bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous Culture of Mouse Primary B Lymphocytes by Forced Expression of Bach2
Authors: Finney Joel , Kelsoe Garnett 
Published: August 2021

Abstract
Stable, long-term culture of primary B lymphocytes has many potential scientific and medical applications, but remains an elusive feat. A major obstacle to long-term culture is that in vitro mitogens quickly drive B cells to differentiate into short-lived plasma cells (PCs). PC differentiation is governed by opposing teams of transcription factors: Pax5, Bach2, and Bcl6 suppress PC commitment, whereas IFN regulatory factor 4 and Blimp1 promote it. To determine whether transcriptional programming could prolong B cell culture by blocking PC commitment, we generated mouse primary B cells harboring gain- or loss-of-function in the key transcription factors, continuously stimulated these cells with CD154 and IL-21, and determined growth potential and phenotypes in vitro. We found that transgenic expression of Bach2 prohibits PC commitment and endows B cells with extraordinary growth potential in response to external proliferation and survival cues. Long-term Bach2-transgenic B cell lines have genetically stable BCRs [i.e., do not acquire V(D)J mutations], express high levels of MHC class II and molecules for costimulation of T cells, and transduce intracellular signals when incubated with BCR ligands. Silencing the Bach2 transgene in an established transgenic cell line causes the cells to secrete large quantities of Ig. This system has potential applications in mAb production, BCR signaling studies, Ag presentation to T cells, and ex vivo clonal expansion for adoptive cell transfer. Additionally, our results provide insight into molecular control over activated B cell fate and suggest that forced Bach2 expression in vivo may augment germinal center B cell or memory B cell differentiation at the expense of PC commitment.
Blood Transfusion and Venous Cannulation — Medical Publication and Innovation Across 350 Years of History
Authors: Zundert Andre Van , Wiepking Floris S. S. , Roets Michelle , Zundert Tom Christophe R. V. Van , Gatt Stephen P. 
Published: August 2021

Abstract
This article reviews historical milestones during the last 350 years starting with early experiments in intravenous injections of drugs and blood transfusion conducted in a climate of scientific discovery rather than clinical application. Technical problems encountered during attempts of vascular cannulation and a lack of knowledge of physiology resulted in complications related to intravenous access, sometimes fatal, which resulted in a complete ban on blood transfusion in Europe for 150 years. Meticulous documentation of these first 17th century experiments was published in Britain, in the “Philosophical Transactions of the Royal Society of London,” the oldest continuously published scientific journal still in existence, and in France, in the “Journal des Sçavans.” These journals became the primary means of communication of scientific research and letters amongst the community of scientists. Intravenous therapy marked the start of the first primitive anesthetic and laid the foundations for anesthesia and blood transfusion, although their clinical application came centuries later. Successful intravenous anesthesia was established around the turn of the 19th century. Brave men in the 17th century endeavored to awaken the spirit of inquiry and research among their peers at the Royal Society of London. Thanks to these bold medical men acting at a time of accelerated change, there was a great impact on clinical practice in many medical fields. Anesthesia now bears the fruits of these initial experiments so that, ultimately, anesthetists can provide safe and effective anesthesia while delivering anesthetic drugs, intravenous fluids, and blood transfusions for the benefit of patients.
Impact of pregnancy outcomes on postpartum depression among women attending primary health-care centers in Al-Madina Al-Munawarah, Saudi Arabia
Authors: Aljehani Yasmeen Talal , Alanzi Mariam Eid , Aljehani Suzan Talal , Saleem Alrehaily Sami , Alraddadi Salman Awadh Rasheed , Alblowi Rema Mahmoud , Aly Hanan Yousef , El Sayed Salah Mohamed 
Published: August 2021

Background:
Postpartum depression (PPD) afflicts women and their families negatively. Unfortunately, PPD often goes undetected and untreated. We previously reported that PPD prevalence was 19.4% in Al-Madina region, Saudi Arabia.

Objectives:
The objective of the study was to identify significant risk factors of PPD among women in Al-Madina, Saudi Arabia.

Methodology:
A multistage random sampling technique recruited women visiting primary health-care centers in Al-Madina to immunize their babies. A cross-sectional descriptive study was done using Arabic translation of Edinburgh Postnatal Depression Scale for PPD screening using a cutoff score of ≥12. Our study also investigated demographic and other possible PPD risk factors.

Results:
This study enrolled 216 women out of 224 (response rate is 96.4%). PPD was not significantly associated with pregnancy planning, infant's gender, or infant's age. Primiparous women (n = 92, 42.7%) had a significant PPD risk (P < 0.05). More than half of mothers enrolled in our study (n = 124, 57.4%) were multiparous. Nearly 30.6% of participants (n = 66) used breastfeeding, while formula feeding was present in 40.7% (n = 88). PDD was reported more among women who breastfed their babies (27.3%) compared to those who artificially fed their babies (15.9%) and those using mixed feeding (16.1%). PPD was more significant among women who delivered by vaginal delivery (P < 0.05) compared to those delivered by cesarean section. Congenital abnormality of babies was reported by almost one-sixth of women (n = 36, 16.7%) but were not significantly associated with PPD.

Conclusion:
More than half of women having PPD (n = 124, 57.4%) were multiparous. PPD may negatively impair women's future pregnancy plans due to depression. PPD is significantly associated with primiparity and vaginal delivery and increases with breastfeeding. To the authors, PPD is a serious medical condition that should be taken into account with all deliveries. Primiparity is a risk factor, and PPD should be anticipated in primiparous women. Psychiatric evaluation and psychotherapy may be needed to help women and alleviate their fears in future pregnancies. Gynecologists should be aware of PPD and should receive a clinical experience in that. Psychiatric consultation is highly recommended whenever necessary.
Significance of human leukocyte antigen-B27 expression in cases of reactive arthritis
Authors: Shougrakpam Jeshyca , Deshmukh Abhay Vilas , Gupta Anupama , Gangane Nitin M 
Published: August 2021

Background:
Reactive arthritis (RA), apart from presenting as an immune reaction to certain microorganisms, had also shown to have a genetic predisposition. Human leukocyte antigen (HLA-B27) is an allele of the HLA Class I molecules and its positivity in a person is shown to be a strong predictor of RA. The present study was aimed to study the significance of HLA-B27 positivity in clinical presentation and progress of RA in rural central India.

Materials and Methods:
One hundred rheumatoid arthritis factor seronegative patients of symptomatic RA were enrolled in the study. HLA-B27 was detected by flow cytometry method and patients were divided into two groups, each of 50 depending on HLA-B27 positivity and negativity as case and control groups. The patients were contacted on their follow-up visits and the clinical information and progress of the disease was assessed and correlated with HLA-B27 status.

Results:
About 74% in study group and 62% in control groups were males in RA (P = 0.001 and 0.0007, respectively). Study cases with HLA-B27 positivity showed many significant differences in their clinical presentation and disease severity and progression over the control cases (HLA-B27 negative). The mean duration of symptoms in the study group was 22.7 ± 31.26 and 12.98 ± 6.94 in control group. Severity of arthritic pain was more in study group as compared to control group (P = 0.0007). Study cases showed more axial skeletal involvement (P = 0.0002), enthesitis (P = 0.0001), and sacroiliac joint involvement (P = 0.0005). Clinical evaluation of back pain with different clinical tests in study cases showed more morning spinal stiffness (P = 0.0001), low Schober index (P = 0.001), higher lateral flexion (P = 0.0001), and lower chest expansion (P = 0.0001). The severity of disease in follow-up period increased significantly in 92% of patients in the study group despite initiation of clinical management of arthritis, while decreased in 60% of patients in the control group (P = 0.0001).

Conclusion:
HLA-B27-associated RA presents with significantly more severe primary disease and a rapid course of disease. Thus, HLA-B27 association should be done in all patients of RS and positive patients must be followed more rigorously to prevent many possible complications. To the best of our knowledge, this is the first study in central India to report the importance of HLA-B27 in patients of RA with regard to its management and prognosis.
Positive correlation of serum angiopoietin-like protein 3 levels with metabolic syndrome in patients with coronary artery disease
Authors: Lian Sy-Harn , Hsu Bang-Gee , Wang Ji-Hung , Chen Ming-Chun 
Published: August 2021

Objectives:
Angiopoietin-like protein 3 (ANGPTL3) regulates triglyceride metabolism by reversibly inhibiting the lipoprotein lipase activity. Metabolic syndrome (MetS) is an independent risk factor for further cardiovascular disease. This study evaluated the relationship between the fasting serum ANGPTL3 levels and MetS in patients with coronary artery disease (CAD).

Materials and Methods:
Fasting blood samples were obtained from 90 patients with CAD. Serum ANGPTL3 levels were measured using a commercial enzyme-linked immunosorbent assay kit. MetS and its components were defined using the diagnostic criteria of the International Diabetes Federation.

Results:
Fifty-three patients (58.9%) had MetS. The hypertension (P = 0.001), diabetes (P < 0.001), body weight (P = 0.027), body mass index (P = 0.001), waist circumference (P < 0.001), systolic blood pressure (P = 0.001), fasting glucose (P < 0.001), triglycerides (P < 0.001), blood urea nitrogen (P = 0.044), C-reactive protein (P = 0.010), insulin (P = 0.040), homeostasis model assessment of insulin resistance (P = 0.002), and ANGPTL3 level (P = 0.001) of CAD patients who had MetS were higher, and the high-density lipoprotein cholesterol (P = 0.001) and estimated glomerular filtration rate (P = 0.016) were lower. A binary logistic regression analysis of the significant variables also revealed that the ANGPTL3 level (odds ratio: 1.023, 95% confidence interval: 1.008–1.038, P = 0.002) was an independent predictor of MetS in patients with CAD.

Conclusion:
The results of our study indicated that the fasting ANGPTL3 level was positively associated with MetS among patients with CAD.
Validity Evidence for the Emergency Medicine Standardized Letter of Evaluation
Authors: Kukulski Paul , Ahn James 
Published: August 2021

ABSTRACT

Background
The standardized letter of evaluation (SLOE) is the application component that program directors value most when evaluating candidates to interview and rank for emergency medicine (EM) residency. Given its successful implementation, other specialties, including otolaryngology, dermatology, and orthopedics, have adopted similar SLOEs of their own, and more specialties are considering creating one. Unfortunately, for such a significant assessment tool, no study to date has comprehensively examined the validity evidence for the EM SLOE.

Objective
We summarized the published evidence for validity for the EM SLOE using Messick's framework for validity evidence.

Methods
A scoping review of the validity evidence of the EM SLOE was performed in 2020. A scoping review was chosen to identify gaps and future directions, and because the heterogeneity of the literature makes a systematic review difficult. Included articles were assigned to an aspect of Messick's framework and determined to provide evidence for or against validity.

Results
There have been 22 articles published relating to validity evidence for the EM SLOE. There is evidence for content validity; however, there is a lack of evidence for internal structure, relation to other variables, and consequences. Additionally, the literature regarding response process demonstrates evidence against validity.

Conclusions
Overall, there is little published evidence in support of validity for the EM SLOE. Stakeholders need to consider changing the ranking system, improving standardization of clerkships, and further studying relation to other variables to improve validity. This will be important across GME as more specialties adopt a standardized letter.
Current State of the Medical Student Performance Evaluation: A Tool for Reflection for Residency Programs
Authors: Brenner Judith M. , Bird Jeffrey B. , Brenner Jason , Orner David , Friedman Karen 
Published: August 2021

ABSTRACT

Background
The Medical Student Performance Evaluation (MSPE) provides important information to residency programs. Despite recent recommendations for standardization, it is not clear how much variation exists in MSPE content among schools.

Objectives
We describe the current section content of the MSPE in US allopathic medical schools, with a particular focus on variations in the presentation of student performance.

Methods
A representative MSPE was obtained from 95.3% (143 of 150) of allopathic US medical schools through residency applications to the Zucker School of Medicine at Hofstra/Northwell in select programs for the 2019–2020 academic year. A manual data abstraction tool was piloted in 2018–2019. After training, it was used to code all portions of the MSPE in this study. The results were analyzed, and descriptive statistics were reported.

Results
In preclinical years, 30.8% of MSPEs reported data regarding performance of students beyond achieving “passes” in a pass/fail curriculum. Only half referenced performance in the fourth year including electives, acting internships, or both. About two-thirds of schools included an overall descriptor of comparative performance in the final paragraph. Among these schools, a majority provided adjectives such as “outstanding/excellent/very good/good,” while one-quarter reported numerical data categories. Regarding clerkship grades, there were numerous nomenclature systems used.

Conclusions
This analysis demonstrates the existence of extreme variability in the content of MSPEs submitted by US allopathic medical schools in the 2019–2020 cycle, including the components and nomenclature of grades and descriptors of comparative performance, display of data, and inclusion of data across all years of the medical education program.
An Analysis of Gender Bias in Plastic Surgery Resident Assessment
Authors: Cooney Carisa M. , Aravind Pathik , Hultman C. Scott , Broderick Kristen P. , Weber Robert A. , Brooke Sebastian , Cooney Damon S. , Lifchez Scott D. 
Published: August 2021

ABSTRACTBackgroundPrevious studies have shown men and women attending physicians rate or provide operating room (OR) autonomy differently to men and women residents, with men attendings providing higher ratings and more OR autonomy to men residents. Particularly with the advent of competency-based training in plastic surgery, differential advancement of trainees influenced by gender bias could have detrimental effects on resident advancement and time to graduation.ObjectiveWe determined if plastic surgery residents are assessed differently according to gender.MethodsThree institutions' Operative Entrustability Assessment (OEA) data were abstracted from inception through November 2018 from MileMarker, a web-based program that stores trainee operative skill assessments of CPT-coded procedures. Ratings are based on a 5-point scale. Linear regression with postgraduate year adjustment was applied to all completed OEAs to compare men and women attendings' assessments of men and women residents.ResultsWe included 8377 OEAs completed on 64 unique residents (25% women) by 51 unique attendings (29% women): men attendings completed 83% (n = 6972; 5859 assessments of men residents; 1113 of women residents) and women attendings completed 17% (n = 1405; 1025 assessments of men residents; 380 of women residents). Adjusted analysis showed men attendings rated women residents lower than men residents (P &lt; .001); scores by women attendings demonstrated no significant difference (P = .067).ConclusionsOur dataset including 4.5 years of data from 3 training programs showed men attendings scored women plastic surgery residents lower than their men counterparts.
Dark Clouds With Silver Linings: Resident Anxieties About COVID-19 Coupled With Program Innovations and Increased Resident Well-Being
Authors: Wietlisbach Larissa E. , Asch David A. , Eriksen Whitney , Barg Frances K. , Bellini Lisa M. , Desai Sanjay V. , Yakubu Abdul-Rakeem , Shea Judy A. 
Published: August 2021

ABSTRACT

Background
The COVID-19 pandemic forced numerous unprecedented systemic changes within residency programs and hospital systems.

Objective
We explored how the COVID-19 pandemic, and associated changes in clinical and educational experiences, were related to internal medicine residents' well-being in the early months of the pandemic.

Methods
Across 4 internal medicine residency programs in the Northeast United States that have previously participated in the iCOMPARE study, all 394 residents were invited to participate in a study with open-ended survey prompts about well-being approximately every 2 weeks in academic year 2019–2020. In March and April 2020, survey prompts were refocused to COVID-19. Content analysis revealed themes in residents' open-ended responses to 4 prompts.

Results
One hundred and eighty-six residents expressed interest, and 88 were randomly selected (47%). There were 4 main themes: (1) in early days of the pandemic, internal medicine residents reported fear and anxiety about uncertainty and lack of personal protective equipment; (2) residents adapted and soon were able to reflect, rest, and pursue personal wellness; (3) communication from programs and health systems was inconsistent early in the pandemic but improved in clarity and frequency; (4) residents appreciated the changes programs had made, including shorter shifts, removal of pre-rounding, and telemedicine.

Conclusions
COVID-19 introduced many challenges to internal medicine residency programs and to resident well-being. Programs made structural changes to clinical schedules, educational/conference options, and communication that boosted resident well-being. Many residents hoped these changes would continue regardless of the pandemic's course.
Fondo Nacional de garantías como alternativa al financiamiento de MIPYMES comerciantes de Guayaquil 2012-2017
Authors: Zea Maridueña Jorge , Paguay Won Mayra , Muñoz Loor Karina 
Published: August 2021

Solo las pymes formales acceden al financiamiento, tanto de banca pública como privada, aunque deberían abrirse más espacios para la MIPYMES no formales. EL fondo de garantía se presenta como una alternativa de financiamiento desempeñando un plan complementario con el desarrollo de líneas de créditos para inyectar liquidez o realizar nuevas inversiones que ayudan de alguna manera al desarrollo de sector económico del país. En la CFN el crédito comercial es el segmento de mayor relevancia representando, entre enero y octubre de 2017, el 74% del monto total que concedió la CFN. Por otro lado, la menor tasa de interés activa efectiva que ofreció la CFN fue en el crédito productivo corporativo, la cual a octubre de 2017 fue de 7.50%. La metodología de este trabajo de investigación comprende una investigación de tipo documental, basada en la estadística de la base de datos de organismos como la Corporación Financiera Nacional B.P., con enfoque cuantitativo y cualitativo. Para la obtención y recolección de datos se aplicó una encuesta que ayudaron a determinar las limitaciones del acceso al crédito que tienen las MIPYMES en el sistema financiero.
LA CESIÓN DE DATOS DE SALUD FUERA DEL ÁMBITO SANITARIO. ANÁLISIS DE SUPUESTOS CONCRETOS EN QUE LA INFORMACIÓN SANITARIA SE TRANSMITE PARA EL CUMPLIMIENTO DE FINES DISTINTOS AL DE LA PROTECCIÓN DE LA S
Authors: ABERASTURI GORRIÑO UNAI , LASAGABASTER HERRARTE IÑAKI 
Published: August 2021

La fórmula más común de transmitir los datos de salud la constituye
la cesión o comunicación de datos. Dejando a un lado los supuestos en que
los datos se transmiten dentro del ámbito estrictamente sanitario, los datos de
salud pueden cederse fuera de este entorno. Partiendo de una interpretación conjunta
de diferentes normas puede llegarse a la conclusión de que en determinados
casos es posible sacar los datos sanitarios de su lugar común de manipulación
con el fin de satisfacer otros intereses. Muchas veces se ha cuestionado desde
diversas instancias en qué casos y cumpliendo qué condiciones pueden transmitirse
los datos de salud fuera del ámbito estrictamente sanitario. Será necesario
atender a la normativa sanitaria, a la reguladora de la protección de los datos de
carácter personal y a determinada normativa sectorial dedicada a regular aspectos
muy variados para tratar de resolver las citadas interrogantes.
Osasunari buruzko datuak transmititzeko modurik ohikoena datuen
lagapena edo komunikazioa da. Datuak hertsiki osasunaren alorrean transmititzen
direneko kasuak alde batera utzita, osasunari buruzko datuak beste alor
batzuetara ere transmiti daitezke. Hainbat arauren interpretaziotik abiatuta ondoriozta
daitekeenez, zenbait kasutan posible da datuak tratatzeko ohiko tokitik ateratzea,
beste interes batzuk asetze aldera. Askotan, hainbat instantzietan zalantzan
jarri dute zer kasutan eta zer baldintzatan transmiti daitezkeen osasunari buruzko
datuak osasunaren alorretik kanpo. Zalantza horiek argitzeko, beharrezkoa da osasunari
buruzko arautegira, datu pertsonalak babesten dituenera eta askotariko
gaiak erregulatzen dituen sektoreko arauetara jotzea.
The most common way of transfer of health data is the assignment or
communication of data. Leaving aside those cases where data are transfered within a
strictly confined health care sphere, the data on health can be transfered beyond that
area. From a joint interpretation of several provisions we can come to the conclusion
that in some specific cases data on health can be extracted from its common place for
the purpose of meeting other different interests. It has many times been questioned
by different instances in which cases and meeting which criteria data on health might
be transferred beyond the strictly health case sphere. It will be necessary to pay attention
to the health care legislation, to the legislation on personal data protection and to
some sectorial rules devoted to regulate a variety of aspects so as to solve the aforementioned
questions.