bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exertional inspiratory capacity and operating lung volumes in health: a population-based study
Authors: Stubbe Beate , Muller Paulo T. , Obst Anne , Kaczmarek Sabine , Mick Robina , Neder J. Alberto , Ewert Ralf 
Published: February 2025

RationaleInspiratory capacity (IC) should increase during exercise to allow unrestrained tidal volume expansion, mitigating uncomfortable respiratory sensations. However, preliminary evidence suggests that this is not universally seen in healthy individuals. Whether this negatively impacts on inspiratory reserves and dyspnoea remains unclear.ObjectivesTo gain novel insights on the regulation of operating lung volumes in community-dwelling individuals, we determined the association of a lack of increase in IC during incremental cardiopulmonary exercise testing (ICdyn) with demographic, anthropometric, and respiratory functional data in a large population-based study.MethodsWe reviewed general characteristics, pulmonary function, and cycle ergometer data from 1065 healthy individuals (51.5% women, aged 20–86 years) with normal lung function.Measurements and Main ResultsICdynremained unchanged or decreased from rest to peak exercise (ΔICdyn≤0 L) in 245/1065 individuals (23.0%). Tidal volume increased to a lower extent after the ventilatory threshold compared to earlier exercise in these subjects; thus, peak end-inspiratory lung volume (EILV) and EILV/total lung capacity were similar to subjects showing ICdyn>0 L despite higher end-expiratory lung volumes. Albeit statistically significant, between-group differences in peak dyspnea scores were modest (p=0.049). Multivariable regression revealed that age (particularly in women), higher body mass index, and higher resting airway resistance were independently associated with ΔICdyn≤0 L (p<0.001).ConclusionsElderly women and overweight/obese individuals may fail to increase ICdynduring incremental exercise due to dynamic hyperinflation. Careful regulation of tidal volume, however, avoids critically high inspiratory constraints and limiting exertional dyspnea.
Type 2 inflammation and cardiometabolic disease in middle-aged adults
Authors: Haglund Johanna , Sundbom Fredrik , Malinovsch Andrei , Janson Christer 
Published: February 2025

BackgroundAsthma has been associated with a higher risk for cardiometabolic disease. One possible explanation is the activation of type 2 inflammation. We aimed to investigate whether there is an association between type 2 inflammation and cardiometabolic disease and whether the association varies between different biomarkers.MethodsThis cross-sectional study included a total of 4277 non-smoking participants with data on cardiometabolic disease and type 2 inflammation (blood eosinophil count (B-Eos), exhaled nitric oxide (FeNO), and IgE sensitisation). The cut-off values of the biomarkers were ≥0.3×109·l−1for B-Eos, ≥25 ppb for FeNO and ≥0.35 PAU·l−1for IgE sensitisation, respectively.ResultsThere was a higher prevalence of cardiometabolic disease among participants with any type-2-biomarker: diabetes (5.2versus3.3%, p=0.002), CVD (3.3versus1.8%, p=0.002) and hypertension (23.7versus20.2%, p=0.007). Diabetes had the strongest association with having all three biomarkers elevated (OR 4.03 (95% CI 1.84–8.87), followed by elevation of both B-Eos count and FeNO (OR 2.38 (1.15–4.91)) and of only B-Eos (2.02 (1.21–3.36), p=0.007). CVD was associated with the combination of elevated B-Eos and IgE sensitisation (OR 4.77 (2.11–10.79)) and with elevated FeNO (OR 2.57 (1.31–5.06)). Hypertension was associated with elevated B-Eos (OR 1.65 (1.26–2.18)).ConclusionWe found an association between type 2 inflammation and cardiometabolic disorder, but the association with the combination of markers varied between the diseases.
Pseudomonas aeruginosainfection is linked to increases in cardiovascular events post exacerbation in bronchiectasis
Authors: L Engin , Owen Caroline A. , Reid Fred , Cabrera Claudia , Haworth Charles S. , Hughes Rod 
Published: February 2025

IntroductionPseudomonas aeruginosa(PsA) infection contributes to disease progression in bronchiectasis (BE), particularly exacerbations which are known to increase the risk of cardiovascular (CV) events. However, the link between PsA infection and CV events in BE is unknown. Thus, we investigated whether there is an association between PsA airway infection and the risk of CV events post-exacerbation.MethodsThis was a US retrospective cohort study using the TriNetX platform between 2008–2019. Adult patients with or without PsA airway infection (wPsA; w/oPsA) were included. Date of first exacerbation corresponded to the index date and patients were followed for up to 5 years post-index. Risk ratios (RR) for hospitalisation, subsequent exacerbation, mortality and incidence of pre-specified CV events were estimated. Propensity score matching (PSM) was used to balance baseline characteristics.ResultsAfter PSM, patients wPsA infection were at a greater risk of hospitalisation (RR:1.40; 95% CI:1.19–1.64), subsequent exacerbation (RR:1.70; 95% CI:1.53–1.90) and mortality (RR:1.37; 95% CI:1.20–1.56) than patients w/oPsA. PsA infection was associated with a higher risk of dysrhythmias (RR:1.32; 95% CI:1.13–1.54), inflammatory heart disease (RR:2.09; 95% CI:1.29–3.37), other cardiac disorders (RR:1.40; 95% CI:1.14–1.72), thrombotic disorders (RR:1.31; 95% CI:1.01–1.68), major adverse cardiovascular events (RR:1.35; 95% CI:1.19–1.52), and any CV outcome (RR:1.42; 95% CI:1.24–1.62).ConclusionPsA infection in patients with BE is associated with an increased risk of CV events following a baseline exacerbation. These data highlight the multisystemic nature of BE and the need to raise awareness of the potential increased risk of CV events in patients with BE experiencing exacerbations.
Respiratory infections after elexacaftor/tezacaftor/ivacaftor treatment in people with cystic fibrosis: analysis of the European Cystic Fibrosis Society Patient Registry
Authors: Pollak Mordechai , Gambazza Simone , Orenti Annalisa , De Rose Virginia , Prais Dario , Kerem Eitan , Mei Zahav Meir ,   on behalf of ECFSPR Steering Group
Published: February 2025

BackgroundElexacaftor/tezacaftor/ivacaftor (ETI) has improved outcomes for people with cystic fibrosis (pwCF). This study evaluated changes in airway microbiological infection status after initiating ETI.MethodsUsing the ECFS registry, pwCF who started ETI between 2019 and 2021 were identified. The changes in microbiological status from one year before to one year after ETI initiation, were compared with the changes seen from three to one years before starting ETI. Mixed-effect regression models were used to analyse changes. Data from two years after initiation were examined for those starting ETI in 2019–2020.ResultsIncluded were 15 739 pwCF from 30 countries. In the year before ETI, 38.4% were positive forPseudomonas aeruginosa(PsA) and 36.4% for methicillin-sensitiveStaphylococcus aureus(MSSA). After ETI, 38.7% of PsA-positive and 47.2% of MSSA-positive patients transitioned to negative status, compared to 14.8% and 29.1%, respectively, in the previous years. The adjusted difference in transitioning to negative was 14.6% (PsA) and 17.1% (MSSA), both p<0.001. Similar improvements were seen forBurkholderia cepaciacomplex andStenotrophomonas maltophilia. For those starting ETI in 2019–2 020, PsA positivity remained low over two years, decreasing from 46.8% pre-ETI to 30.4% and 27.7% at one and two years post ETI treatment.Conclusion.One year after starting ETI, many pwCF who were initially positive for various CF related pathogens, shifted to a negative status, a change less common before ETI. These findings suggest that ETI reduces airway infections, with benefits extending into the second year of treatment, though some pwCF continue to carry these pathogens despite treatment.
Increased loop gain and upper airway collapsibility among smoking patients with obstructive sleep apnoea
Authors: Hang Liang-Wen , Finnsson Eysteinn , Ágústsson Jón S. , Sands Scott A. , Cheng Wan-Ju 
Published: February 2025

BackgroundSmoking is a known risk factor for obstructive sleep apnea (OSA). However, the specific pathological mechanism linking smoking to OSA remains unclear. This study aims to explore the endotypic traits of OSA among current and former smokers.MethodsWe prospectively collected polysomnographic data from 980 patients with an apnea-hypopnea index (AHI)≥15 h−1from a single clinical sleep center. Smoking status was determined through self-reported questionnaires completed prior to polysomnography. Endotypic traits—including arousal threshold, collapsibility, loop gain, circulatory delay, ventilatory response to arousal, and upper airway compensation—were estimated using polysomnographic signals. Adjusted multivariate linear regression analysis was conducted to investigate the association between smoking and endotypic traits.ResultsCompared to non-smokers, current smokers were associated with a 7.6 h−1higher AHI, an 8.8%eupnea higher arousal threshold, a 4.0%eupnea lower Vpassive, a 6.7%eupnea lower Vactive, a 0.03 higher loop gain, and a 0.64 lower delay during non-rapid eye movement (NREM) sleep. During REM sleep, current smokers showed an 11.1%eupnea higher arousal threshold, a 6.5%eupnea lower Vactive, a 4.6%eupnea lower Vmin, a 0.05 higher loop gain, and a 0.57 lower delay. Former smokers exhibited a 5.7%eupnea lower upper airway compensation and a 6.7%eupnea lower Vactiveduring REM sleep compared to non-smokers. Smoking amount and duration since quitting were not linearly associated with AHI or endotypic traits.ConclusionsSmoking is associated with increased upper airway collapsibility and loop gain among patients with OSA. These effects may be reversible following smoking cessation.
Top ten priorities for chronic cough: Canadian James Lind Alliance Priority Setting Partnership (CAN-COUGH)
Authors: Samari Saif , Oliveira Ana , Brister Danica , Kum Elena , Aaron Shawn D. , Adamko Darryl , Bhalla Anurag , Carlsten Christopher , Cormier Maxime , Ellis Anne K. , Field Stephen K. , Godbout Krystelle , Hernandez Paul , Hirota Jeremy A. , Kaplan Alan , Kovesi Tom , Mancopes Renata , Sedeno Maria , Smith Maeve , Newman Robert , King Philip , Gallagher Tiffany , Butson Sarah , Brooks Dina , Satia Imran ,   on behalf of the CAN-COUGH Committee Members
Published: February 2025

BackgroundChronic cough significantly impacts individuals' quality of life and poses challenges for healthcare providers due to limited licensed treatments, side effects of available medications, and difficulty accessing non-pharmacologic interventions. Understanding priorities for research, education, and knowledge dissemination from the perspectives of individuals with chronic cough and healthcare providers can guide future efforts. This study aimed to identify these key priorities in Canada.Study design and methodsWe conducted a cross-sectional study using the James Lind Alliance (JLA) method to set priorities. Chronic cough was identified as the healthcare problem. Participants rated items related to research, education, and knowledge dissemination in an online survey using a 7-point Likert scale. Results of the survey were reviewed by the Canadian Thoracic Society's (CTS) multidisciplinary working group and patient partners who engaged in a face-to-face Priority Setting Partnership, to establish a “Top 10” Priorities list for chronic cough.ResultsSeventy-four individuals with chronic cough and 62 healthcare providers completed the scoping survey. The top-rated priorities included enhancing knowledge of existing treatments, developing new treatments, and improving diagnostic testing. The final “Top 10” priorities list emphasized the need for developing infrastructure for evaluating new treatments, improving understanding of biological mechanisms, and raising awareness among the public and policymakers.ConclusionThis is the first priority-setting project for chronic cough, highlighting key areas to address in research, education, and dissemination. The identified priorities will serve as a foundation for future efforts to improve the management and care of individuals with chronic cough.
The AFFIRM Framework for gender-affirming care: qualitative findings from the Transgender and Gender Diverse Health Equity Study
Authors: Quint Meg , Bailar Schuyler , Miranda Alexis , Bhasin Shalender , O’Brien-Coon Devin , Reisner Sari L. 
Published: February 2025

Abstract

Background
Transgender, nonbinary, and gender diverse (TGD) people experience stigma in healthcare settings impacting healthcare utilization, including avoidance of care due to anticipated discrimination. Gender-affirming care refers to care for medical gender affirmation, such as gender-affirming hormones and surgery, as well as general care that affirms and respects TGD patients. This study sought to explore the experiences of TGD adults to inform gender-affirming care delivery and develop an actionable framework for practice.

Methods
Between May–October 2021, one-time individual in-depth interviews were conducted with 27 TGD adults receiving any healthcare in the greater Boston Massachusetts area to gather data about gender-affirming care. Interviews were semi-structured, explored prior and current experiences in healthcare and ideal gender-affirming care models, and conducted virtually via a secure Zoom platform. Analyses were conducted using immersion crystallization and reflexive thematic analysis; interview transcripts were double coded by two coders.

Results
Participants had a mean age of 28.5, ranging 18–45 years, and were: 7 transgender men, 6 transgender women, 8 nonbinary, 3 genderqueer, 1 agender, and 2 gender not specified. Themes about gender-affirming care coalesced into the acronym AFFIRM: (1) Affirms in individual interactions: Participants called for affirmation of TGD identity, lived expertise, and competent TGD providers and staff. (2) Flexible and accessible: Participants expressed the need for gender-affirming care to be available beyond urban population-specific clinics, in a timely fashion without long wait lists, and in a community-centered manner such as offering non-traditional times and settings. (3) Fights systemic oppression: Participants emphasized the need for providers and health systems to eliminate gatekeeping practices for gender-affirming care and create care models that resist intersecting oppressive systems such as racism and cisgenderism. (4) Interacts with community: Patients desired intentional interaction with TGD community to holistically address health and unmet gender affirmation needs. (5) Retains patients in care: Patients shared the need to collaboratively identify and problem-solve obstacles to gender-affirming care with providers and healthcare systems to optimize TGD-specific retention strategies. (6) Multidisciplinary: Patients called for interdisciplinary teams with co-located services such as primary care and mental healthcare with letter-writing for surgical care, and incorporation of peer navigators to meet the broader social, health, and well-being needs of TGD people.

Conclusions
Findings from this study and the AFFIRM Framework which emerged from TGD patient narratives can be applied to improve current care and set benchmarks for high-quality gender-affirming care delivery and practice.
Barriers faced by undergraduate dental students when conducting research: a qualitative study
Authors: Sarhan Mohammed Mahmoud , Aljohani Lama Nasser , Alsaleh Raghad Ibrahim , Mubaraki Roze Abdulaziz , Almozaen Malak Abdulaziz , Alharbi Rimas Sabih 
Published: February 2025

Abstract

Background
Research is an important part of dental education. While several quantitative studies have examined the barriers that undergraduate dental students face when conducting research, qualitative studies exploring the details and contexts of these barriers are rare. To bridge this gap, this research qualitatively explores the barriers faced by undergraduate dental students when conducting research.

Methods
The present qualitative study employs what is known as the “performative knowledge strategy.” The 14 study participants were dental trainees included 10 undergraduate students and 4 interns who participated in research projects that were not part of their mandatory curriulum requirements. Diaries and semi-structured virtual (online) interviews were used to collect the data. Finally, using an inductive strategy, a thematic analytical approach was conducted to analyze the data.

Results
Six key themes emerged from the data analysis. The themes of “inadequate knowledge,” “time constraints” and “lack of resources” confirm and align with the findings of previous studies, while the themes “misaligned schedules,” “delayed response” and “lack of orientation” represent new insights into the barriers to research faced by undergraduate dental students.

Conclusion
This study identified six factors that posed substantial barriers to research by undergraduate dental students. Analysis of these barriers can lead to the design and implementation of strategies to enhance and improve research experience. Additional qualitative research in this area would help to reveal further details of the barriers to research, while additional quantitative studies are required to assess the frequency and trends of the newly revealed barriers.

Clinical trial number
Not applicable.
An idiopathic left internal iliac artery aneurysm in an 11-year-old boy: a case report
Authors: Gorji Meghdad Ghasemi , Baratinezhad Amirhossein , Mirali Rojan Abdollahzadeh 
Published: February 2025

Abstract

Background
Idiopathic isolated aneurysms in pediatric patients are rare and present significant diagnostic and therapeutic challenges owing to their low incidence, small anatomical size, and the associated risks of injury to surrounding structures. Timely diagnosis and the selection of the most appropriate intervention require careful consideration.

Case presentation
An 11-year-old Persian boy presenting with abdominal pain for 2 months before admission was diagnosed with an isolated left internal iliac artery aneurysm through computed tomography imaging. He underwent open surgery for excision of the aneurysm. The iliac vein was adherent to the aneurysmal sac and significantly compressed, complicating the dissection and exploration. Nevertheless, proximal control was achieved, and the iliac vein was gradually separated and decompressed, allowing for the safe excision of the aneurysmal sac. The surgery was completed without intraoperative or postoperative complications.

Conclusion
Successful surgical intervention in pediatric patients with iliac artery aneurysms is achievable with careful planning and technique. This case report demonstrates the effectiveness of surgical management, with the patient remaining asymptomatic and showing no signs of recurrence during follow-up.
Dietary steviol glycosides mixture supplementation modulates the gene expression of gut chemoreceptors and enhances the antioxidant capacity in weaned piglets
Authors: Xiong Yunxia , He Zhentao , Wu Qiwen , Xiao Hao , Cao Shuting , Yang Xuefen , Li Yajing , Jiang Zongyong , Zhu Cui , Wang Li 
Published: February 2025

Abstract

Background
Stevia glycosides (SGs) have been widely used as an ideal sugar alternative in the food industry. However, the potential application of SGs mixture in the diets of weaned piglets remains unexplored. This study aimed to investigate the effect of dietary SGs mixture supplementation on growth performance, gene expression of gut chemoreceptors, and antioxidant capacity in weaned piglets.

Methods
A total of 216 weaned piglets (Duroc × Landrace × Yorkshire, 7.36 ± 0.04 kg body weight) were randomly assigned to 6 groups (6 pens/group with 6 piglets/pen), and were fed with the basal diet supplemented with 0, 100, 150, 200, 250, or 300 mg/kg SGs mixture for 42 days. The serum, liver, longissimus thoracis, and jejunal samples were collected on day 43.

Results
The results showed that inclusion the SGs mixture in the diet did not have a significant impact on growth performance from days 1 to 28 (P > 0.05). But increasing the concentration of SGs mixture tended to linearly decrease the average daily gain from days 1 to 42 (P = 0.052). However, 150 mg/kg SGs mixture supplementation significantly increased the mRNA expression of taste receptor family 1 member 2 (T1R2) and glucose transporters 2 (GLUT2) in the jejunum (P < 0.05), while 150 and 200 mg/kg SGs mixture supplementation significantly increased T1R3 mRNA expression (P < 0.05). Moreover, 150 mg/kg SGs mixture supplementation significantly reduced serum malondialdehyde content (P < 0.05). Increasing the concentration of SGs mixture linearly and quadratically increased serum total superoxide dismutase (T-SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) activity, as well as hepatic T-SOD, GSH-Px activity, and muscle total antioxidant capacity contents (P < 0.05). Furthermore, piglets fed a diet supplemented with 100 mg/kg SGs mixture had higher serum T-SOD, CAT, and GSH-Px activities compared with the other treatments (P < 0.05).

Conclusions
Therefore, our results suggest that dietary 100 ~ 150 mg/kg SGs mixture supplementation modulates gene expression of sweet taste recognition receptors and glucose transporters, while also enhancing the antioxidant capacity of weaned piglets.
Vestibular and balance dysfunction in attention deficit hyperactivity disorder and cognitive disengagement syndrome risk groups
Authors: Koc Apaydın Zuhal , Soylemez Emre , Demir Nefise 
Published: February 2025

Abstract

Background
In the past, cognitive disengagement syndrome (CDS) and attention deficit hyperactivity disorder (ADHD) were considered similar concepts. However, many differences have recently been identified between the two disorders, and they have been separated from each other. This study aims to investigate balance and vestibular function in individuals at high risk for ADHD and CDS.

Materials and methods
This study involved 60 college students. Participants were given the Adult ADHD Self-Report Scale and the Adult Concentration Inventory. Using the applied indices, participants with high and low risk for CDS and ADHD were identified. Every participant underwent static posturography, the video head impulse test (vHIT), and cervical vestibular myogenic-evoked potentials (cVEMP).

Results
People with low and high risk for CDS did not differ in terms of static posturography or cVEMP (p > 0.05). Similarly, no differences were found in ADHD (p > 0.05). While right ear lateral vHIT responses were worse in individuals with high-risk CDS (p > 0.05), bilateral posterior vHIT rates were worse in individuals with high-risk ADHD (p > 0.05).

Conclusion
The fact that individuals at high risk for CDS and ADHD show different vestibular involvement strengthens the fact that there are different clinical pictures.