bluuebunny/crossref_metadata_2025_split huggingface dataset:
Roles of the oncometabolite enantiomers of 2-hydroxyglutarate and their metabolism by diverse dehydrogenases
Authors: Garcia Ivelitza , Cornely Kathleen , Peterson Celeste N. , Berkmen Melanie B. 
Published: June 2024

Abstract
2-Hydroxyglutarate (2HG) is an oncometabolite that can contribute to tumor progression. Two enantiomer forms, L-2HG and D-2HG, arise from independent pathways starting from the precursor α-ketoglutarate (αKG). L-2HG production occurs through the promiscuous activities of malate dehydrogenase (MDH) and lactate dehydrogenase (LDH) under acidic and/or hypoxic conditions. D-2HG frequently accumulates by gain-of-function mutations in the genes encoding two isoforms of isocitrate dehydrogenase (IDH1 and IDH2). Cognate metabolite repair enzymes, L- and D-2-hydroxyglutarate dehydrogenases, oxidize the enantiomers and cause abnormally high 2HG accumulation and disease when mutated. Elevated levels of either oncometabolite affect redox homeostasis, metabolism, and immune system functioning. Moreover, the oncometabolites inhibit several α-ketoglutarate-dependent dioxygenases resulting in epigenetic changes such as DNA and histone hypermethylation as well as deficiencies in DNA repair. L-2HG, and D-2HG in some cases, inhibit degradation of hypoxia-inducible factor (HIF1α), a transcription factor that alters gene expression to adapt to hypoxic conditions, favoring tumorigenesis. Patients with the rare disease 2-hydroxyglutaric aciduria (2HGA) have exceedingly high levels of 2HG, which is neurotoxic, causing developmental delays and brain abnormalities. D-2HG also has specific effects on collagen production and NADPH pools. Recently, D-2HG has been targeted in new chemotherapies aimed at disrupting the gain-of-function IDH1 and IDH2 mutants, resulting in successful clinical trials for several cancers.
Thyroid Cartilage Metastases from Prostate Cancer on 18F PSMA PET CT: A Case Series
Authors: Loyal Poonamjeet , Gitau Samuel , Makhdomi Khalid 
Published: June 2024

AbstractProstate cancer metastases to the thyroid cartilage is an extremely rare phenomenon. We report three cases of advanced prostate carcinoma with metastases to the thyroid cartilage identified on 18F prostate-specific membrane antigen-1007 (PSMA-1007) positron emission tomography (PET)/computed tomography (CT). The pathophysiology and possibility for under-reporting are also discussed. Prostate cancer metastases to the larynx should be considered in the differential diagnosis of thyroid cartilage lesions in patients with advanced prostate cancer and is associated with poor prognosis.
A taxonomy for business news audiences in MENA: a step in reducing information asymmetries
Authors: Alaqil Fisal 
Published: June 2024

AbstractThis study looks at how a possible categorization or taxonomy of the audiences that consume business and financial news could be a first step to setting policies and approaches to reduce information asymmetries in a region characterized by deep inequalities. This study looks at how changes in the way people access and use news, which now is predominantly via social media, opens the opportunity to address some of these gaps. The study is based on eight focus groups that took place in Egypt, Kuwait, Qatar, and Lebanon using Zoom. The overall data suggests that MENA audiences have shifted to social media as the main source from where they get their news, and this is significantly important for the future of the mainstream media, particularly in relation to our news beat. It also confirms that there is now an opportunity to categorize MENA business and financial news consumers, although it would be one that is extremely skewed in two tiers.
A pilot study expanding participatory epidemiology to explore community perceptions of human and livestock diseases among pastoralists in Turkana County, Kenya
Authors: Griffith Evan F. , Kipkemoi Job Ronoh , Mariner Jeffrey C. , Coffin-Schmitt Jeanne , Whittier Christopher A. 
Published: June 2024

Abstract
In Kenya, pastoralists grapple with significant health and livelihood challenges due to livestock, zoonotic, and human-specific diseases. These diseases threaten the sustainability of their unique food production system and its considerable economic, nutritional, and ecologic value. Disease control and prevention in arid and semi-arid lands are currently inadequate due to underfunded and ill-adapted health programs coupled with a shortage of personnel. Participatory epidemiology (PE) presents a valuable tool for understanding community perceptions of disease importance and epidemiology, thereby aiding in improving control measures and promoting community involvement in centralized service delivery programs. Yet, the use of PE has focused on livestock and zoonotic diseases, leaving perceptions of human-specific disease and the complex interplay between pastoralists, their livestock, and the rangelands largely unexplored. To address this gap, we utilized PE to achieve three objectives: (1) establish links between human and livestock diseases, (2) determine perceptions of disease priorities, and (3) assess knowledge of disease epidemiology. Our findings indicate that the relationships between human and livestock diseases primarily manifest in two categories: disease symptoms and zoonoses. Disease priorities differed between locations, with no apparent pattern emerging that human or livestock diseases are considered more important. Importance indicators such as prevalence, mortality, morbidity, and spatial/temporal variation were shared across diseases. Diseases perceived as more prevalent and deadly were deemed most consequential, while those seen as less prevalent, less deadly, and exhibiting more spatial/temporal variation were considered important. Our results underscore the added value of including human-specific diseases in PE, which can help improve disease prevention and control initiatives among pastoralists. Human, animal, and environmental health programs and research can leverage and expand upon our approach, combining it with household surveys and other surveillance methods to address health challenges among pastoralists in the drylands of Northern Kenya and beyond.
On covering systems of polynomial rings over finite fields
Authors: Li Huixi , Wang Biao , Wang Chunlin , Yi Shaoyun 
Published: June 2024

In 1950, Erdős posed a question known as the minimum modulus problem on covering systems for

Z

\mathbb {Z}

, which asked whether the minimum modulus of a covering system with distinct moduli is bounded. This long-standing problem was finally resolved by Hough [Ann. of Math. (2) 181 (2015), no. 1, pp. 361–382] in 2015, as he proved that the minimum modulus of any covering system with distinct moduli does not exceed

10

16

10^{16}

. Recently, Balister, Bollobás, Morris, Sahasrabudhe, and Tiba [Invent. Math. 228 (2022), pp. 377–414] developed a versatile method called the distortion method and significantly reduced Hough’s bound to

616
,
000

616,000

. In this paper, we apply this method to present a proof that the smallest degree of the moduli in any covering system for

F

q

[
x
]

\mathbb {F}_q[x]

of multiplicity

s
s

is bounded by a constant depending only on

s
s

and

q
q

. Consequently, we successfully resolve the minimum modulus problem for

F

q

[
x
]

\mathbb {F}_q[x]

and disprove a conjecture by Azlin [Covering Systems of Polynomial Rings Over Finite Fields, University of Mississippi, Electronic Theses and Dissertations. 39, 2011].
Trends in population attributable fraction of modifiable risk factors for cardiovascular diseases across three decades
Authors: Zhu Fang , Boersma Eric , Tilly Martijn , Ikram M Kamran , Qi Hongchao , Kavousi Maryam 
Published: June 2024

Abstract

Aims
To evaluate temporal trends, across three decades, in the population attributable fractions (PAFs) of modifiable risk factors for 5-year risk of cardiovascular diseases (CVDs).

Methods and results
Within population-based Rotterdam Study, we defined three time groups of individuals without established CVD at ‘baseline’ with a mean age of 70 years, and followed for five years: Epoch 1990s (1989–93, n = 6195), Epoch 2000s (1997–2001, n = 5572), and Epoch 2010s (2009–14, n = 5135). The prevalence of risk factors and related relative risks were combined to quantify PAFs. The PAF of the six risk factors combined for global CVD was 0.57 [95% confidence interval (CI) 0.47–0.65], 0.52 (0.39–0.62), and 0.39 (0.18–0.54) in three respective epochs. Hypertension contributed the highest PAF to global CVD in Epoch 1990s (0.37, 95% CI: 0.28–0.44) and 2000s (0.34, 95% CI: 0.22–0.43), while smoking was the largest contributor in Epoch 2010s (0.20, 95% CI: 0.06–0.32). Dyslipidaemia changed population-level coronary heart disease risk over time. For stroke, hypertension became a less significant contributor over time, but smoking became a larger contributor. For heart failure, all risk factors showed non-significant PAFs in Epoch 2010s. PAFs related to individual risk factor varied among women and men.

Conclusion
Six modifiable risk factors to population-level global CVD risk decreased over time, but still explained 39% of total CVD in the latest decade. PAFs changed considerably for hypertension, dyslipidaemia, and smoking. Risk factors had different PAFs for different CVDs with pronounced sex differences.
Population Dynamics of HIV-1 Inferred From Gene Sequences
Authors: Grassly Nicholas C , Harvey Paul H , Holmes Edward C 
Published: June 2024

Abstract
A method for the estimation of population dynamic history from sequence data is described and used to investigate the past population dynamics of HIV-1 subtypes A and B. Using both gag and env gene alignments the effective population size of each subtype is estimated and found to be surprisingly small. This may be a result of the selective sweep of mutations through the population, or may indicate an important role of genetic drift in the fixation of mutations. The implications of these results for the spread of drug-resistant mutations and transmission dynamics, and also the roles of selection and recombination in shaping HIV-1 genetic diversity, are discussed. A larger estimated effective population size for subtype A may be the result of differences in time of origin, transmission dynamics, and/or population structure. To investigate the importance of population structure a model of population subdivision was fitted to each subtype, although the improvement in likelihood was found to be nonsignificant.
A Comparison of Remote vs In-Person Proctored In-Training Examination Administration for Internal Medicine
Authors: Ong Thai Q. , Krumm Becky , Wells Margaret , Read Susan , Harris Linda , Altomare Andrea , Paniagua Miguel 
Published: June 2024

Abstract

Purpose
In response to COVID-19, the American College of Physicians provided residents the option to complete the 2020 Internal Medicine In-Training Examination (IM-ITE) via in-person and remote proctoring. This study evaluated the extent to which scores obtained from both testing modalities were comparable.

Method
Data were analyzed from residents from all U.S.-based Accreditation Council for Graduate Medical Education–accredited IM residency programs and participating Canadian and international programs who completed the IM-ITE in 2020. The final sample contained 27,115 IM residents: 9,205 postgraduate year (PGY) 1, 9,332 PGY-2, and 8,578 PGY-3. Testing modality, gender, PGY, time spent on assessment, and native language were used to predict percent-correct scores in a multilevel regression model. This model included all main effects and all 2-way interactions between testing modality and each resident-level demographic variable, allowing those effects to be controlled for.

Results
Of 27,115 residents studied, 11,354 (42%) tested remotely and 15,761 (58%) in person. Across the parameters of interest (main effect of testing modality and 2-way interactions), the only statistically significant effects were the interaction effects between testing mode (interaction effect: −0.61; 95% confidence interval [CI], −1.01 to −0.21) and PGY (interaction effect: −0.54; 95% CI, −0.95 to −0.13) (P = .002). Differences between in-person and remote predicted scores were slightly larger for PGY-1 than for PGY-2 and PGY-3 residents, but the magnitude of these differences across residency training was well under one percentage point. Because these statistically significant effects were deemed educationally nonsignificant, the study concluded that performance did not substantively differ across in-person and remote examinees.

Conclusions
Residents taking the 2020 IM-ITE performed similarly across in-person and remote proctoring. This study provides evidence of score comparability across the 2 testing modalities and supports continued use of remote proctoring for the IM-ITE.
An Analysis of Trainee Status of the Primary Care Physician and Ambulatory Care Outcomes
Authors: Graham Kelly L. , Norian Elizabeth , Li Jonathan , Amat Maelys , Davis Roger B. 
Published: June 2024

Abstract

Purpose
Prior studies report disparities in outcomes for patients cared for by trainees versus faculty physicians at academic medical centers. This study examined the effect of having a trainee as the primary care physician versus a faculty member on routine population health outcomes after adjusting for differences in social determinants of health and primary care retention.

Method
This cohort study assessed 38,404 patients receiving primary care at an academic hospital–affiliated practice by 60 faculty and 110 internal medicine trainees during academic year 2019. The effect of primary care practitioner trainee status on routine ambulatory care metrics was modeled using log-binomial regression with generalized estimating equation methods to account for physician-level clustering. Risk estimates before and after adjusting for social determinants of health and loss to follow-up are presented.

Results
Trainee and faculty cohorts had similar distributions of acute illness burden; however, patients in the trainee cohort were significantly more likely to identify as a race other than White (2,476 [52.6%] vs 14,785 [38.5%], P < .001), live in a zip code associated with poverty (1,688 [35.9%] vs 9,122 [23.8%], P < .001), use public health insurance (1,021 [21.7%] vs 6,108 [15.9%], P < .001), and have limited English proficiency (1,415 [30.1%] vs 5,203 [13.6%], P < .001). In adjusted analyses, trainee status of primary care physician was not associated with lack of breast cancer screening but was associated with missed opportunities to screen for colorectal cancer (relative risk [RR], 0.77; 95% confidence interval [CI], 0.68–0.88), control type 2 diabetes mellitus (RR, 0.78; 95% CI, 0.64–0.94), and control hypertension (RR, 0.80; 95% CI, 0.69–0.94).

Conclusions
Primary care physician trainee status was associated with poorer quality of care in the ambulatory setting after adjusting for differences in socioeconomic factors and loss to follow-up, highlighting a potential ambulatory training gap.
Building on Strengths: An Affirmational and Systems-Level Approach to Revisiting Character in Medicine
Authors: Cianciolo Anna T. , O’Brien Bridget C. , Klamen Debra L. , Mellinger John 
Published: June 2024

Abstract
Although U.S. medical education has continued to place increased emphasis on defining competency standards and ensuring accountability to the public, health care inequities have persisted, several basic health outcomes have worsened, public trust in the health care system has eroded, and moral distress, burnout, and attrition among practicing physicians have escalated. These opposing trends beg the question of how the “good doctor” concept may be strengthened. In this perspective, the authors argue that revisiting the construct of physician character from an affirmational perspective could meaningfully improve medical education’s impact on overall health by more holistically conceptualizing what—and who—a good doctor is. The authors introduce positive psychology’s framework of character strengths, probe the distinction between character strengths and medical professionalism, and summarize the role of character strengths in promoting physician engagement and well-being in health care work. They contend that a systems-level approach to cultivating character strengths will foster physician moral agency and well-being and, by extension, transformational change in health care. Consistent with best practice in modern character education, the authors propose that institutions mindfully cultivate moral community among all stakeholders (students, faculty, staff, postgraduate trainees, and patients) and that moral community interaction centers on each member’s personal aspirations with respect to living a good life, guided by the character strengths framework and informed by patient perspectives.
Development and Initial Validation of the Shame Frequency Questionnaire in Medical Students
Authors: Bynum William E. , Dong Ting , Uijtdehaage Sebastian , Belz Franz , Artino Anthony R. 
Published: June 2024

Abstract

Purpose
This study presents the steps taken to develop and collect initial validity evidence for the Shame Frequency Questionnaire in Medical Students.

Method
The instrument was based on a 7-step survey design; validity evidence was collected from content, response process, internal structure, and relationship to other variables. A literature review and qualitative interviews led to the design of the initial 16-item scale. Expert review and cognitive interviewing led to minor modifications in the original structure. Initial pilot testing was conducted in August 2019 in Uniformed Services University (USU) medical students; reliability assessment and exploratory factor analysis were performed. The revised 12-item scale was tested in January 2022 in Duke University School of Medicine medical students; reliability assessment, exploratory factor analysis, and correlation analysis with depression, burnout, anxiety, emotional thriving, and emotional well-being were performed.

Results
A total of 336 of 678 USU students (50%) and 106 of 522 Duke students (20%) completed the survey. Initial exploratory factor analysis of the USU data revealed 1 factor (shame), and 4 items were dropped from the scale according to predefined rules. Subsequent exploratory factor analysis of the Duke data revealed 1 factor; no further items were removed according to predefined rules. Internal consistent reliability was 0.95, and all interitem correlations were less than 0.85 for USU and Duke samples. As predicted, mean shame scale scores were positively correlated with anxiety (r = 0.54, P < .001), burnout (r = 0.50, P < .001), and depression (r = 0.47, P < .001) and negatively correlated with emotional thriving (r = −0.46, P < .001) and emotional recovery (r = −0.46, P < .001).

Conclusions
The Shame Frequency Questionnaire in Medical Students is a psychometrically sound instrument with strong internal reliability and multisource validity evidence, supporting its use in studying shame in medical students.
Association between liver fat level and risk of hypertension: evidence from a Chinese health examination dataset
Authors: Sun Yongbing , Qi Xin , Wang Xuan , Lin Xinbei , Zhou Yang , Du Yawei , Liu Ao , Lv Xue , Zhou Jing , Li Zhonglin , Wu Xiaoling , Zou Zhi , Dou Shewei , Zhang Michael , Zhu Jiadong , Shang Feifei , Li Fengli , Hu Yangxi , Li Hao , Li Yongli 
Published: June 2024

Background:
Hypertension development is predominantly influenced by inflammation, excessive fat deposition, and metabolic irregularities. Among these factors, liver fat accumulation is a critical metabolic disorder. However, the quantification of liver fat levels and its associated risk for hypertension incidence remain ambiguous. This project is designed to explore the association between liver fat levels and the risk of hypertension in a healthy population.

Methods:
This cross-sectional study involved 4955 participants from the Health Management Center at Henan Provincial People's Hospital who were surveyed between February 2020 and February 2023. Participants were categorized into four groups based on liver fat quartiles. Subgroup analyses, restricted cubic spline regression models, and logistic regression were utilized to assess the association between liver fat levels and hypertension risk. The relationships between liver fat levels and inflammatory markers were examined using multiple linear regression models. Additionally, a mediation analysis was conducted to explore the role of inflammatory factors in the relationship between liver fat and hypertension risk.

Results:
Participants with hypertension exhibited greater liver fat levels than did those without hypertension. An increased risk of hypertension was associated with elevated liver fat levels, even after adjusting for other covariates [Q4 vs. Q1 in model II: odds ratio (OR = 1.28), 95% confidence interval (CI) = 1.04–1.59, P = 0.022; P for trend = 0.039]. A nonlinear relationship was observed between liver fat level and hypertension risk, with a notable increase in hypertension risk occurring at liver fat levels greater than 8.65%. Additionally, a positive correlation was found between inflammatory markers and liver fat levels. A mediation effect of 4.76% was noted, linking hypertension risk and liver fat levels through neutrophils.

Conclusion:
Liver fat levels exceeding 8.65% significantly elevated the risk of hypertension. Inflammatory factors serve as crucial mediators of the relationship between liver fat and hypertension.
Five-year survival rate of cancer patients in Ethiopia – systematic review and meta-analysis, 2022
Authors: Gedfew Mihretie , Afenigus Abebe Dilie , Akalu Tadesse Y. , Andualem Atsedemariam , Ayenew Temesgen , Getie Addisu 
Published: June 2024

Background:
Cancer and other non-communicable diseases (NCDs) were once thought to be diseases of high-income countries. However, new studies suggest that they are now a major public health burden in low- and middle-income countries as well. The rate of survival after diagnosis significantly varied across types of cancer and the treatment options they received. Therefore, we conducted this study to determine the survival status of cancer patients in Ethiopia.

Methods:
PubMed, Web of Science, Google Scholar, and Scopus databases from inception to 10 April 2022 were searched to identify relevant studies. A funnel plot and Egger’s regression test were used to determine publication bias. The I
2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random effects model was applied to estimate pooled effect size and 95% confidence interval across studies. Sensitivity analysis was deployed to determine the effect of a single study on the overall estimation, and the analysis was done using STATA Version 14 software.

Results:
A total of 19 studies with 12 847 study participants were included to estimate the pooled survival rate of cancer patients. The estimated pooled survival rate of cancer patients in Ethiopia was 57.15 (95% CI: 56.34–57.97). Regarding the subgroup analysis, based on cancer type, the highest pooled survival rate was recorded among prostate cancer patients at 80.47 (95% CI: 73.60–87.34), followed by cervical cancer patients at 60.89 (95% CI: 37.78–84.00) while the smallest was among colorectal cancer patients at 40.04 (95% CI: 9.11–70.9) and based on study design the highest pooled survival rate was among prospective cohort study at 63.91 (95% CI: 30.86–96.96). Based on publication year, the highest pooled survival rate was recorded in 2020 with 69.61 (95% CI: 48.51–90.70), followed by in 2018 at 63.13 (95% CI: 50.01–76.25).

Conclusion:
The survival rate of cancer patients is low in Ethiopia. This demonstrates that the survival of cancer patients is a major problem in Ethiopia. Therefore, situation-based interventions and preventive strategies should be developed to enhance the survival rate of cancer patients.