The impact of a virtual orthopaedic surgery symposium on medical students: Increasing awareness and knowledge of the field

UNLABELLED: Orthopaedic surgery has become an increasingly popular field of residency training for medical students. Many institutions offer elective time to explore areas of interest through clinical rotations and research; however, most of these opportunities are reserved for senior medical students. The purpose of this study was to evaluate the impact of a dedicated medical student orthopaedic surgery symposium to increase awareness about the field and to assess students\u27 interest and knowledge of orthopaedic surgery before and after the symposium. METHODS: Medical students were invited to submit orthopaedic surgery-related research to a free, 1-day virtual symposium held in April 2022. Abstracts were reviewed and selected from 9 different orthopaedic surgery subspecialty categories. Survey assessments were sent to medical students to complete before and after the symposium. The surveys included questions related to participant demographics as well as interest and knowledge about the field of orthopaedic surgery. Statistical analyses were completed to compare the participants\u27 responses before and after the symposium. RESULTS: In total, 962 medical students registered for the 4-hour symposium. Of these, 58.5% completed the presymposium survey and 48.0% completed the postsymposium survey. 13.3% of the respondents reported being very knowledgeable about the various orthopaedic surgery subspecialties before the symposium, which increased to 18.4% after the symposium. 46.9% of the participants stated that they were knowledgeable about the daily life of an orthopaedic surgery resident before the symposium, which increased to 67.3% after the symposium. Similarly, the percentage of respondents who reported that they were very knowledgeable about the residency match process increased from 12.2% presymposium to 22.4% postsymposium. CONCLUSIONS: As interest in pursuing a career in orthopaedic surgery increases, medical students will continue to seek information, mentorship, and opportunities to present their research in preparation for residency applications. Our study demonstrated that a large-scale, national, virtual orthopaedic surgery symposium provided a platform to augment medical students\u27 knowledge of the field, present their research, and interact with faculty members. LEVEL OF EVIDENCE: Level V

Specific features of telomerase RNA from Hansenula polymorpha.

Telomerase, a ribonucleoprotein, is responsible for the maintenance of eukaryotic genome integrity by replicating the ends of chromosomes. The core enzyme comprises the conserved protein TERT and an RNA subunit (TER) that, in contrast, displays large variations in size and structure. Here, we report the identification of the telomerase RNA from thermotolerant yeast Hansenula polymorpha (HpTER) and describe its structural features. We show further that the H. polymorpha telomerase reverse transcribes the template beyond the predicted boundary and adds a nontelomeric dT in vitro. Sequencing of the chromosomal ends revealed that this nucleotide is specifically present as a terminal nucleotide at the 3' end of telomeres. Mutational analysis of HpTER confirmed that the incorporation of dT functions to limit telomere length in this species

Treatment efficacy and tuberculosis relapses in HIV infected patients with severe immunosuppression who started antiretroviral therapy

The objective: to analyze treatment efficacy and causes of tuberculosis relapses in HIV-infected patients with severe immunosuppression who have started antiretroviral therapy (ART). Subjects and methods. 139 case histories were studied, those case history belonged to the patients with TB/HIV co-infection and CD4 count below 100 cells/μl, a median of 33.2 cells/μl – 4.2%, who started ART in the in-patient unit. The efficacy of inpatient treatment was assessed; 89 patients were followed up after discharge from hospital. The follow-up period lasted from January 2011 to May 2019. Results. ART did not increase the efficacy of the in-patient stage of TB/HIV treatment due to the development of immune reconstitution inflammatory syndrome, which occurred in 34.5% of patients and accounted for 70.0% of hospital lethality cases. After discharge from hospital, 69.7% of patients successfully completed anti-tuberculosis chemotherapy, 25.8% died before completing treatment, the main cause of death was tuberculosis (56.5%), including multiple drug resistance in 30.8% of cases. At the outpatient stage, 29.1% of patients interrupted ART, their death rate was higher (p = 0.007), and tuberculosis and HIV-associated diseases became the cause of death more often (p = 0.042) versus the compliant patients. Tuberculosis relapses developed in 17.7% after 16.7 ± 1.7 months after completion of treatment; 63.6% had multiple drug resistance, patients with tuberculosis relapses interrupted ART more often (p = 0.002), had a lower CD4 count (p = 0.030) versus patients without relapses. As of May 2019, 46.1% of patients survived and had no signs of active tuberculosis; 42.7% died, tuberculosis dominated among the causes of death – 50.0% (in 52.6% – multiple drug resistance) as well as HIV-associated diseases (21.1%)

The Impact of a Virtual Orthopaedic Surgery Symposium on Medical Students: Increasing Awareness and Knowledge of the Field

UNLABELLED: Orthopaedic surgery has become an increasingly popular field of residency training for medical students. Many institutions offer elective time to explore areas of interest through clinical rotations and research; however, most of these opportunities are reserved for senior medical students. The purpose of this study was to evaluate the impact of a dedicated medical student orthopaedic surgery symposium to increase awareness about the field and to assess students\u27 interest and knowledge of orthopaedic surgery before and after the symposium. METHODS: Medical students were invited to submit orthopaedic surgery-related research to a free, 1-day virtual symposium held in April 2022. Abstracts were reviewed and selected from 9 different orthopaedic surgery subspecialty categories. Survey assessments were sent to medical students to complete before and after the symposium. The surveys included questions related to participant demographics as well as interest and knowledge about the field of orthopaedic surgery. Statistical analyses were completed to compare the participants\u27 responses before and after the symposium. RESULTS: In total, 962 medical students registered for the 4-hour symposium. Of these, 58.5% completed the presymposium survey and 48.0% completed the postsymposium survey. 13.3% of the respondents reported being very knowledgeable about the various orthopaedic surgery subspecialties before the symposium, which increased to 18.4% after the symposium. 46.9% of the participants stated that they were knowledgeable about the daily life of an orthopaedic surgery resident before the symposium, which increased to 67.3% after the symposium. Similarly, the percentage of respondents who reported that they were very knowledgeable about the residency match process increased from 12.2% presymposium to 22.4% postsymposium. CONCLUSIONS: As interest in pursuing a career in orthopaedic surgery increases, medical students will continue to seek information, mentorship, and opportunities to present their research in preparation for residency applications. Our study demonstrated that a large-scale, national, virtual orthopaedic surgery symposium provided a platform to augment medical students\u27 knowledge of the field, present their research, and interact with faculty members. LEVEL OF EVIDENCE: Level V

Insights into the structure and function of Est3 from the Hansenula polymorpha telomerase

Abstract Telomerase is a ribonucleoprotein enzyme, which maintains genome integrity in eukaryotes and ensures continuous cellular proliferation. Telomerase holoenzyme from the thermotolerant yeast Hansenula polymorpha, in addition to the catalytic subunit (TERT) and telomerase RNA (TER), contains accessory proteins Est1 and Est3, which are essential for in vivo telomerase function. Here we report the high-resolution structure of Est3 from Hansenula polymorpha (HpEst3) in solution, as well as the characterization of its functional relationships with other components of telomerase. The overall structure of HpEst3 is similar to that of Est3 from Saccharomyces cerevisiae and human TPP1. We have shown that telomerase activity in H. polymorpha relies on both Est3 and Est1 proteins in a functionally symmetrical manner. The absence of either Est3 or Est1 prevents formation of a stable ribonucleoprotein complex, weakens binding of a second protein to TER, and decreases the amount of cellular TERT, presumably due to the destabilization of telomerase RNP. NMR probing has shown no direct in vitro interactions of free Est3 either with the N-terminal domain of TERT or with DNA or RNA fragments mimicking the probable telomerase environment. Our findings corroborate the idea that telomerase possesses the evolutionarily variable functionality within the conservative structural context

Structure and function of the N-terminal domain of the yeast telomerase reverse transcriptase

The elongation of single-stranded DNA repeats at the 3′-ends of chromosomes by telomerase is a key process in maintaining genome integrity in eukaryotes. Abnormal activation of telomerase leads to uncontrolled cell division, whereas its down-regulation is attributed to ageing and several pathologies related to early cell death. Telomerase function is based on the dynamic interactions of its catalytic subunit (TERT) with nucleic acids—telomerase RNA, telomeric DNA and the DNA/RNA heteroduplex. Here, we present the crystallographic and NMR structures of the N-terminal (TEN) domain of TERT from the thermotolerant yeast Hansenula polymorpha and demonstrate the structural conservation of the core motif in evolutionarily divergent organisms. We identify the TEN residues that are involved in interactions with the telomerase RNA and in the recognition of the ‘fork’ at the distal end of the DNA product/RNA template heteroduplex. We propose that the TEN domain assists telomerase biological function and is involved in restricting the size of the heteroduplex during telomere repeat synthesis