bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of severe asthma in children: a systematic review and meta-analysis
Authors: Manti Sara , Magri Paola , De Silvestri Annalisa , De Filippo Maria , Votto Martina , Marseglia Gian Luigi , Licari Amelia 
Published: October 2024

BackgroundSevere asthma significantly impacts a minority of children with asthma, leading to frequent symptoms, hospitalisations and potential long-term health consequences. However, accurate global data on severe asthma epidemiology is lacking. This study aims to address this gap, providing data on severe asthma epidemiology, regional differences and associated comorbidities.MethodsWe conducted a rigorous systematic review and meta-analysis following a registered protocol (PROSPERO CRD42023472845). We searched PubMed, Scopus and Web of Science for cohort or cross-sectional studies published since 2003, evaluating severe asthma incidence and prevalence in children. Study quality and risk of bias were assessed using STROBE guidelines.ResultsNine studies investigating European children with asthma (aged 5–18 years) were included in the meta-analysis. No significant publication bias was found. The overall severe asthma prevalence in children with asthma was 3% (95% CI 1–6; I2=99.9%; p<0.001), with no significant difference between males and females. Prevalence estimates varied significantly depending on the diagnostic criteria used (Global Initiative for Asthma: 6%; European Respiratory Society/American Thoracic Society: 1%; other: 3%). Because none of the examined studies were prospectively designed, incidence rates could not be determined.ConclusionsThis systematic review and meta-analysis provide the first robust assessment of severe asthma prevalence among European children. Our findings underscore the need for comprehensive research to address knowledge gaps in severe asthma, including determining incidence rates, standardising definitions, investigating regional differences and evaluating comorbidities and treatment strategies.
Growth, phytochemical, and phytohormonal responses of basil to different light durations and intensities under constant daily light integral
Authors: Eghbal Elyas , Aliniaeifard Sasan , Mehrjerdi Mahboobeh Zare , Abdi Sahar , Hassani Seyedeh Batool , Rassaie Tina , Gruda Nazim S. 
Published: October 2024

AbstractHorticulture in controlled environments has been increasingly used to tackle limitations on crop production. As a crucial environmental factor, light regulate plant growth and metabolism. In the present study, basil plants were subjected to different light durations and intensities considering constant daily light integral (DLI). The lighting environment included 200, 300, and 400 µmol m− 2 s− 1 intensities for 18, 12, and 9 h, respectively. DLI amounted to 12.96 mol m− 2 d− 1 among all light treatments (LI200 for 18 h, LI300 for 12 h, and LI400 for 9 h). Half of the plants under each light treatment were exposed to 30 µmol m− 2 s− 1 of far-red light. The results indicated the general negative impact of LI400/9 on the growth of basils. Exposure to far-red light hurt the growth of the shoot, while it enhanced stem and petiole elongation. This effect was due to higher gibberellin accumulation, which resulted in shade avoidance responses. Exposure to far-red light also reduced anthocyanin and flavonoid contents, as two important nutritional components. Soluble carbohydrates increased, while storage carbohydrates decreased by increasing lighting duration/decreasing light intensity or by far-red light inclusion. The lowest antioxidant activity was detected in LI400/9. In the LI200/18, the highest level of auxin and the lowest level of cytokinin were detected, while the LI300/12 exhibited the highest level of gibberellin hormone. Low light intensity and long photoperiod enhanced plant biomass and phytochemical production and are recommended for basil production in controlled environments.
Predictive model for identification of gangrenous or perforated appendicitis in adults: a multicenter retrospective study
Authors: Liang Yun , Sailai Maimaitiaili , Ding Rui , Yimamu Baihitiyaer , kazi Tayierjiang , He Ming , Liu Zehui , Lin Junyu , Liu Yile , Deng Chaolun , Huang Jiangtao , Zhang Xingwei , Chen Zheng , Su Yonghui 
Published: October 2024

Abstract
Background
Gangrene and perforation are severe complications of acute appendicitis, associated with a higher mortality rate compared to uncomplicated appendicitis. Accurate preoperative identification of Gangrenous or perforated appendicitis (GPA) is crucial for timely surgical intervention.

Methods
This retrospective multicenter study includes 796 patients who underwent appendectomy. Univariate and multivariate logistic regression analyses are used to develop a nomogram model for predicting GPA based on laboratory tests and computed tomography (CT) findings. The model is validated using an external dataset.

Results
Seven independent predictors were included in the nomogram: white blood cell count, lymphocyte count, D-dimer, serum glucose, albumin, maximum outer diameter of the appendix, and presence of appendiceal fecalith. The nomogram achieved good discrimination and calibration in both the training and testing sets. In the training set, the AUC was 0.806 (95%CI: 0.763–0.849), and the sensitivity and specificity were 82.1% and 66.9%, respectively. The Hosmer-Lemeshow test showed good calibration (P = 0.7378). In the testing set, the AUC was 0.799 (95%CI: 0.741–0.856), and the sensitivity and specificity were 70.5% and 75.3%, respectively. Decision curve analysis (DCA) confirmed the clinical utility of the nomogram.

Conclusion
The laboratory test-CT nomogram model can effectively identify GPA patients, aiding in surgical decision-making and improving patient outcomes.
Identifying group metacognition associated with medical students’ teamwork satisfaction in an online small group tutorial context
Authors: Chao Chia-Ter , Chiu Yen-Lin , Tsai Chiao-Ling , Lin Mong-Wei , Yang Chih-Wei , Ho Chiao-Chi , Hsu Chiun , Chen Huey-Ling 
Published: October 2024

Abstract
Background
Collaborative learning is an essential pedagogy in medical education, within which small group learning constitutes an integral component. Online small group teaching has been widely applied and blended with in-person sessions in the aftermath of the Covid-19 pandemic. This study examined whether group metacognition was associated with teamwork satisfaction in an online small group teaching curriculum for medical students.

Methods
We enrolled medical students of the 2nd and 4th years during the 2021 fall semester after they participated in 3 consecutive sessions of online small group tutorials (SGTs), which have been implemented in our medical school for more than 20 years. The students completed a group metacognitive scale (GMS) and a teamwork satisfaction scale (TSS) after the sessions. We analyzed whether group metacognition in 4 dimensions (knowledge of cognition, planning, evaluating, and monitoring) could be connected with medical students’ teamwork satisfaction using partial least squares-structural equation modeling (PLS-SEM).

Results
A total of 263 medical students participated in this study. Both GMS and TSS exhibited good reliability and validity. Three of the 4 dimensions of group metacognition (cognition, planning, and evaluating) positively correlated with teamwork satisfaction (path coefficients 0.311, 0.279, and 0.21; p = 0.002, 0.002, and 0.043, respectively) following the online SGT curriculum, whereas the monitoring dimension did not (path coefficient 0.087; p = 0.357). The model achieved an adjusted R square of 0.683.

Conclusion
We discovered that group metacognition correlated positively with better teamwork satisfaction, supporting the importance of group metacognitive competency for online collaborative learning.
Personal responsibility for health in Bulgarian public health law and social legislation
Authors: Aleksandrova-Yankulovska Silviya , Steger Florian 
Published: October 2024

Abstract
Background
In the last decades all health systems have experienced a lack of resources. Against this background, the idea of ​​applying personal responsibility of the patient as a criterion for allocation of resources (PRCAR) is gaining increasing attention. Bulgarian healthcare reform has been marked by the implementation of many new strategies, that grounded our scientific interest towards investigating PRCAR in Bulgarian public health law and social legislation.

Methods
Through a search of national legal databases 7 documents were selected and subjected to content analysis.

Results
Prospective responsibility was found in two and retrospective responsibility - in three documents, two of which imposed explicit penalties on the patient. Two documents did not distinguish between the types of patient responsibility. PRCAR was found to be controversial through the prism of the social justice principle. The discussion was conducted through the perspectives of evidence translation of research to law, particularities of social cohesion in Bulgaria, and the interpretation of principles of public health ethics.

Conclusion
Although PRCAR was traceable in Bulgarian legislation, no supporting arguments for its introduction were deduced. The applicability of PRCAR should be further studied and wider public debate should be initiated.
Evaluation of Praziquantel effectiveness in treating Nile tilapia clinostomid infections and its relationships to fish health and water quality
Authors: Mahdy Olfat A. , Attia Marwa M. , Shaheed Iman B , Abdelsalam Mohamed , Elgendy Mamdouh Y. , Salem Mai A. 
Published: October 2024

AbstractThis study aimed to conduct a multidisciplinary investigation integrating detailed morphology, molecular characterization, water parameters, histopathology alteration, and the trials of treatment of Clinostomum spp. In this study, 300 Nile tilapia (Oreochromis niloticus) were collected from the farmed and wild Nile River at Al Bahr Al Aazam, Giza Governorate to assess Clinostomid infection prevalence. Fish and water samples were collected from private fish farms, and water drains at Dakahlia, and Giza, Egypt. Analysis of the water revealed inadequate water quality, particularly in the fish farms. Snails and piscivorous birds were abundant at fish collection sites. The recovered Clinostomid MCs morphological characteristics and COI gene sequence analysis identified them as Clinostomum complanatum, C. phalacrocoracis, and Euclinostomum heterostomum. Clinostomid MCs disturbed the fish’s hematological and biochemical blood parameters. Bath treatment of parasitized fish with praziquantel (2 mg/L for 24 h) revealed a significant reduction in the number of vital MCs vs. infected fish (non-treated). Praziquantel (PZQ) is an effective and safe therapy for controlling Clinostomid infections affecting farmed Nile tilapia. The current findings indicate a link between poor environmental conditions and Clinostomum infections in tilapia. The study highlights the impacts of Clinostomid MCs on fish health and recommends bath treatment with PZQ as an efficient control method for these dangerous parasites to protect human and fish health.
Influence of future climate scenarios using CMIP 5 data on malaria transmission in India
Authors: Peri Subrahmanya Hari Prasad 
Published: October 2024

Abstract
Background
Vector-borne diseases, such as malaria, pose a significant global threat, and climatological factors greatly influence their intensity. Tropical countries, like India, are particularly vulnerable to such diseases, making accurate estimation of malaria risk crucial.

Methods
This study utilized the well-known Vector-borne Disease Community Model, VECTRI, developed by the International Centre for Theoretical Physics in Trieste. The model was implemented to estimate malaria’s Entomological Inoculation Rate (EIR). Future climatic prediction datasets, including CMIP 5 and population data sets, were used as inputs for the analysis. Three RCP scenarios are considered (Representative Concentration Pathways are climate change scenarios that project radiative forcing to 2100 due to future greenhouse gas concentrations). The projections covered the period from 1 Jan, 2020, to 31 Dec, 2029.

Results
The estimated mean EIR for the years 2020–2029 ranged, and a significant decline in malaria risk was observed with all RCP 2.6, 4.5, and 8.5 scenarios. Each year 0.3 to 2.6 [min–max] EIR/person/day decline is observed with a strong decline in man rainfall ranging from 5 to 17 [min–max] mm/year and associated high temperatures ranging from 0.03 to 0.06 [min–max] °C/year. During the post-monsoon period, August to November were identified as highly prone to malaria transmission. Spatial analysis revealed that the east coast of India faced a higher vulnerability to malaria risk, which kept increasing through RCP scenarios. Thus, it is essential to exercise caution, especially in areas with heavy rainfall.

Conclusion
This research provides valuable insights for policy-makers, highlighting the need to implement future strategies to mitigate malaria risk effectively. By utilizing these findings, appropriate measures can be taken to combat the threat posed by malaria and protect public health.
Evaluating the effects of short-term low temperature on the growth and development of Trichopria drosophilae based on the age–stage two-sex life table
Authors: Chen Qiang , Zhang Jinlong , Tian Ye , Li Juan , Ning Weizhi , Chen Guohua , Zhang Xiaoming 
Published: October 2024

Abstract
Background
The effects of low temperatures on parasitic wasps are crucial for maintaining farmland biodiversity and enhancing biological control, especially given the implications of global warming and frequent extreme cold events.

Methods
We studied the effects of different low temperatures (−8 ± 1 °C, −4 ± 1 °C, 0 ± 1 °C, 4 ± 1 °C, and 8 ± 1 °C) on the mating frequency and duration of male adults of Trichopria drosophilae and the number of pupae beaten by female adults, and constructed the age–stage two-sex life table of T. drosophilae.

Results
This study found that male T. drosophilae adults exposed to low temperatures for 12 h significantly altered their mating behavior, peaking between 15:00 and 17:00. As the temperature dropped during the exposure, both the mating frequency of T. drosophilae and the duration of pupal beating were affected. The survival rate of female adults dropped from 39.55% at 8 °C to just 21.17% at −8 °C. Low-temperature treatment shortened the development period and lifespan for T. drosophilae adults. They developed 4.71 days faster and had a total lifespan that was 10.66 days shorter than those in the control group after being exposed to −8 °C. Furthermore, the average number of eggs laid by females at −8 °C was 4.46 less than that at 8 °C and 6.16 less than that in the control group, which laid an average of 21.55 eggs. The net reproductive rate (R0) of T. drosophilae decreased with lower temperatures, reaching a low of 23.64 at −8 °C. Conversely, the intrinsic growth rate (rm) actually increased as temperatures dropped, with the lowest value being 0.21 at −8 °C.

Conclusions
The findings indicate that short-term exposure to low temperatures hampers the growth and population increase of T. drosophilae, thereby reducing their effectiveness as biological control agents.

Graphical Abstract
Uptake of biosimilars in China: a retrospective analysis of the case of trastuzumab from 2018 to 2023
Authors: Wu Qiyou , Wang Zhitao , Fu Yihan , Luo Ren , Sun Jing 
Published: October 2024

Abstract
Background
The Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels.

Methods
This study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed.

Results
After rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure.

Conclusions
The uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.
Segmentation-based quantitative measurements in renal CT imaging using deep learning
Authors: Koukoutegos Konstantinos , ’s Heeren Richard , De Wever Liesbeth , De Keyzer Frederik , Maes Frederik , Bosmans Hilde 
Published: October 2024

Abstract
Background
Renal quantitative measurements are important descriptors for assessing kidney function. We developed a deep learning-based method for automated kidney measurements from computed tomography (CT) images.

Methods
The study datasets comprised potential kidney donors (n = 88), both contrast-enhanced (Dataset 1 CE) and noncontrast (Dataset 1 NC) CT scans, and test sets of contrast-enhanced cases (Test set 2, n = 18), cases from a photon-counting (PC)CT scanner reconstructed at 60 and 190 keV (Test set 3 PCCT, n = 15), and low-dose cases (Test set 4, n = 8), which were retrospectively analyzed to train, validate, and test two networks for kidney segmentation and subsequent measurements. Segmentation performance was evaluated using the Dice similarity coefficient (DSC). The quantitative measurements’ effectiveness was compared to manual annotations using the intraclass correlation coefficient (ICC).

Results
The contrast-enhanced and noncontrast models demonstrated excellent reliability in renal segmentation with DSC of 0.95 (Test set 1 CE), 0.94 (Test set 2), 0.92 (Test set 3 PCCT) and 0.94 (Test set 1 NC), 0.92 (Test set 3 PCCT), and 0.93 (Test set 4). Volume estimation was accurate with mean volume errors of 4%, 3%, 6% mL (contrast test sets) and 4%, 5%, 7% mL (noncontrast test sets). Renal axes measurements (length, width, and thickness) had ICC values greater than 0.90 (p < 0.001) for all test sets, supported by narrow 95% confidence intervals.

Conclusion
Two deep learning networks were shown to derive quantitative measurements from contrast-enhanced and noncontrast renal CT imaging at the human performance level.

Relevance statement
Deep learning-based networks can automatically obtain renal clinical descriptors from both noncontrast and contrast-enhanced CT images. When healthy subjects comprise the training cohort, careful consideration is required during model adaptation, especially in scenarios involving unhealthy kidneys. This creates an opportunity for improved clinical decision-making without labor-intensive manual effort.

Key Points

Trained 3D UNet models quantify renal measurements from contrast and noncontrast CT.

The models performed interchangeably to the manual annotator and to each other.

The models can provide expert-level, quantitative, accurate, and rapid renal measurements.

Graphical Abstract
Virtual reality in stroke recovery: a meta-review of systematic reviews
Authors: Khan Ammar , Imam Yahia Z. , Muneer Mohamed , Al Jerdi Salman , Gill Sumanjit K. 
Published: October 2024

Abstract
Background
Virtual Reality (VR) is an emerging technology in post stroke recovery. However, its precise role in stroke rehabilitation is not well defined. The aim of this paper is to conduct an overview of systematic reviews on the role of VR in stroke rehabilitation.

Methods
A meta-review with results from a search of 7 databases from inception till 5th December 2022 with subsequent quality appraisal was conducted. The primary outcome was to produce a narrative review on the efficacy of VR versus usual or other care in stroke recovery. Data was synthesized in a descriptive fashion and high-quality systematic reviews were emphasized. The AMSTAR-2 tool was used for quality assessment of the included studies.

Results
Evidence from high-quality systematic reviews suggests that there is benefit from VR in upper limb, lower limb, gait, and balance recovery particularly when additive to conventional therapy. There is also limited evidence to suggest that VR has a positive effect in those with impaired cognition.

Conclusion
VR is safe and effective as an adjunct to conventional therapy for adults after stroke and should be used routinely for upper and lower limb motor recovery. Further high-quality studies that evaluate its efficacy and explore ways to increase its positive impact in areas such as cognition are required. There is also a scope for the development of stroke-specific virtual environments. (PROSPERO registration # CRD42022372926).