bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contribution of county-level socioeconomic indicators to racial or ethnic differences in neonatal anthropometry in the USA: a prospective cohort study
Authors: Gleason Jessica L , Lambert Calvin , Chen Zhen , Wagner Kathryn A , Mendola Pauline , Ouidir Marion , Grobman William A , Newman Roger , Tekola-Ayele Fasil , Grantz Katherine L 
Published: December 2024

IntroductionRacial and ethnic differences in fetal growth and birth size in the USA have not been adequately explained by individual-level socioeconomic status (SES) factors. We explored whether differences may be partially explained by county-level indicators of SES.MethodsWe linked participant zip codes from the National Institute of Child Health and Human Development Fetal Growth Studies (2009–2013; n=1614) to county-level US census data to calculate a neighbourhood deprivation index, education isolation index and two indices of segregation: racial isolation and evenness. Using causal mediation methods, we evaluated the extent to which racial/ethnic differences in neonatal anthropometrics could be eliminated in a hypothetical setting where everyone lived in counties with high resource availability and racial/ethnic integration.ResultsSetting racial evenness to levels consistent with the highest diversity eliminated 79.9% of the difference in birth weight between non-Hispanic White and non-Hispanic Black and all the difference (106.3%) in birth weight between Hispanic and non-Hispanic White individuals. Setting racial evenness, racial isolation and education isolation to levels consistent with higher diversity and education was also associated with similar reductions in differences for other anthropometric measures.ConclusionsOur findings suggest that, in a hypothetical scenario where everyone lived in counties with low deprivation or segregation, race/ethnic differences in neonatal anthropometry may substantially decrease or be eliminated. Our results also highlight the importance of considering community-level and structural factors in analyses of race/ethnic health disparities.
E-learning module on tobacco counselling for students of medicine and dentistry in India: a needs analysis using mixed-methods research
Authors: B R Chandrashekar , Khanum Nishath , Kulkarni Praveen , Basavegowda Madhu , M Kishor , S Suma 
Published: December 2024

IntroductionIn the background of lack of integrated tobacco counselling training (TCT) in the existing medical and dental curriculum, the present study was undertaken to determine the need for developing an e-learning module on tobacco counselling for students of medicine and dentistry in India.MethodsA mixed-method research with a modified exploratory sequential design was undertaken between January and August 2022 in a private medical and a dental college in Southern India, where the qualitative research was done by conducting in-depth interviews with six subject experts and two focus group discussions (FGDs) separately among six medical and six dental interns to identify the gaps in current TCT. Based on the themes from qualitative research, a questionnaire was developed and validated to elicit the knowledge and competence in tobacco counselling. This questionnaire was subsequently used to explore quantitatively the current knowledge and competence in tobacco counselling among the final-year MBBS (bachelor of medicine and bachelor of surgery) and BDS (bachelor of dental surgery) students. The results of the questionnaire study were triangulated with the themes of the qualitative research.ResultsThe qualitative research proffered the lack of structured TCT in the present curriculum and emphasised the need for an integrated, self-paced e-learning tobacco counselling training module (TCTM) in the background of curricular time constraints to accommodate a conventional classroom-based TCTM. During the in-depth interviews and FGDs, the participants suggested including the global burden and pattern of tobacco consumption, tobacco control laws and tobacco counselling methods, as some of the key contents of the module. The quantitative data analysis revealed the lack of knowledge and competence of students in tobacco counselling. The results of the quantitative phase substantiated the themes that emerged from the qualitative phase.ConclusionThere is a need for introducing a customised, self-paced, integrated e-learning module on tobacco counselling for the students of medicine and dentistry in India. The e-learning module can be included as a choice-based value addition to the regular curriculum.
Associations between adolescent psychiatric disorders and adulthood payment problems: a Norwegian register study of complete birth cohorts of 1995–1997
Authors: Hiilamo Aapo , Jensen Maria Reinholdt , Hermansen Åsmund 
Published: December 2024

BackgroundPsychiatric disorder diagnoses are linked to long-term socioeconomic ‘shadows’ into adulthood, but little is known about how these diagnoses are associated with adulthood payment problems in Norway and whether these associations are moderated by parental and area characteristics.MethodsWe combine Norwegian registry data with payment problem records from the public debt enforcement agency for the 1995–1997 birth cohorts (n=173 750). We ascertain behavioural, neurotic, mood and substance use disorder diagnoses from specialised care at ages 13–17. Payment problems are defined as any records of mandatory deductions in wages or benefits up to age 23. Causal forests are used to explore the potential moderating role of sociodemographic variables.ResultsSome 6% of the sample have payment problems, but the share is higher among men and among people with low childhood socioeconomic status. After adjusting for background characteristics, behavioural problem diagnoses are linked to a 4.6 percentage point higher risk of payment problems (95% CI 4.1 to 5), mood disorder diagnoses to a 2.2 percentage point higher risk (95% CI 1.5 to 2.9), neurotic disorder diagnoses to a 2.5 percentage point higher risk (95% CI 2 to 3.1) and substance use disorder diagnoses to a 9.3 percentage point higher risk (95% CI 7.6 to 10.9). The associations between substance use and behavioural diagnoses and payment problems are stronger for people with low childhood socioeconomic status.ConclusionThe associations between adolescent substance and behavioural diagnoses and adulthood payment problems are particularly strong among people with low childhood socioeconomic status. Reducing these associations is critical for preventing the accumulation of disadvantages.
Quiet effect of lacking leadership in healthcare education
Authors: Arigapudi Nithya 
Published: December 2024

BackgroundIn the landscape of Indian healthcare, the role of leadership in addressing disparities and driving change is often overlooked, particularly within medical education. Through the lens of the author journeying from a volunteer to ultimately a leader of a student-led non-profit organisation, this article explores the reason, rhyme and possible resolutions to the quiet effect of lacking leadership in healthcare education.MethodsDrawing from personal experience and reflections, the article highlights the profound impact of grassroots initiatives in reaching underserved populations and how inadequate leadership hindered their ability to scale effectively. Insights into the challenges encountered and the barriers that needed to be overcome have been elaborated to unravel the possible origins of this problem and address potential solutions throughout various levels of health education.ResultsAlthough there is rarely a simple solution to a complex challenge, building adequate mentorship and support can help sustain leadership efforts in leadership by providing a pillar to lean on without diminishing individualised effort for growth. Cultivating collaborative networks can further provide opportunities to kindle the flame of leadership among young doctors.ConclusionsBy fostering a culture of leadership, medical education can produce professionals who are skilled clinicians and innovative leaders capable of driving change in the community.
Impact of competency training on medical administrators: an evaluation of medical management and leadership development programme
Authors: Cheng Shuyuan , He Fengying , Su Xiaoxin , Liu Yanxin , Cheung Mingyen , Mah Alastair P 
Published: December 2024

BackgroundChina’s healthcare sector is facing unprecedented challenges, placing substantial requirements on the competencies of medical administrators. Training programmes play a crucial role in enhancing the competencies of medical administrators to deliver high-quality healthcare services. This study aims to investigate the outcome of training on the competency of medical administrators and to use the findings to guide the development of future training content.MethodsThe Medical Management and Leadership Development Programme, grounded in the Royal Australasian College of Medical Administrators competency model, was implemented as a three-phase training programme for medical administrators at United Family Healthcare to assess the impact of training on their competency.ResultsThe study’s results revealed significant differences in participants’ competencies across various domains between the pretest and post-test phases of the training programmes. These findings highlight parts where the training was effective and areas that may require further development to enhance overall competency.ConclusionsThe results indicate a positive impact of competency training on enhancing the skills of medical administrators. Additionally, the study offers valuable insights for optimising future training content.
Patients achieving low lupus disease activity state, systemic lupus erythematosus disease control or remission showed lower rates of organ damage during longitudinal follow-up: analysis of the Hopkins Lupus Cohort
Authors: Hunnicutt Jacob , Georgiou Mary Elizabeth , Richards Anna , Quasny Holly , Magder Laurence , Goldman Daniel , Petri Michelle A 
Published: December 2024

ObjectiveOne key target of treating patients with systemic lupus erythematosus (SLE) is to prevent organ damage. This analysis quantified the association between time spent in four specific SLE low disease activity (LDA) states and organ damage rate.MethodsThis retrospective real-world data analysis (GSK Study 207168), undertaken to help contextualise the BLISS-BELIEVE clinical trial, included adults with SLE enrolled for≥1 year in the Hopkins Lupus Cohort and treated with standard therapy in a specialist care centre between 1987 and 2019. LDA states (Lupus Low Disease Activity State (LLDAS), disease control, clinical and complete remissions) were defined using SLE Disease Activity Index (SLEDAI)/Physician Global Assessment scores, prednisone-equivalent dose and medication use criteria combinations. Time spent in each LDA state was expressed as a percentage of total follow-up (0%; >0–<25%; 25–49%; 50–74%; ≥75%). Pooled logistic models were used to estimate adjusted rate ratios (aRR) between time spent in LDA states and organ damage rate (assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)).ResultsOverall, 1632 patients experienced 1246 organ damage events. Follow-up time (calculated from days of follow-up) totalled 9841.1 person-years. At baseline, the mean (SD) SLEDAI score was 2.8 (3.3) and the mean (SD) SDI score was 1.7 (1.9). Organ damage rates were lower in patients who achieved an LDA state versus those who did not. Rates decreased with increasing time spent in each LDA state. Even a small percentage of time (>0–<25% vs 0%) spent in an LDA state was associated with reduced damage (aRR (95% CI): LLDAS, 0.75 (0.61, 0.91); disease control, 0.80 (0.68, 0.93); clinical remission, 0.73 (0.60, 0.88); complete remission, 0.80 (0.68, 0.93)).ConclusionsRegardless of definition, achieving and maintaining a low disease activity state was associated with reduced organ damage in patients with SLE.
What do medical students, residents and graduated physicians think about occupational physicians? A cross-national survey on stereotypes
Authors: Lamouroux Céline , Julien Cédric , Rolland Franck , Gouy Evan , Truong Linh-Nam , Frajerman Ariel , Vinchon Florent , Hadouiri Nawale 
Published: December 2024

Introduction
French medical students can access occupational medicine after passing the residency examination. Few studies have looked at the lack of attractiveness of occupational medicine, contributing to the demographic decline of occupational physicians (OPs). The purpose of this study was to explore the stereotypes of OPs by their colleagues at different levels of formation to understand the determinants of the current lack of attractiveness.

Methods
An anonymous survey was sent to medical students, residents and graduated physicians in March and April 2021. After filling a part about socio-demographic data, participants were asked to give four words about OP, based on the hierarchical evocation method. A descending hierarchical classification method was used to classify words according to their lexical proximity. Then, the corpus’ central core was defined by prototypical analysis.

Results
268 students (107 medical students and 161 residents) and 136 graduated physicians completed the questionnaire. The most important class was about ‘negative stereotypes of OP’. In the prototypical analysis, the central core was composed of both words relative to the « OP’s skills » and a majority of words concerning ‘OP’s negative stereotypes’.

Conclusion
This study confirmed that OPs suffer from negative stereotyping by their colleagues. Better communication of their functions throughout medical school would improve their image in the medical community.
Effect of Increasing or Decreasing Use of Polypharmacy on Recovery of Activities of Daily Living in Patients With Stroke in the Recovery‐Phase Rehabilitation Ward: A Retrospective Cohort Study Using Propensity Score Matching
Authors: Hanaoka Shunsuke , Iwabuchi Kaede , Hirai Toshiyuki , Seki Toshiichi , Hayashi Hiroyuki 
Published: December 2024

Background: Polypharmacy is a predictor of adverse outcomes, making its management crucial for improving patient health and recovery. Managing polypharmacy is particularly challenging in patients with stroke with many comorbidities and sequelae. Although reducing inappropriate prescribing is necessary, the number of medications may increase to effectively implement secondary prevention, potentially offsetting any changes in medication count. For patients with stroke undergoing recovery‐phase rehabilitation, balancing secondary prevention and optimizing drug use early without hindering recovery of activities of daily living are crucial. This study is aimed at examining the effect of increasing or decreasing the use of polypharmacy on recovery of motor and cognitive function during recovery‐phase rehabilitation in patients with stroke.Methods: The study was conducted from July 2010 to June 2019 among patients with stroke discharged from the convalescent rehabilitation ward during the study period. Patients who were using more than five drugs on admission and had either an increase or decrease in the number of drugs used on discharge were compared. Propensity score matching (PSM) was used to control for background variables such as patient demographics, laboratory values, and functional independence measure (FIM) scores at baseline. The primary outcomes were motor, cognition, and total FIM gain.Results: Of the 226 patients initially enrolled, 156 were matched on propensity score. The total motor FIM gain, total cognitive FIM gain, and total FIM gain were significantly higher in the decreased group than in the increased group (p = 0.0139, p = 0.0377, and p = 0.0077, respectively).Conclusion: In patients with stroke, reducing rather than increasing the number of drugs administered during recovery‐phase rehabilitation could improve rehabilitation outcomes. Therefore, it is important to consider whether the drugs are essential for the patient and proactively revise the drug regimen to ensure rapid rehabilitation of patients with stroke.
Preclinical Evaluation of Bavdegalutamide (ARV-110), a Novel PROteolysis TArgeting Chimera Androgen Receptor Degrader
Authors: Snyder Lawrence B. , Neklesa Taavi K. , Willard Ryan R. , Gordon Deborah A. , Pizzano Jennifer , Vitale Nicholas , Robling Kaitlynn , Dorso Madeline A. , Moghrabi Walid , Landrette Sean , Gedrich Richard , Lee Sang Hyun , Taylor Ian C.A. , Houston John G. 
Published: December 2024

Abstract
Androgen receptor (AR) signaling is the principal driver of prostate cancer, and drugs that target this pathway (e.g., abiraterone and enzalutamide) are standard treatments for metastatic hormone-sensitive prostate cancer and metastatic castration-resistant prostate cancer. However, continual evolution during prostate cancer progression can result in AR alterations (e.g., mutation, amplification, and splicing) that can cause tumors to become resistant to these therapies. Bavdegalutamide (ARV-110) is a PROteolysis TArgeting Chimera (PROTAC) protein degrader that recruits the cereblon-containing E3 ubiquitin ligase to direct the polyubiquitination and subsequent proteasomal degradation of AR. Bavdegalutamide selectively degrades wild-type AR and most clinically relevant mutants with low nanomolar potency. The advantages of the degradation mechanism of action are demonstrated by the higher activity of bavdegalutamide relative to the AR antagonist enzalutamide in cell-based systems that assess effects on PSA synthesis, proliferation of prostate cancer cells, and induction of apoptosis. In an AR-expressing patient-derived xenograft mouse model, bavdegalutamide showed substantial AR degradation and greater tumor growth inhibition compared with enzalutamide. Bavdegalutamide also showed robust tumor growth inhibition in enzalutamide- and abiraterone-resistant prostate cancer animal models and enhanced activity in combination with abiraterone. These promising preclinical data supported the clinical development of bavdegalutamide as a potential treatment for patients with prostate cancer. Bavdegalutamide was the first PROTAC protein degrader to enter human clinical trials, specifically in patients with metastatic castration-resistant prostate cancer in a phase I/II study (NCT03888612).
Mumia: Luxury Between Art and Medicine in Safavid Iran and Ottoman Turkey
Authors: Casale Sinem Arcak 
Published: December 2024

Abstract
Mumia, a kind of omnipotent panacea or simply cure-all drug, was a highly valued rare substance with a long and complex history that nevertheless fell into oblivion towards the end of the eighteenth century. From ancient times to the early modern period, a range of naturally found materials and substances related to the preservation of or parts of human and animal corpses have been associated with mumia, mummy, and related words. Used as a drug for a range of illnesses and conditions, in the sixteenth century mineral mumia extracted from mountains in Iran was believed to have extraordinary potency. This article examines a selection of sources that discuss mumia’s substance, collection, use, and exchange. A rediscovery of this material expands the vocabulary of early modern visual and material culture. More significantly, as a forgotten, non-global object, mumia also highlights the limits and the conceptual boundaries of that vocabulary.
Ethnocentrism and Ahmadi Muslims
Authors: Raja Rameez 
Published: December 2024

Abstract
The Ahmadi question is paramount in many Muslim states globally because these are falsely accused as impure/inferior/fake Muslims based on their beliefs different from mainstream Muslims. The secular character of the British India granted religious freedom to people of different faiths allowed Mirza Ghulam Ahmad as the founder of the Ahmadiyya community to propagate his claims in the sub-continent. After the birth of Pakistan as an Islamic state, Ahmadis met an identity problem subject to their beliefs which found un-Islamic by hardline Muslims. Pakistan favours the human rights violations against Ahmadis though it is signatory of the UN Human Rights Council. In contrast, India’s secular structure permits religious communities including Ahmadis to propagate their religious belief across India. Interestingly, the Muslims in India have similar opinion against Ahmadiyya community but the structure of the Indian constitution promotes human rights, religious freedom as well as the protection of minority groups.
Love Is Just a Four Letter Word
Authors: Klabbers Jan 
Published: December 2024

Abstract
This essay takes issue with Jean d’Aspremont’s analysis of international lawyers’ attitude towards international organizations in terms of love. Apart from questioning the object of his analysis (his international lawyer might be a rather small category), the paper suggests that an analysis in terms of the emotions obscures far more than it can possibly reveal. Instead, it suggests that the prevailing attitude towards international organizations (reflected in the existing legal framework) is the result of socialisation into a number of strong tropes, such as the trope that cooperation is a good thing, that agreement is better than disagreement, and that the end justifies the means. Recognition of such tropes and their role facilitates the development of a much-needed critical approach to the international organizations.
Distinctively African: The Unique Appeal of the African Union to International Lawyers of African Origin
Authors: Negm Namira 
Published: December 2024

Abstract
This article explores the African Union’s (AU) distinct allure to international legal scholars of African descent, charting its evolution from the post-colonial era to a comprehensive continental collaboration. The AU’s departure from the limited scope of its precursor, the Organization of African Unity (oau), is evident in its holistic approach encompassing economic development, human rights, peace, and sovereignty. It emphasizes African-led solutions, robust human rights mechanisms like the African Court on Human and Peoples’ Rights, recognition of customary law, economic integration initiatives such as the African Continental Free Trade Area (AfCFTA), and advocacy for decolonisation. African lawyers are drawn to the AU’s inclusive legal frameworks, engaging in legal reforms that resonate with African realities and identities. Ultimately, the AU stands as a catalyst for justice, self-determination, and holistic development, offering a platform for African legal scholars to shape a distinctly African legal landscape.
Our Love for the European Union
Authors: Palchetti Paolo , Wessel Ramses A. 
Published: December 2024

Abstract
In his paper on ‘The Love for International Organizations’, Jean d’Aspremont mentions a number of drivers behind the scholarly interest in the phenomenon of international organizations. Inspired by that paper, the present contribution argues that the European Union is an attractive object of study because it allows us to locate power and because the Union’s creation may have helped to build a unique cooperation among European states. Perhaps more than the drivers suggested by d’Aspremont, this contribution addresses the unclear, ever-changing and complex identity or nature of the EU as a reason for the affection both authors admittedly have for the EU. The paper revisits the classic question of whether the EU can be seen as an international organization and argues that any claims pointing to a sui generis nature of the EU do not seem to be very helpful.