Relative hypoxia at high altitudes increases the incidence of phaeochromocytomas
Bibliographic record
Abstract
We read with great interest the recent paper reporting a high incidence of phaeochromocytomas and paragangliomas in an unselected population from the western region of Canada (1). All cases were identified based on clinical data available over a 7 years period. Interestingly, Alberta has a higher altitude (3678 ft, https://en-gb.topographic-map.com/maps/lrg4/Alberta/) compared with other geographical areas from where a lower incidence was reported in previous papers (Table 1). Similarly, detailed epidemiological data from multiple geographical area are not easily available. Previous reports involving the entire USA population cannot be scrutinised as they lack ‘granular details' regarding states with different altitudes. There is, however, a convincing trend that suggests that high altitude (as in Alberta) and its associated relative hypoxia modulate the risk of development of phaeochromocytomas. In support of this hypothesis, in an analysis of 58 subjects from 23 families with SDHD mutations, subjects with phaeochromocytomas lived at higher altitudes and were exposed to higher altitude-years than those without them. Furthermore, those who were diagnosed with single tumours at their first clinical evaluation lived at lower average altitudes and were exposed to lower altitude-years than those with multiple tumours (7). Population-weighted elevations were approximately 260 m for the United States and 2 m for the central-Western Netherlands (P~0), suggesting that low altitudes in The Netherlands reduce penetrance and relax the natural selection on SDHD mutations (7).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".