bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving diagnostic accuracy using a clinical diagnostic support system for medical students during history-taking: a randomized clinical trial
Authors: Yanagita Yasutaka , Shikino Kiyoshi , Ishizuka Kosuke , Uchida Shun , Li Yu , Yokokawa Daiki , Tsukamoto Tomoko , Noda Kazutaka , Uehara Takanori , Ikusaka Masatomi 
Published: May 2023

Abstract
Background
A clinical diagnostic support system (CDSS) can support medical students and physicians in providing evidence-based care. In this study, we investigate diagnostic accuracy based on the history of present illness between groups of medical students using a CDSS, Google, and neither (control). Further, the degree of diagnostic accuracy of medical students using a CDSS is compared with that of residents using neither a CDSS nor Google.

Methods
This study is a randomized educational trial. The participants comprised 64 medical students and 13 residents who rotated in the Department of General Medicine at Chiba University Hospital from May to December 2020. The medical students were randomly divided into the CDSS group (n = 22), Google group (n = 22), and control group (n = 20). Participants were asked to provide the three most likely diagnoses for 20 cases, mainly a history of a present illness (10 common and 10 emergent diseases). Each correct diagnosis was awarded 1 point (maximum 20 points). The mean scores of the three medical student groups were compared using a one-way analysis of variance. Furthermore, the mean scores of the CDSS, Google, and residents’ (without CDSS or Google) groups were compared.

Results
The mean scores of the CDSS (12.0 ± 1.3) and Google (11.9 ± 1.1) groups were significantly higher than those of the control group (9.5 ± 1.7; p = 0.02 and p = 0.03, respectively). The residents’ group’s mean score (14.7 ± 1.4) was higher than the mean scores of the CDSS and Google groups (p = 0.01). Regarding common disease cases, the mean scores were 7.4 ± 0.7, 7.1 ± 0.7, and 8.2 ± 0.7 for the CDSS, Google, and residents’ groups, respectively. There were no significant differences in mean scores (p = 0.1).

Conclusions
Medical students who used the CDSS and Google were able to list differential diagnoses more accurately than those using neither. Furthermore, they could make the same level of differential diagnoses as residents in the context of common diseases.

Trial registration
This study was retrospectively registered with the University Hospital Medical Information Network Clinical Trials Registry on 24/12/2020 (unique trial number: UMIN000042831).
Exploring sex disparities in cardiovascular disease risk factors using principal component analysis and latent class analysis techniques
Authors: Khamis Gamal Saad Mohamed , Alanazi Sultan Munadi 
Published: May 2023

Abstract
Background
This study used machine learning techniques to evaluate cardiovascular disease risk factors (CVD) and the relationship between sex and these risk factors. The objective was pursued in the context of CVD being a major global cause of death and the need for accurate identification of risk factors for timely diagnosis and improved patient outcomes. The researchers conducted a literature review to address previous studies' limitations in using machine learning to assess CVD risk factors.

Methods
This study analyzed data from 1024 patients to identify the significant CVD risk factors based on sex. The data comprising 13 features, such as demographic, lifestyle, and clinical factors, were obtained from the UCI repository and preprocessed to eliminate missing information. The analysis was performed using principal component analysis (PCA) and latent class analysis (LCA) to determine the major CVD risk factors and to identify any homogeneous subgroups between male and female patients. Data analysis was performed using XLSTAT Software. This software provides a comprehensive suite of tools for Data Analysis, Machine Learning, and Statistical Solutions for MS Excel.

Results
This study showed significant sex differences in CVD risk factors. 8 out of 13 risk factors affecting male and female patients found that males and females share 4 of the eight risk factors.
Identified latent profiles of CVD patients, suggesting the presence of subgroups among CVD patients. These findings provide valuable insights into the impact of sex differences on CVD risk factors. Moreover, they have important implications for healthcare professionals, who can use this information to develop individualized prevention and treatment plans. The results highlight the need for further research to elucidate these disparities better and develop more effective CVD prevention measures.

Conclusions
The study explored the sex differences in the CVD risk factors and the presence of subgroups among CVD patients using ML techniques. The results revealed sex-specific differences in risk factors and the existence of subgroups among CVD patients, thus providing essential insights for personalized prevention and treatment plans. Hence, further research is necessary to understand these disparities better and improve CVD prevention.
From idea to systems solution: enhancing access to primary care in Malawi
Authors: van Niekerk L. , Fosiko N. , Likaka A. , Blauvelt C. P. , Msiska B. , Manderson L. 
Published: May 2023

AbstractMalawi, like many other countries, faces challenges in providing accessible, affordable, and quality health services to all people. The Malawian policy framework recognizes the value of communities and citizens, as co-creators of health and leaders of localized and innovative initiatives, such as social innovations.Social innovations involve and include communities and citizens, as well as bring about changes in the institutions responsible for care delivery. In this article, we describe the institutionalization process of a citizen-initiated primary care social innovation, named Chipatala Cha Pa Foni, focused on extending access to health information and appropriate service-seeking behavior.An interdisciplinary multi-method qualitative case study design was adopted, drawing on data collected from key informant interviews, observations, and documents over an 18-month period. A composite social innovation framework, informed by institutional theory and positive organizational scholarship, guided the thematic content analysis. Institutional-level changes were analyzed in five key dimensions as well as the role of actors, operating as institutional entrepreneurs, in this process.A subset of actors matched the definition of operating as Institutional Entrepreneurs. They worked in close collaboration to bring about changes in five institutional dimensions: roles, resource flows, authority flows, social identities and meanings. We highlight the changing role of nurses; redistribution and decentralization of health information; shared decision-making, and greater integration of different technical service areas.From this study, the social innovation brought about key institutional and socio-cultural changes in the Malawi health system. These changes supported strengthening the system’s integrity for achieving Universal Health Coverage by unlocking and cultivating dormant human-based resources. As a fully institutionalized social innovation, Chipatala Cha Pa Foni has enhanced access to primary care and especially as part of the Covid-19 response.
Perspectives of patients with colorectal cancer liver metastases on e-consultation in transmural care: a qualitative study
Authors: Hellingman T. , van Beneden M. L.H. , den Bakker C. M. , Zonderhuis B. M. , Kazemier G. 
Published: May 2023

Abstract
Background
Comprehensive cancer networks have been established to deliver high-quality care for patients with cancer. Logistic challenges are faced, when patients need to be referred for specialized treatments. Despite strengthened privacy legislations, digital platforms are increasingly used to consult specialists from dedicated liver centers or refer patients with colorectal cancer liver metastases (CRLM) for local treatment strategies. This qualitative study aimed to explore the perspectives of patients with CRLM regarding e-consultation of transmural specialists.

Methods
A focus group study was conducted. Patients referred from regional hospitals to an academic liver center for treatment of CRLM were asked to participate. Focus group discussions were audio-recorded and transcribed verbatim. A thematic content analysis of data was conducted, comprising open, axial, and selective coding of the transcripts. The consolidated criteria for reporting qualitative research (COREQ) were used.

Results
Two focus groups were held, involving 11 patients and 8 relatives. Three major themes were identified with regard to e-consultation in transmural care: ‘data management’, ‘expertise’, and ‘information and coordination’. Confidence in the expertise of physicians appeared most important during the course of treatment, as patients experienced uncertainty after diagnosis of cancer. Despite the privacy risks, use of digital communication platforms to contact experts in the field were strongly endorsed to improve eligibility for potentially curative treatment. Moreover, e-consultation of specialists may reduce waiting times, due to effective coordination of care.

Conclusion
Initiatives to improve medical data transfer between care providers were encouraged to achieve effective coordination of oncological care. The potential hazard of privacy violation associated with digital data exchange is accepted by patients and their relatives, provided that use of digital data improves patient’s own health care, research or education.
Mental healthcare services in Kenyan counties: a descriptive survey of four counties in Western Kenya
Authors: Kwobah Edith Kamaru , Turissini Matthew , Barasa Julius , Kimaiyo Mercy , Okeyo Lily , Araka Joash , Njiriri Faith , Matundura Richard , Jaguga Florence 
Published: May 2023

Abstract
Background
The government of Kenya has made progressive efforts towards improving mental health services in the country. However there is little documentation of mental health services in the counties that would support actualization of the legislative frameworks in the context of a devolved healthcare system. This study sought to document existing mental health services within 4 counties in Western Kenya.

Methods
We conducted a cross sectional descriptive survey of four counties using the World Health Organization, Assessment Instrument for Mental Health Systems (WHO-AIMS). Data was collected in 2021, with 2020 being the year of reference. We collected data from the facilities offering mental healthcare within the counties as well as from County health policy makers and leaders.

Results
Mental healthcare was provided at higher level facilities within the counties, with minimal structures at primary care facilities. No county had a stand-alone policy on mental health services or dedicated budget for mental healthcare. The national referral hospital, within Uasin-Gishu county, had a clear mental health budget for mental health. The national facility in the region had a dedicated inpatient unit while the other three counties admitted patients in general medical wards but had mental health outpatient clinics. The national hospital had a variety of medication for mental health care while the rest of the counties had very few options with antipsychotics being the most available. All the four counties reported submitting data on mental health to Kenya health information system (KHIS). There were no clearly defined mental healthcare structures in the primary care level except for funded projects under the National referral hospital and the referral mechanism was not well defined. There was no established mental health research in the counties except that which was affiliated to the national referral hospital.

Conclusion
In the four counties in Western Kenya, the mental health systems are limited and not well structured, are faced with limited human and financial resources and there is lack of county specific legistrative frameworks to support mental healthcare. We recommend that counties invest in structures to support provision of quality mental healthcare to the people they serve.
Ambient fine particulate matter and allergic symptoms in the middle-aged and elderly population: results from the PIFCOPD study
Authors: Wei Shanshan , Liao Jiping , Xue Tao , Yu Kunyao , Fu Xiuhua , Wang Ruiying , Dang Xiaomin , Zhang Cheng , Qiao Hua , Jiang Shujuan , Xiao Jianhong , Dong Lixia , Yin Jinzhi , Yan Xixin , Jia Weihua , Zhang Guifang , Chen Rui , Zhou Bo , Song Beibei , Li Jing , Yin Mengyu , Zhang Lina , Xie Liping , Dong Shaochen , Sun Jian , Gao Peng , Miao Bifang , Li Wei , He Lan , Ning Qian , Zhao Limin , Liu Hengyi , Cao Han , Wang Guangfa 
Published: May 2023

Abstract
Background
The associations between short- and long-term exposure to ambient fine particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM2.5) and allergic symptoms in middle-aged and elderly populations remain unclear, particularly in China, where most cities have severe air pollution.

Methods
Participants (n = 10,142; age = 40–75 years) were recruited from ten regions in China from 2018 to 2021 for the Predictive Value of Inflammatory Biomarkers and Forced Expiratory Volume in 1 s (FEV1) for Chronic Obstructive Pulmonary Disease (PIFCOPD) study. Short-term (lag0 and lag0–7 day) and long-term (1-, 3- and 5-year) PM2.5 concentrations at residences were extracted from the air pollutant database known as Tracking Air Pollution (TAP) in China. Multivariate logistic regression models were used to estimate associations for short- and long-term PM2.5 exposure concentrations and long-term exposure models were additionally adjusted for short-term deviations.

Results
A 10 µg/m3 increase in PM2.5 on the day the allergic symptoms questionnaire was administered (lag0 day) was associated with higher odds of allergic nasal (1.09, 95% CI 1.05, 1.12) and eye symptoms (1.08, 95% CI 1.05, 1.11), worsening dyspnea caused by allergens (1.06, 95% CI 1.02, 1.10), and ≥ 2 allergic symptoms (1.07, 95% CI 1.03, 1.11), which was similar in the lag0–7 day concentrations. A 10 µg/m3 increase in the 1-year average PM2.5 concentration was associated with an increase of 23% for allergic nasal symptoms, 22% for eye symptoms, 20% for worsening dyspnea caused by allergens, and 21% for ≥ 2 allergic symptoms, similar to the 3- and 5-year average PM2.5 concentrations. These associations between long-term PM2.5 concentration and allergic symptoms were generally unchanged after adjustment for short-term deviations.

Conclusions
Short- and long-term exposure to ambient PM2.5 was associated with an increased risk of allergic nasal and eye symptoms, worsening dyspnea caused by allergens, and ≥ 2 allergic symptoms.

Trial registration

Clinical trial ID: NCT03532893 (29 Mar 2018).
Hyperglycemia and O-GlcNAc transferase activity drive a cancer stem cell pathway in triple-negative breast cancer
Authors: Ayodeji Saheed A. , Bao Bin , Teslow Emily A. , Polin Lisa A. , Dyson Greg , Bollig-Fischer Aliccia , Fehl Charlie 
Published: May 2023

Abstract
Background
Enhanced glucose metabolism is a feature of most tumors, but downstream functional effects of aberrant glucose flux are difficult to mechanistically determine. Metabolic diseases including obesity and diabetes have a hyperglycemia component and are correlated with elevated pre-menopausal cancer risk for triple-negative breast cancer (TNBC). However, determining pathways for hyperglycemic disease-coupled cancer risk remains a major unmet need. One aspect of cellular sugar utilization is the addition of the glucose-derived protein modification O-GlcNAc (O-linked N-acetylglucosamine) via the single human enzyme that catalyzes this process, O-GlcNAc transferase (OGT). The data in this report implicate roles of OGT and O-GlcNAc within a pathway leading to cancer stem-like cell (CSC) expansion. CSCs are the minor fraction of tumor cells recognized as a source of tumors as well as fueling metastatic recurrence. The objective of this study was to identify a novel pathway for glucose-driven expansion of CSC as a potential molecular link between hyperglycemic conditions and CSC tumor risk factors.

Methods
We used chemical biology tools to track how a metabolite of glucose, GlcNAc, became linked to the transcriptional regulatory protein tet-methylcytosine dioxygenase 1 (TET1) as an O-GlcNAc post-translational modification in three TNBC cell lines. Using biochemical approaches, genetic models, diet-induced obese animals, and chemical biology labeling, we evaluated the impact of hyperglycemia on CSC pathways driven by OGT in TNBC model systems.

Results
We showed that OGT levels were higher in TNBC cell lines compared to non-tumor breast cells, matching patient data. Our data identified that hyperglycemia drove O-GlcNAcylation of the protein TET1 via OGT-catalyzed activity. Suppression of pathway proteins by inhibition, RNA silencing, and overexpression confirmed a mechanism for glucose-driven CSC expansion via TET1-O-GlcNAc. Furthermore, activation of the pathway led to higher levels of OGT production via feed-forward regulation in hyperglycemic conditions. We showed that diet-induced obesity led to elevated tumor OGT expression and O-GlcNAc levels in mice compared to lean littermates, suggesting relevance of this pathway in an animal model of the hyperglycemic TNBC microenvironment.

Conclusions
Taken together, our data revealed a mechanism whereby hyperglycemic conditions activated a CSC pathway in TNBC models. This pathway can be potentially targeted to reduce hyperglycemia-driven breast cancer risk, for instance in metabolic diseases. Because pre-menopausal TNBC risk and mortality are correlated with metabolic diseases, our results could lead to new directions including OGT inhibition for mitigating hyperglycemia as a risk factor for TNBC tumorigenesis and progression.
New opportunities for RGD-engineered metal nanoparticles in cancer
Authors: Qin Wei , Chandra Jyoti , Abourehab Mohammed A.S. , Gupta Neelima , Chen Zhe-Sheng , Kesharwani Prashant , Cao Hui-Ling 
Published: May 2023

AbstractThe advent of nanotechnology has opened new possibilities for bioimaging. Metal nanoparticles (such as gold, silver, iron, copper, etc.) hold tremendous potential and offer enormous opportunities for imaging and diagnostics due to their broad optical characteristics, ease of manufacturing technique, and simple surface modification. The arginine-glycine-aspartate (RGD) peptide is a three-amino acid sequence that seems to have a considerably greater ability to adhere to integrin adhesion molecules that exclusively express on tumour cells. RGD peptides act as the efficient tailoring ligand with a variety of benefits including non-toxicity, greater precision, rapid clearance, etc. This review focuses on the possibility of non-invasive cancer imaging using metal nanoparticles with RGD assistance.
Graphical abstract
Magnetic-activated cell sorting identifies a unique lung microbiome community
Authors: Dunlap Daniel G. , Yang Libing , Qin Shulin , Li Kelvin , Fitch Adam , Huang Laurence , McVerry Bryan J. , Hand Timothy W. , Methé Barbara A. , Morris Alison 
Published: May 2023

Abstract
Background
The advent of culture-independent, next-generation DNA sequencing has led to the discovery of distinct lung bacterial communities. Studies of lung microbiome taxonomy often reveal only subtle differences between health and disease, but host recognition and response may distinguish the members of similar bacterial communities in different populations. Magnetic-activated cell sorting has been applied to the gut microbiome to identify the numbers and types of bacteria eliciting a humoral response. We adapted this technique to examine the populations of immunoglobulin-bound bacteria in the lung.

Methods
Sixty-four individuals underwent bronchoalveolar lavage (BAL). We separated immunoglobulin G-bound bacteria using magnetic-activated cell sorting and sequenced the 16S rRNA gene on the Illumina MiSeq platform. We compared microbial sequencing data in IgG-bound bacterial communities compared to raw BAL then examined the differences in individuals with and without HIV as a representative disease state.

Results
Immunoglobulin G-bound bacteria were identified in all individuals. The community structure differed when compared to raw BAL, and there was a greater abundance of Pseudomonas and fewer oral bacteria in IgG-bound BAL. Examination of IgG-bound communities in individuals with HIV demonstrated the differences in Ig-bound bacteria by HIV status that were not seen in a comparison of raw BAL, and greater numbers of immunoglobulin-bound bacteria were associated with higher pulmonary cytokine levels.

Conclusions
We report a novel application of magnetic-activated cell sorting to identify immunoglobulin G-bound bacteria in the lung. This technique identified distinct bacterial communities which differed in composition from raw bronchoalveolar lavage, revealing the differences not detected by traditional analyses. Cytokine response was also associated with differential immunoglobulin binding of lung bacteria, suggesting the functional importance of these communities.
To what extent do secondary effects shape migrants’ educational trajectories after lower-secondary education?
Authors: Busse Robin , Michaelis Christian , Nennstiel Richard 
Published: May 2023

AbstractResearch shows a heterogeneous picture of migration-related disparities regarding adolescents’ educational trajectories at the end of lower-secondary education. Among other disparities, migrants face large disadvantages with regard to the transition to vocational education and training (VET). They are, however, also more likely to change to upper-secondary school tracks at the end of lower-secondary education. Using longitudinal data drawn from the German National Educational Panel Study (NEPS, Starting Cohort 4), this study empirically captures patterns in school-leavers’ transition trajectories after lower-secondary education and empirically tests theoretical mechanisms of migration-related educational inequalities. Building on the concept of secondary effects of migrant origin, this study asks to what extent self-selection explains migration-related disparities in the educational trajectories at the end of lower-secondary education. Particular attention is devoted to the extent to which migration-related inequalities in adolescents’ transitions can be explained by differences in (1) rational choice factors and (2) the educational expectations and demands of parents and friends. The results show that rational choice factors and the educational expectations of social groups largely contribute to migration-related educational inequalities. The results provide important starting points for educational policy discussions on strategies and measures to address migration-related inequalities in the transition to VET.