bluuebunny/crossref_metadata_2025_split huggingface dataset:
Co-designing the implementation of a rural health systems-strengthening rheumatic heart disease program with remote First Nations Australian communities using Theory of Change
Authors: Jones Benjamin , Mitchell Alice , Haynes Emma , Howard Natasha J. , Wade Vicki , Pears Chantelle , Rossingh Bronwyn , Gatti Jessica , Ramadani Seide , Corpus Emma , Yan Jennifer , Marangou James , Kaethner Alex , Bailey Meghan , Francis Joshua R , English Mike , Nagraj Shobhana 
Published: February 2025

Abstract

Background
Rheumatic heart disease (RHD) is highly prevalent and under-detected in remote First Nations Australian communities. Rural communities face severe health workforce shortages that impact negatively on health outcomes. Task-sharing using local healthcare workers, trained to screen for active RHD cases (using handheld ultrasound with remote support from experts), has been proposed as a means of improving early detection whilst also strengthening referral pathways. Implementing new models of care within remote communities, however, requires local knowledge, cultural and operational adaptation, whilst ensuring consistency and quality assurance across multiple sites. This study aimed to co-design local implementation strategies for an RHD active case finding program with five remote communities and explain how and why the task-sharing program might lead to improved health outcomes.

Methods
A qualitative study using a Theory of Change approach and ‘yarning’ methods, was conducted with five remote First Nations Australian communities. We used a combination of participant observation, extensive field notes over sequential visits to each site, supplemented with document analysis to inform co-design of Theories of Change for each community. Data were curated using NVivo software and analysed using Powell’s refined compilation of implementation strategies framework.

Results
Through the co-design process, a total of 24 locally tailored implementation strategies were identified. All sites identified the need for a positive implementation environment, including recognition of local healthcare workers through positive messaging and celebratory events for achieving key training milestones. Other key themes included the importance of opportunistic RHD screening, and the integration of local languages during both training and screening. Five locally adapted versions of the Theory of Change were co-designed to include planned outcomes, assumptions, causal mechanisms, and indicators for the program at each community.

Conclusions
Our study identified implementation strategies and Theories of Change for the training and screening aspects of a new model of care for RHD screening in five remote First Nation Australian communities. These findings will be used to support future program evaluation and exploration the mechanisms by which the RHD screening program achieves its outcomes.
Association of triglyceride-glucose index and derived indices with cataract in middle-aged and elderly Americans: NHANES 2005–2008
Authors: Wei Bin , Hu Xin , Shu Ben-Liang , Huang Qin-Yi , Chai Hua , Yuan Hao-Yu , Zhou Lin , Duan Yi-Chong , Yao Li-Li , Dong Zhuo-Er , Wu Xiao-rong 
Published: February 2025

Abstract

Aim
Explore the relationship between the triglyceride-glucose (TyG) index, along with its derivative indices, and the prevalence of cataracts.

Methods
Data from 20,497 participants in the 2005–2008 National Health and Nutrition Examination Survey (NHANES) were compiled. A final total of 4,499 individuals met the eligibility criteria. Cataract presence was assessed through a self-reported history of cataract surgery. The TyG index and its derivatives—TyG-waist-to-height ratio (WHtR), TyG-neutrophil-to-lymphocyte ratio (NLR), TyG-monocyte-to-lymphocyte ratio (MLR), TyG-log platelet-to-lymphocyte ratio (lgPLR), TyG-log systemic inflammation index (lgSII), and TyG-systemic inflammation response index (SIRI)—were calculated. Statistical analyses included multivariable logistic regression, restricted cubic spline (RCS) curves for nonlinear relationships, and receiver operating characteristic (ROC) analysis.

Results
Higher TyG indices were significantly associated with cataract presence (P < 0.001). Specifically, TyG-WHtR, TyG-NLR, TyG-lgPLR, TyG-lgSII, and TyG-SIRI exhibited positive correlations with cataract prevalence, even after adjustment for potential confounders (odds ratio [OR] = 1.17; 95% confidence interval [CI]: 1.01, 1.37; P = 0.0403; [OR] = 1.01; 95% [CI]: 1.00, 1.02; P = 0.0258; [OR] = 1.08; 95% [CI]: 1.01, 1.16; P = 0.0223; [OR] = 1.08; 95% [CI]: 1.03, 1.14; P = 0.001; [OR] = 1.02; 95% [CI]: 1.00, 1.04; P = 0.0120). Furthermore, the stratified analysis showed that in the 61–85 age group, TyG-lgPLR and TyG-lgSII remained positively associated with cataract prevalence ([OR] = 1.09; 95% [CI]: 1.01, 1.17; P = 0.024; [OR] = 1.08; 95% [CI]: 1.02, 1.13; P = 0.005). RCS analysis revealed a linear association between these indices and cataracts, with no apparent threshold effect. ROC analysis indicated that TyG-MLR demonstrated the highest predictive ability for cataract presence.

Conclusion
The study results indicate a positive association between TyG-related indicators and cataract the prevalence of cataracts in middle-aged and elderly individuals, suggesting that these markers may serve as practical biomarkers for identifying high-risk individuals. Early detection and management of metabolic and inflammatory factors could contribute to effective preventive strategies for cataract development in the elderly population.
Targeting PI3K signaling in Lung Cancer: advances, challenges and therapeutic opportunities
Authors: Zhang Bitian , Leung Ping-Chung , Cho William Chi-Shing , Wong Chun-Kwok , Wang Dongjie 
Published: February 2025

Abstract
Lung cancer remains the leading cause of cancer-related mortality globally, necessitating the continual exploration of novel therapeutic targets. The phosphoinositide 3-kinase (PI3K) signaling pathway plays a pivotal role in oncogenic processes, including cell growth, survival, metabolism and immune modulation. This comprehensive review delineates the distinct roles of PI3K subtypes—PI3Kα, PI3Kβ, PI3Kγ and PI3Kδ—in lung cancer pathogenesis and progression. We evaluate the current landscape of PI3K inhibitors, transitioning from non-selective early-generation compounds to isoform-specific agents, highlighting their clinical efficacy, resistance mechanisms and potential combination strategies. Furthermore, the intricate interplay between PI3K signaling and the tumor immune microenvironment is explored, elucidating how PI3K modulation can enhance immunotherapeutic responses. Metabolic reprogramming driven by PI3K signaling is also dissected, revealing vulnerabilities that can be therapeutically exploited. Despite promising advancements, challenges such as therapeutic resistance and adverse effects underscore the need for personalized medicine approaches and the development of next-generation inhibitors. This review underscores the multifaceted role of PI3K in lung cancer and advocates for integrated strategies to harness its full therapeutic potential, paving the way for improved patient outcomes.
Validation of the alcohol use disorders identification test in a Danish hospital setting
Authors: Schøler Peter Næsborg , Andersen Max Benjamin , Andersen Kjeld , Becker Ulrik , Thiele Maja , Nielsen Anette Søgaard 
Published: February 2025

Abstract

Background
Early identification of potential alcohol-problems is central for timely intervention and treatment referral. The Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-Consumption (AUDIT-C) serve as globally recognized and validated screening tools for this purpose. We aimed to evaluate the diagnostic validity of internationally recommended AUDIT cut-off scores ≥ 8, ≥16, ≥ 20, and AUDIT-C cut-off scores ≥ 4, ≥5 using the Danish language versions of questionnaires in a hospital setting.

Methods
Questionnaire data were collected from 2/15/2023, to 4/27/2023 at the Department of Gastroenterology and Hepatology, Odense University Hospital, Denmark. We tested the World Health Organization’s recommended AUDIT cut-offs: ≥8 for hazardous use, ≥ 16 suggestive of dependence, ≥ 20 high likelihood of dependence, along with AUDIT-C ≥ 4 and ≥ 5 using the following reference standard: Danish low-risk drinking guidelines (≤ 10 standard drinks/week) for hazardous use and self-reported ICD-10 alcohol dependence criteria for alcohol dependence. Analyses included ROC curves, AUC, sensitivity, specificity, predictive values, and agreement.

Results
Three hundred patients participated, mean age 52 years (SD 17.4, median 54) and 51.3% males. Mean AUDIT score was 4.5 (SD 5.8, median 3) with fourteen (4.7%) meeting at least three self-reported ICD-10 criteria for alcohol dependence. The prevalence of hazardous use was 10.7%. AUDIT ≥ 8 exhibited a sensitivity of 56% (95% CI 40.6–73.6) and specificity 91% (95% CI 87.8–94.5) for detecting hazardous use. Against at least three self-reported ICD-10 criteria for alcohol dependence, AUDIT cut-off ≥ 16 showed a sensitivity of 85% (95% CI 66.1–98.2) with 97% specificity (95% CI 96.0-99.2), while cut-off ≥ 20 had a sensitivity of 71% (95% CI 49.2–91.6) with 99% specificity (95% CI 98.1–99.9). The AUDIT-C cut-offs ≥ 4 and ≥ 5 exhibited low positive predictive values in detecting hazardous use (30.8% for ≥ 4 and 36.8% for ≥ 5) and dependence (13.5% for ≥ 4 and 18.4% for ≥ 5) and demonstrated a specificity ranging from 68.5 to 82.1% with negative predictive values from 98.2 to 100%.

Conclusion
In Danish gastroenterology and hepatology departments, the AUDIT and AUDIT-C may be used to identify patients who are unlikely to have an alcohol problem, while positive screen results should be carefully considered and followed by more exhaustive assessment.
Real-world evidence for Pompe disease remains fragmented. Comment on “A rare partnership: patient community and industry collaboration to shape the impact of real-world evidence on the rare disease ecosystem” by Klein et al.
Authors: Kruijshaar Michelle E. , House Tiffany , Schoser Benedikt , Laforêt Pascal , Theunissen Maudy T. M. , Wenninger Stephan , Hundsberger Thomas , Diaz-Manera Jordi , van der Ploeg Ans T. , van der Beek Nadine A. M. E. 
Published: February 2025

Abstract
In a recent publication by Klein et al., the need for real-world data on rare diseases is highlighted. We strongly support this need, and the collaboration with the patient community to collect data, as promoted in this publication. Our concern, however, is that this paper may be misunderstood as suggesting that the Sanofi-run Rare Disease Registries (RDRs) are sufficient to provide the datasets needed to evaluate current and future therapies. Industry-driven registries focus on their own product(s) and, therefore, do not provide the opportunity to compare products from different companies. Today, multiple companies produce treatments for all diseases included in the RDRs. Each company will have to run its own registry for regulatory purposes. This will lead to data fragmentation, which is prohibitive of truly understanding the effects of the various treatment options for these rare diseases. Therefore, independently funded and owned registries are essential to generate real-world evidence (RWE) unrelated to specific products. We discuss options for this for Pompe disease, including the International Pompe Survey, which has collected patient-reported outcomes independently from industry since 2002. This letter aims to raise awareness of the problem of siloed data and advocate for a new way forward where independent registries provide post-marketing surveillance data.
Individual differences in treatment effects of internet-based cognitive behavioral therapy in primary care: a moderation analysis of a randomized clinical trial
Authors: Hyland Karin , Romero Danilo , Andreasson Sven , Hammarberg Anders , Hedman-Lagerlöf Erik , Johansson Magnus 
Published: February 2025

Abstract

Background and aims
Little is known regarding predictors of outcome in treatment of alcohol dependence via the internet and in primary care. The aim of the present study was to investigate the role of socio-demographic and clinical factors for outcomes in internet-based cognitive behavioral treatment (ICBT) added to treatment as usual (TAU) for alcohol dependence in primary care.

Design
Secondary analyses based on data from a randomized controlled trial in which participants were randomized to ICBT + TAU or to TAU only.

Setting
The study was conducted in collaboration with 14 primary care centers in Stockholm, Sweden.

Participants
The randomized trial included 264 adult primary care patients with alcohol dependence enrolled between September 2017 and November 2019.

Interventions
Patients in the parent trial were randomized to ICBT that was added to TAU (n = 132) or to TAU only (n = 132). ICBT was a 12-week intervention based on motivational interviewing, relapse prevention and behavioral self-control training.

Measures
Primary outcome was number of standard drinks last 30 days. Sociodemographic and clinical predictors were tested in separate models using linear mixed effects models.

Findings
Severity of dependence, assessed by ICD-10 criteria for alcohol dependence, was the only predictor for changes in alcohol consumption and the only moderator of the effect of treatment. Participants with severe dependence showed a larger reduction in alcohol consumption between baseline and 3-months follow-up compared to participants with moderate dependence. The patients with moderate dependence continued to reduce their alcohol consumption between 3- and 12-months follow-up, while patients with severe dependence did not.

Conclusions
Dependence severity predicted changes in alcohol consumption following treatment of alcohol dependence in primary care, with or without added ICBT. Dependence severity was also found to moderate the effect of treatment. The results suggest that treatment for both moderate and severe alcohol dependence is viable in primary care.

Clinical trial registration: The study was approved by the Regional Ethics Board in Stockholm, no. 2016/1367–31/2. The study protocol was published in Trials 30 December 2019. The trial identifier is ISRCTN69957414, available at http://www.isrctn.com, assigned 7 June 2018, retrospectively registered.
Human dispersal into East Eurasia: ancient genome insights and the need for research on physiological adaptations
Authors: Abood Steven , Oota Hiroki 
Published: February 2025

Abstract
Humans have long pondered their genesis. The answer to the great question of where Homo sapiens come from has evolved in conjunction with biotechnologies that have allowed us to more brightly illuminate our distant past. The “Multiregional Evolution” model was once the hegemonic theory of Homo sapiens origins, but in the last 30 years, it has been supplanted by the “Out of Africa” model. Here, we review the major findings that have resulted in this paradigmatic shift. These include hominin brain expansion, classical insight from the mitochondrial genome (mtDNA) regarding the timing of the divergence point between Africans and non-Africans, and next-generation sequencing (NGS) of the Neanderthal and Denisovan genomes. These findings largely bolstered the “Out of Africa” model, although they also revealed a small degree of introgression of the Neanderthal and Denisovan genomes into those of non-African Homo sapiens. We also review paleogenomic studies for which migration route, north or south, early migrants to East Eurasia most likely traversed. Whichever route was taken, the migrants moved to higher latitudes, which necessitated adaptation for lower light conditions, colder clines, and pro-adipogenic mechanisms to counteract food scarcity. Further genetic and epigenetic investigations of these physiological adaptations constitute an integral aspect of the story of human origins and human migration to East Asia.
Current status and research trend of English language assessment: a bibliometric analysis
Authors: Yang Zhaoyu , Wang Ping 
Published: February 2025

Abstract
This study offers a bibliometric overview of the English language assessment research from 1992 to 2024. It aims to uncover the current state, research trends, and future directions of the field. A total of 927 articles published in Web of Science (WoS) were analyzed using the VOSviewer bibliometric software tool. Based on the sample of 927 articles from the WoS, the findings indicate that (1) the prominent topics and themes include writing assessment, second language writing, language, L2, bilingualism, and self-assessment; (2) potential research directions focus on writing assessment, multilingualism, translanguaging, dynamic assessment, and sociocultural theory; (3) English language assessment research has been gradually increasing since 1992, with a significant growth phase beginning in 2006; (4) journals such as Language Testing, Language Assessment Quarterly, System, Assessing Writing, and Modern Language Journal are pivotal for publications in this field; and (5) Yu Shulin, Pavel Trofimovich, Matthew E. Poehner, Kazuya Saito, and Judit Kormos are notably prolific authors with significant impact. The study highlights the critical role of English language assessment in influencing English language teaching through the “washback effect,” which shapes teaching approaches. This analysis is of significance to all researchers and illustrates the developmental trajectories of the field, emphasizing the need for a paradigm shift toward more holistic and inclusive assessment models.
External validation and comparative performance of the SLANT score for neuroprognostication in out-of-hospital cardiac arrest survivors undergoing targeted temperature management: insights from an Asian cohort
Authors: Ho Yi-Ju , Fan Cheng-Yi , Kuo Yi-Chien , Chen Chi-Hsin , Lien Chun-Ju , Huang Chun-Hsiang , Huang Chien-Tai , Huang Sih-Shiang , Chen Ching-Yu , Sung Chih-Wei , Chiang Wen‑Chu , Chang Wei-Tien , Huang Chien-Hua , Huang Edward Pei-Chuan 
Published: February 2025

Abstract

Background
Neurological outcomes after out-of-hospital cardiac arrest (OHCA) depend on multiple factors, including the patient’s baseline condition and post-arrest management. The SLANT, developed specifically for OHCA survivors treated with targeted temperature management (TTM), requires further validation, particularly in Asian populations.

Methods
This multicenter retrospective cohort study analyzed data from 2016 to 2023, examining demographics, pre-arrest conditions, resuscitation events, and laboratory biomarkers following TTM. The primary outcome was defined as a poor neurological outcome at hospital discharge. Model performance was assessed using the area under the receiver operating characteristic curve. Multivariate logistic regression analysis was used to analyze the included variables.

Results
A total of 448 eligible adult patients were included, of whom 77.9% experienced poor neurological outcomes at discharge. The performance of the current cohort was comparable to that of the original SLANT cohort, achieving an area under the curve of 0.797 (95% confidence interval: 0.746–0.849). All five factors of the SLANT score remained statistically significant in predicting poor neurological outcomes. At a cutoff of ≥ 6.5, the SLANT score demonstrated a specificity of 53.5% and positive predictive value (PPV) of 86.9%. Increasing the cutoff value to 8.5 improved the specificity to 66.7% and the PPV to 89.6%.

Conclusion
The SLANT showed high PPV for predicting poor neurological outcomes at discharge in patients with OHCA undergoing TTM across a multicenter Asian cohort. Combining the score with other neurological assessments is recommended for improved neuroprognostication.

Graphical Abstract
Prevalence estimation of Pestivirus scrofae (atypical porcine pestivirus) among Hungarian pig herds and the effects of different sample types on detection rates
Authors: Dénes Lilla , Albert Mihály , Igriczi Barbara , Balka Gyula 
Published: February 2025

Abstract

Background
Atypical porcine pestivirus (APPeV), also known as Pestivirus scrofae, is a member of the Pestivirus genus within the Flaviviridae family. Experimental infections have directly linked APPeV to congenital tremor (CT) type A-II in congenitally infected piglets born to challenged sows. Here, we report the assessment of the prevalence of APPeV in Hungarian pig herds and the influence of different sample types on detection rates.

Results
Altogether, 2650 blood serum, 198 oral fluid and 163 processing fluid samples were obtained via a systemic approach from 26 Hungarian farms and one Slovakian farm. The samples originated from different age groups and were analyzed via reverse transcription–quantitative polymerase chain reaction (RT–qPCR). The estimated prevalence of APPeV was determined to be 66.67% in the sampled farms, indicating the widespread distribution of the virus within Hungary. Within the positive farms, APPeV genetic material was detected in the serum (21%), processing fluid (57%), and oral fluid (72%) samples. Notably, in some farms, the presence of APPeV was confirmed in only specific sample types, and five farms had APPeV in all three sample types. Age group analysis revealed that 10-week-old animals had the highest positivity rate in their blood serum (27%), whereas 20-week-old animals presented the highest rate in their oral fluid samples (59%). Processing fluid and oral fluid samples proved to be valuable for noninvasive diagnostic matrices, allowing for efficient population-level virus detection. We determined the partial NS2–3 coding region of 15 Hungarian strains and a Slovakian strain, and our phylogenetic analysis revealed that very similar strains can be found on different farms.

Conclusion
In conclusion, our study provides insights into APPeV prevalence in Hungarian pig herds, emphasizing the importance of different sample types for accurate diagnostics. These findings contribute to our understanding of the virus's distribution across different age groups.
Study of the quality of life after endoscopic frontal sinus drill out procedures: a prospective study
Authors: Hagras Mohamed Mahmoued , Gamea Ahmed Moawad , Erfan Fatt‘he Ali , Elsherif Hossam Sayed 
Published: February 2025

Abstract

Background
Full access to the frontal sinus is necessary for the effective treatment of some disorders affecting the frontal sinus, such as chronic frontal sinusitis [1,2]. This study aimed to evaluate the quality of life after endoscopic frontal sinus drill out procedures (Draf III. frontal drill out).

Methods
Thirty patients were admitted between June 2019 and June 2022 for Draf III as guided by endoscopic examination and CT information related to demographics, 22-item Sino-Nasal Outcome Test (SNOT-22) score, and endoscopic ostium assessment were recorded with a minimum follow-up of 6 months.

Results
There were 30 patients (13 men and 17 women, age range (20–60) years. Pathology of the frontal sinus disease was chronic rhinosinusitis with nasal polyposis (CRSwNP) (12 patients), chronic rhinosinusitis without nasal polyposis (CRSsNP) (11 patients), and (7) patients presented with other pathologies. We reported ostium patency 6 months postoperatively with patent frontal ostia in 54 out of 60 sinuses (90%). Patients had a significant improvement in the total mean SNOT-22 (40.62 ± 19.66) preoperatively and was reduced to (13.47 ± 10.87) 6 months postoperatively. In addition, each of its mean subscale scores was reduced. There was also significant SNOT-22 individual item level improvement postoperatively in all items. No major complications were recorded in our series.

Conclusion
In carefully selected patients with frontal sinus disease, Draf III procedure offers a very significant improvement in their quality of life.