thereby inhibiting MDM2-mediated p53 ubiquitination and degradation; in addition, RPS27a as important roles in LUAD progression and prognosis, and may be a therapeutic target for patients with LUAD.

Graphical Abstract
The FACAM study: protocol for a randomized controlled study of an early interdisciplinary intervention to support women in vulnerable positions through pregnancy and the first 5 years of motherhood
Authors: Pontoppidan Maiken , Nygaard Lene , Thorsager Mette , Friis-Hansen Mette , Davis Deborah , Nohr Ellen Aagaard 
Published: January 2022

Abstract
Background
Inequality in health can have profound short- and long-term effects on a child’s life. Infants develop in a responsive environment, and the relationship between mother and infant begins to develop during pregnancy. The mother’s ability to bond with the fetus and newborn child may be challenged by mental health issues which can cause impaired functioning and poorer health outcomes. Families with complex problems need interdisciplinary interventions starting in early pregnancy to be prepared for motherhood and to ensure healthy child development. This study aims to examine the effects of an early and coordinated intervention (the Family Clinic and Municipality (FACAM) intervention) offered to vulnerable pregnant women during pregnancy and the child’s first year of life on the mother-child relationship, maternal social functioning, mental health, reflective functioning, well-being, parental stress, and the development and well-being of the child.

Methods
The study is a prospective randomized controlled trial where we will randomize 320 pregnant women enrolled to receive antenatal care at the family clinic at Odense University Hospital, to either FACAM intervention or usual care. The FACAM intervention consists of extra support by a health nurse or family therapist during pregnancy and until the child starts school. The intervention is most intensive in the first 12 months and also includes attachment-based support provided either individually or in groups. The participants are assessed at baseline, and when the infant is 3 and 12 months old. The primary outcome is maternal sensitivity measured by the Coding Interactive Behavior (CIB) instrument. Secondary outcomes include prenatal parental reflective functioning, mental well-being, depressive symptoms, breastfeeding duration, maternal satisfaction, child development, parent competence, parental stress, and activities with the child.

Discussion
The trial is expected to contribute knowledge about the effect of early coordinated support in antenatal and postnatal care for vulnerable pregnant women and their families.

Trial registration
ClinicalTrials.gov NCT03659721. Registered on September 6, 2018
Diagnosis of visceral and cutaneous leishmaniasis using loop-mediated isothermal amplification (LAMP) protocols: a systematic review and meta-analysis
Authors: Erber Astrid Christine , Sandler Peter Julian , de Avelar Daniel Moreira , Swoboda Ines , Cota Gláucia , Walochnik Julia 
Published: January 2022

AbstractSensitive, reliable and fast diagnostic tools that are applicable in low-resource settings, at the point of care (PoC), are seen as crucial in the fight against visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL). Addressing the need for a PoC test, several diagnostic tests, including serological and molecular methods, have been developed and evaluated in the past. One promising molecular method, already implemented for diagnosis of a range of diseases, is the loop-mediated isothermal amplification (LAMP) protocol. In this systematic review and meta-analysis, using a comprehensive search strategy, we focus on studies evaluating the performance of LAMP for the diagnosis of leishmaniasis in humans and other mammals such as dogs, compared with microscopy and/or any other molecular diagnostic method. A meta-analysis, pooling sensitivity and specificity rates and calculating areas under the curve (AUCs) in summary receiver operating characteristic (SROC) plots, was conducted on datasets extracted from studies, grouped by clinical condition and sample type. We found high sensitivity and specificity for LAMP when compared with microscopy and PCR using blood samples, with pooled estimate values of > 90% for all subgroups, corresponding to calculated AUC values > 0.96, except for LAMP compared to microscopy for diagnosis of CL. However, only a limited number of studies were truly comparable. Most of the observed heterogeneity is likely based on true differences between the studies rather than sampling error only. Due to simple readout methods and low laboratory equipment requirements for sample preparation compared to other molecular methods, LAMP is a promising candidate for a molecular (near-)PoC diagnostic method for VL and CL.
Graphical Abstract
Eimeria proteins: order amidst disorder
Authors: Olajide Joshua Seun , Qu Zigang , Yang Shunli , Oyelade Oyeseyi Joshua , Cai Jianping 
Published: January 2022

AbstractApicomplexans are important pathogens that cause severe infections in humans and animals. The biology and pathogeneses of these parasites have shown that proteins are intrinsically modulated during developmental transitions, physiological processes and disease progression. Also, proteins are integral components of parasite structural elements and organelles. Among apicomplexan parasites, Eimeria species are an important disease aetiology for economically important animals wherein identification and characterisation of proteins have been long-winded. Nonetheless, this review seeks to give a comprehensive overview of constitutively expressed Eimeria proteins. These molecules are discussed across developmental stages, organelles and sub-cellular components vis-à-vis their biological functions. In addition, hindsight and suggestions are offered with intention to summarise the existing trend of eimerian protein characterisation and to provide a baseline for future studies.
Graphical
Abstract
Severe acute respiratory syndrome coronavirus 2, primary varicella zoster virus coinfection, and a polymicrobial ventilator-associated tracheobronchitis in an adult immunocompetent male: a case report
Authors: Bruno Jowita , Ragozzino Silvio , Quitt Jonas , Siegemund Martin , Labhardt Niklaus 
Published: January 2022

Abstract
Background
The spectrum of clinical manifestations and differential diagnosis associated with coronavirus disease 2019 is broad, ranging from fever and cutaneous eruptions to respiratory distress or even neurological disorders. Coexisting multipathogen infections significantly increase the complexity of the proper diagnostic and therapeutic approach and correlate with the rate of intensive care unit admissions and in-hospital mortality.

Case presentation
We present a case of multipathogen respiratory infection with severe acute respiratory syndrome coronavirus 2, varicella zoster virus, and polymicrobial tracheobronchitis in a 48-year-old Caucasian male hospitalized after traumatic brain injury. The patient tested positive for severe acute respiratory syndrome coronavirus 2 infection upon admission. During his stay in the intensive care unit, the patient developed a vesicular exanthema along with respiratory failure and signs of septic shock.

Conclusion
This case of an adult presenting with severe acute respiratory syndrome coronavirus 2 infection and simultaneous primary varicella zoster virus infection illustrates the importance of considering coinfections in patients with coronavirus disease 2019 with unusual clinical manifestations.
Autoimmune glial fibrillary acidic protein astrocytopathy in children: a retrospective study
Authors: Zhuang Xiamei , Jin Ke , Li Xiaoming , Li Junwei 
Published: January 2022

Abstract
Objective
To describe the clinical features of autoimmune glial fibrillary acidic protein (GFAP) astrocytopathy in children.

Method
Data from 11 pediatric patients with autoimmune GFAP astrocytopathy were retrospectively analyzed.

Results
All of the patients showed encephalitis and meningoencephalitis or meningoencephalomyelitis with or without myelitis. 45.4% of the patients had fever, 27.3% headaches, 18.2% dizziness, 18.2% drowsiness, and 18.2% mental disorders. Cerebrospinal fluid (CSF) was detected in all patients. The white blood cell counts (WBC) (90.9%), lactic dehydrogenase levels (72.7%), protein level (36.4%), and adenosine deaminase activity (ADA) level (27.3%) were elevated, and the CSF glucose levels (72.7%) were slightly reduced. Nine patients (90%) were found to have brain abnormalities, of which five (50.0%) patients had abnormal symmetrical laminar patterns or line patterns hyperintensity lesions on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images in the basal ganglia, hypothalamus, subcortical white matter and periventricular white matter. The linear radial enhancement pattern of the cerebral white matter was only seen in two patients, with the most common being abnormal enhancement of leptomeninges (50%). Five patients had longitudinally extensive spinal cord lesions.

Conclusion
The findings of pediatric patients with autoimmune GFAP astrocytopathy are different from previous reports.
The establishment, development and future of the Chinese environmental mutagen society
Authors: Cao Jia 
Published: January 2022

AbstractIt has been 40 years since the Chinese Environmental Mutagen Society (CEMS) was established in 1981. Now, it has grown a first-level national society in China, which has 15 professional committees and more than 5000 members. Over the past 40 years, the CEMS has been making many contributions to advance the research of environmental mutagens in China and cultivate professional talents in this field. In the twenty-first century, looking back on what the CEMS has gone through and accomplished, and in light of the major changes in our tasks and mission in the new era, we must plan well for the future, to overcome our shortcomings, to embrace greater development of the CEMS.
Developing a simulation safety policy for translational simulation programs in healthcare
Authors: Brazil Victoria , Scott Clare , Matulich Jack , Shanahan Brenton 
Published: January 2022

AbstractHealthcare simulation may present risks to safety, especially when delivered ‘in situ’—in real clinical environments—when lines between simulated and real practice may be blurred. We felt compelled to develop a simulation safety policy (SSP) after reading reports of adverse events in the healthcare simulation literature, editorials highlighting these safety risks, and reflecting on our own experience as a busy translational simulation service in a large healthcare institution.The process for development of a comprehensive SSP for translational simulation programs is unclear. Personal correspondence with leaders of simulation programs like our own revealed a piecemeal approach in most institutions. In this article, we describe the process we used to develop the simulation safety policy at our health service, and crystalize principles that may provide guidance to simulation programs with similar challenges.
Societal perspectives on disease and treatment attributes characterizing rare diseases: a qualitative study from the United States
Authors: Szabo Shelagh M. , Audhya Ivana F. , Feeny David , Neumann Peter , Malone Daniel C. , Gooch Katherine L. 
Published: January 2022

Abstract
Purpose
Under a societal perspective, disease and treatment attributes that the general public deem important should be considered within value frameworks. The objective was to investigate how members of the general public value attributes beyond health gains and healthcare system expenditures; and better understand their perspectives regarding the importance of attributes typically characterizing rare genetic diseases like Duchenne muscular dystrophy (DMD).

Methods
Qualitative interviews were conducted to elicit feedback on the importance of disease and treatment attributes from general public participants from three US cities. Participants ranked attributes (scale, 1–10) in terms of importance for future research, reported their rationale for ranking, and provided feedback specific to rare diseases. Interview transcripts were coded using NVivo for thematic analysis.

Results
The 33 participants (median age, 51 years; 48.5% male) ranked disease severity (mean [median] ranking, 8.7 [9.0]), treatment availability (8.7 [9.0]), and impact on life expectancy (8.4 [9.0]), as most important. The impact on the family, need for equity, and intrinsic value of life were frequently provided rationales. While rare disease as an attribute received a relatively low ranking (6.1 [7.0]), 88% of participants prioritized disease profiles including attributes of severity, health related quality of life (HRQoL) impact, limited lifespan and young age at onset.

Conclusion
Attributes including disease severity, impact on life expectancy and HRQoL, and treatment availability were all highly important to members of the general public. These findings support the growing evidence regarding the importance of expanding value assessments to include attributes considered important from a societal perspective.
Theoretical Investigation on Electron Transport Capabilities of Helically Twisted Molecules Based on Decay Constants of Exchange Interaction
Authors: Nakakuki Yusuke , Hirose Takshi , Matsuda Kenji 
Published: January 2022

Abstract
The electron transport capabilities of helically twisted molecules were theoretically evaluated based on the decay constant of the exchange interaction (βJ) between terminal nitronyl nitroxide radicals using broken-symmetry unrestricted density functional theory (UDFT) calculations. A small βJ value (βJ = 0.16 Å−1) was estimated for a homogeneously π-extended helicene consisting of a helically fused oligo-phenanthrenes, which is less than half that of the original carbohelicene (βJ = 0.39 Å−1) and comparable to that of rylene (βJ = 0.13 Å−1). The excellent electron transport capability suggested by the small βJ of the π-extended helicene can be attributed to the olefinic electronic nature found inside the helical framework.
2-Germaazulene: Synthesis and Properties of 2-Heteraazulene Containing a Germanium Atom as a Skeletal Element
Authors: Oshiro Taku , Mizuhata Yoshiyuki , Tokitoh Norihiro 
Published: January 2022

Abstract
We have succeeded in the synthesis of a 2-germaazulene stable in solution, in which the carbon atom at the 2-position of azulene is replaced by a germanium atom, the fourth period element in Group 14. The properties of the obtained 2-germaazulene were verified both experimentally and theoretically, indicating its sufficient aromaticity. In comparison with the parent azulene, significant differences were found in its orbital levels, charge distribution, and the resulting properties.
Barriers to access and utilization of healthcare by children with neurological impairments and disability in low-and middle-income countries: a systematic review
Authors: Mwangi Lucy W. , Abuga Jonathan A. , Cottrell Emma , Kariuki Symon M. , Kinyanjui Samson M. , Newton Charles RJC. 
Published: January 2022

Background: Neurological impairments (NI) and disability are common among older children in low-and middle-income countries (LMICs). We conducted a systematic review to examine the barriers limiting access and utilization of biomedical and rehabilitative care by children and adolescents with NI in LMICs. Methods: We searched PubMed, Latin America and Caribbean Health Sciences Literature, Global Index Medicus, and Google Scholar for studies published between 01/01/1990 and 14/11/2019 to identify relevant studies. We included all studies reporting on barriers limiting access and utilization of preventive, curative, and rehabilitative care for children aged 0-19 years with NI in five domains: epilepsy, and cognitive, auditory, visual, and motor function impairment. Data from primary studies were synthesized using both qualitative and quantitative approaches. Results: Our literature searches identified 3,258 reports of which 20 were included in the final analysis. Fifteen studies (75.0%) originated from diverse settings in sub-Saharan Africa (SSA). Factors limiting access and utilization of healthcare services in >50% of the studies were: financial constraints (N=17, 85.0%), geographical and physical inaccessibility (N=14, 70.0%), inadequate healthcare resources (N=14, 70.0%), prohibitive culture and beliefs (N=12, 60.0%), and inadequate education/awareness (N=11, 55.0%). Factors reported in <50% of the studies included competing domestic roles (N=4, 20%) and a lack of confidentiality for personal information (N=2, 10.0%). Very few reports were identified from outside Africa preventing a statistical analysis by continent and economic level. Conclusions: Financial constraints, geographic and physical inaccessibility, and inadequate healthcare resources were the most common barriers limiting access and utilization of healthcare services by children with NI in LMICs. PROSPERO registration: CRD42020165296 (28/04/2020)
Manifestasi Gastrointestinal dan Peran Swab Anal pada COVID-19: Laporan Kasus dari Rumah Sakit Rujukan Tersier, Jakarta
Authors: Fadhillah Muhamad Rizqy , Zaini Jamal , Putra Andika Chandra , Isbaniah Fathiyah , Ananta Muammar Emir , Sabila Ginindha Izzati 
Published: January 2022

<p align="justify"><strong><em>Introduksi:</em></strong><em> Coronavirus Disease 2019 (COVID-19) merupakan penyakit infeksius yang masih menjadi permasalahan serius di dunia. Meskipun presentasi klinis utama COVID-19 adalah gejala respirasi, manifestasi gastrointestinal seperti nyeri perut dan diare dapat ditemukan sebagai satu-satunya presentasi dari penyakit ini. Swab anal dapat dilakukan untuk penegakkan diagnosis COVID-19 dengan presentasi gastrointestinal. Namun perananya dalam diagnosis COVID-19 masih belum diketahui secara pasti.</em></p><p align="justify"><strong><em>Laporan kasus:</em></strong><em> Laporan kasus ini membahas seorang pasien dewasa yang datang dengan keluhan gastrointestinal tanpa adanya gejala respirasi. Pasien ini kemudian terkonfirmasi COVID-19 melalui pemeriksaan polymerase chain reaction (PCR) pada sampel swab nasofaring dan swab anal.</em></p><p align="justify"><strong><em>Diskusi: </em></strong><em>COVID-19 dapat ditandai dengan berbagai gejala dari organ tubuh manapun, salah satunya adalah gejala gastrointestinal. Swab anal menjadi sampel yang cukup representatif dalam membantu penegakkan diagnosis COVID-19 dengan gejala gastrointestinal. </em></p><div><p align="justify"><strong><em>Kesimpulan</em></strong><em>: Di tengah pandemi ini, presentasi gastrointestinal tanpa gejala respirasi perlu dipertimbangkan sebagai presentasi klinis atipikal dari COVID-19. Hal ini menuntut kehati-hatian tenaga kesehatan untuk menghindari misdiagnosis COVID-19 dengan menggunakan pengambilan sampel dari organ lain seperti swab anal.</em></p></div>