bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of a nomogram for predicting cough variant asthma diagnosis
Authors: Min Jiao , Tang Xiaomiao , Zhang Di , Yang Jin , Li Fei , Lei Wei 
Published: January 2025

Abstract

Background
Cough variant asthma (CVA) is a specific type of asthma characterized by chronic cough as the sole or predominant symptom. Accurate diagnosis is crucial for effective treatment, yet bronchial provocation test is not always feasible in clinical settings. To identify independent predictors of CVA diagnosis, we developed a nomogram for predicting CVA. Univariate and multivariate logistic regression analyses were employed to construct the model, and the accuracy and consistency of the prediction model were subsequently validated.

Methods
We conducted a retrospective review of clinical data from 241 outpatients with chronic cough (≥ 8 weeks) who underwent bronchial provocation test at our hospital between January 2018 and December 2021. Patients were categorized into CVA group and Non-CVA group based on diagnostic criteria. Univariate analysis (chi-square and t-tests) was performed, followed by multivariate logistic regression to identify independent predictors. A nomogram was constructed using these predictors and validated using Bootstrap resampling (B = 200) to calculate the C-index. Additionally, receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA) were employed to assess the model's accuracy.

Results
Of the 241 outpatients, 156 (64.7%) were diagnosed with CVA. Multivariate analysis identified several independent predictors of CVA, including cough triggered by cold air (OR = 12.493, P = 0.019), exposure to pungent odors (OR = 3.969, P = 0.002), cough phasing (OR = 4.515, P < 0.001), history of allergic rhinitis (OR = 3.231, P = 0.018), and the percentage of the predicted value of maximum mid-expiratory flow (MMEF%pred) (OR = 0.981, P = 0.039) were independent predictors of CVA. The nomogram demonstrated good discrimination (AUC = 0.829) and calibration, with a sensitivity of 75.3% and specificity of 77.6% at the optimal cutoff. The C-index was 0.920, indicating excellent model performance.

Conclusions
We successfully developed and validated a user-friendly nomogram that accurately predicted CVA diagnosis based on clinical characteristics and pulmonary function test. This nomogram model could assist clinicians in diagnosing CVA, especially in patients without bronchial provocation test or with contraindications to bronchial provocation test.
Transcutaneous vagus nerve stimulation as a pain modulator in knee osteoarthritis: a randomized controlled clinical trial
Authors: Elsehrawy Gehad Gamal , Ibrahim Maha Emad , A.moneim Nermeen Hassan , Hefny Mohamed Ahmed , El Shaarawy Nashwa Kamel 
Published: January 2025

Abstract

Background
Our understanding of osteoarthritis (OA) has evolved from a degenerative disease to one in which low-grade, chronic inflammation plays a central role. In addition, evidence suggests that OA is accompanied by both peripheral and central nervous system sensitization that can cause pain. It has been demonstrated that transcutaneous vagus nerve stimulation (tVNS) can relieve pain, inflammation, and central sensitization in other conditions including fibromyalgia, pelvic pain, and headaches. We aimed to assess the efficacy and safety of tVNS on nociceptive pain, central sensitization, and physical function in knee OA.

Methods
In this 12-week study, we stimulated the auricular branch of the vagus nerve with an auricular electrode connected to a transcutaneous electrical nerve stimulation device once a day for 3 days each week for 12 weeks. A total of 68 patients with chronic knee OA were randomly assigned to the active and sham groups (34 patients in each group). We used a variety of outcome measures, including the visual analog scale (VAS), pressure pain threshold (PPT), knee injury and osteoarthritis outcome score (KOOS), PainDETECT (PD-Q) and Douleur Neuropathique 4 (DN4) questionnaires. Outcome measures were recorded at baseline, At the end of the stimulation period, and then after 4 weeks.

Results
In the active group, compared to baseline, there was a significant improvement in VAS scores between the first and second follow-up visits (P < 0.001). A significant improvement in PPT was seen in the right knee, left knee, and right elbow in active tVNS, and this improvement persisted for four weeks post-intervention. Meanwhile, in the sham group, right knee PPT was improved but not maintained. There were statistically significant improvements in the PD-Q and DN4 scores in the active tVNS group (P < 0.001), whereas in the sham group, DN4 questionnaire did not show any improvement. In terms of functional outcomes, the improvement in KOOS was significant only in the active group (31.44 ± 18.49, P < 0.001). No serious adverse events were observed.

Conclusion
There is preliminary evidence to support the benefits of tVNS in OA, suggesting that neuromodulation can be used as an adjunct to existing pharmacological and non-pharmacological treatments.

Trial registration
The study was registered on ClinicalTrials.gov (NCT05387135) on 24/05/2022.
Bonding performance of universal adhesive systems with dual-polymerising resin cements to various dental substrates: in vitro study
Authors: Takano Shunsuke , Takahashi Rena , Tabata Tomoko , Zeng Chen , Ikeda Masaomi , Shimada Yasushi 
Published: January 2025

Abstract

Background
Resin cements often require substrate-specific pretreatment. Recently, universal adhesive systems have been introduced, simplifying procedures by eliminating the need for multiple adhesives and offering options that do not require light curing. This study investigated the bonding performance of universal adhesive systems combined with dual-polymerising resin cements on enamel, dentin, zirconia, lithium disilicate ceramics (LDS), and resin blocks.

Methods
Two universal adhesive and dual-polymerising resin cement combinations from the same manufacturer were tested: Bondmer Lightless II (BLII) with Estecem II (ECII), and Scotchbond Universal Plus adhesive (SBU) with RelyX Universal resin cement (RXU). Enamel, dentin, zirconia (Katana Zirconia UTML), LDS (IPS e.max CAD CEREC), and resin blocks (Katana Avencia P Block) were used as substrates. The universal adhesive was applied to all bonding surfaces, followed by resin cement application in micro-bore Tygon tubes and light curing for 40 s. Micro-shear bond strength (μSBS) was measured after 0 thermal cycles (0TC) or 10,000 thermal cycles (10kTC) (n = 20). Statistical analyses were conducted using t-tests and Welch's t-tests with Bonferroni correction (α = 0.05), and failure modes were examined.

Results
In the BLII/ECII group, the mean μSBS values exceeded 15 MPa for all substrates at 0TC. After thermocycling, μSBS increased significantly for the enamel (p < 0.05), remained unchanged for dentin and zirconia (p > 0.05) and decreased for LDS and resin blocks (p < 0.05). In the SBU/RXU group, 0TC μSBS values exceeded 15 MPa for enamel, zirconia, and resin blocks, but thermocycling significantly decreased μSBS for all substrates (p < 0.05). Comparison between BLII/ECII and SBU/RXU group showed no significant differences for enamel and resin blocks at 0TC (p > 0.05), but the BLII/ECII group exhibited higher SBS in the other groups (p < 0.05). Adhesive failure was the most frequently observed failure type across all groups.

Conclusion
The adhesive performance on diverse dental substrates including enamel, dentin, zirconia, LDS, and resin blocks was notably affected by the selection of universal adhesive systems in combination with dual-polymerising resin cements that were applied. The BLII/ECII combination demonstrated long-term stable bonding performance for enamel, dentin, and zirconia.
Evaluation of a mentorship matchmaking event at an academic research institution to reinforce the scientific workforce pathway for underrepresented minority groups
Authors: Gutierrez Sirena , Seuferer Jennifer A. , Guerrero Angel-Max , Carrasco Yazmin , Bibbins-Domingo Kirsten , Nguyen Tung , Márquez-Magaña Leticia , Nystul Todd , Morris Meghan D. 
Published: January 2025

Abstract

Background
Mentorship and research experiences are crucial for STEMM career entry and advancement. However, systemic barriers have excluded people from historically underrepresented groups.

Methods
In 2021, a virtual “matchmaking event” was held to connect NIH-funded research mentors with historically underrepresented trainees and initiate mentored research experiences. Survey data collected over 12 months was analyzed to evaluate the program’s success considering the number of mentor-trainee connections, mentor-trainee research experience matches, and NIH diversity supplement application status. Statistical tests, including student’s t-test, ANCOVAs, and chi-square tests, evaluated differences between attendee groups and survey time points.

Results
Out of 314 mentors contacted and 99 registered trainees, 113 mentors and 92 trainees participated. Among mentors (n = 73), 53% identified as women, 56% as non-Hispanic white, and a majority (81%) reported being the first in their family to attend college. Among trainees (n = 79), about two-thirds (67%) identified as women, 47% identified as Hispanic/Latinx, and 15% identified as Black/African American. Both mentors and trainees were extremely satisfied with the overall event (57% and 69%, respectively) and would recommend it to others (74% and 90%, respectively). Most mentor participants established at least one mentor-trainee connection after the event (n = 64, 57%), a mentor-trainee research experience match (n = 40, 35%), and planned to submit an NIH diversity supplement (n = 31, 27%). Many trainees obtained paid positions through the mentor-trainee research experience. One year after the event, 11 trainees secured NIH diversity supplement funding with their mentors.

Conclusions
The matchmaking event began bridging a much-needed gap in the research pathway by creating opportunities for trainees to connect with mentors and obtain funded research opportunities.
A qualitative exploration of feedback experience among final-year physiotherapy students using activity theory
Authors: Lupton-Smith Alison , Herman Nicoline , Schmutz Anna 
Published: January 2025

Abstract

Background
Feedback is an important part of learning, however, it often does not have the desired effect. Much work has been done exploring students’ engagement with feedback and factors which may impact engagement. Mutual understanding of feedback and feedback practice on the part of the student and educator is essential.

Methods
This study explored the perceptions of feedback of final-year physiotherapy students at Stellenbosch University (South Africa). Twelve semi-structured interviews were conducted to generate data. Cultural-historical activity theory was used as an analytic lens in the data analysis.

Results
Students understood feedback to be a continuous, bidirectional conversation in which they were actively involved. Students recognised their agency in feedback practice. Despite their understanding, their agency was often undermined by factors such as the environment, context and most notably the perceived positioning and relationships between students and educators. Educators who were perceived as credible and created a safe psychosocial space had a positive influence on the students’ perception of feedback.

Conclusions
Students’ perceptions of feedback and their engagement was the product of a complex and dynamic interplay of factors. While students recognise their agency, this may be hindered by relationships and the design of feedback in the curriculum. As educators, one must consider how we contribute to this and enable students to activate and use their agency in feedback practice.
The organizational challenges of municipal call centers as a health service in Norway-a multiple case study
Authors: Grøndal-Eeles Linda , Dugstad Janne , Eide Hilde , Nilsen Etty 
Published: January 2025

Abstract

Background
To maintain sustainability in the health care system, technology such as social alarms and sensors has been implemented in people’s homes with the goal of increasing independent living for elderly and multimorbid health care recipients. When implementing technology, someone needs to monitor and answer the alarms and calls, which is often coined ‘telecare’. Many countries have organized telecare service in call centers, which in the health care domain is a service innovation. This study aims to research how call centers in Norway were organized, what services they offered, and what challenges they faced.

Method
This was an explorative study, using multiple case methodology. The study included five call centers, covering approximately 60 municipalities across Norway. 11 interviews with 15 informants, holding a variety of positions, such as managers, assistant managers, health personnel, technicians, advisors, and subject coordinators, call center observations and document studies were conducted. The data was analyzed inductively, and empirical literature as well as a framework for service innovation were used as theoretical perspectives.

Results
Four types of organizational structures of call centers were identified: 1) call center combined with emergency room; 2) call center combined with other technology; 3) call center combined with ambulant team and 4) call center combined with an advisory department. One factor for innovation success has been identified as market conditions which are expected to be increasing, whilst the study identified several challenges, for example the complexity of stakeholders. Based on different stakeholder worldviews, the various methods of innovation and organization have led to a variation in services.

Conclusions
Stakeholders with different worldviews, service innovation strategies and municipal autonomy have influenced how the call centers have developed in different directions. They are still in a service innovation phase, implementing new services and technology. The call centers appeared to be ‘caught between a rock and a hard place’ – situated between health and social care, but slowly moving towards acute and contingency services, that is, from telecare towards telehealth.
Optimization of fermentation conditions to increase the production of antifungal metabolites from Streptomyces sp. KN37
Authors: Yang Xiaoyue , Yuan Lijing , Zeeshan Muhammad , Yang Chuntian , Gao Wen , Zhang Guoqiang , Wang Chunjuan 
Published: January 2025

Abstract
The bacterium Streptomyces sp. KN37 was isolated from the soil of Kanas, Xinjiang. The broth dilution of strain KN37 has a strong inhibitory effect against a variety of crop pathogenic fungi. However, in practical applications, its effective biological activity is limited by medium formulations and fermentation conditions. In this study, we used the response surface method to optimize the fermentation medium and conditions of the strain KN37, for investigating the reasons for the enhanced biological activity at both the metabolic and transcriptomic levels. The results of the Plackett-Burman design showed that millet, yeast extract, and K2HPO4 were the key factors influencing its antifungal activity. Subsequently, optimization by the response surface methodology yielded the final fermentation conditions as: millet 20 g/L, yeast extract 1 g/L, K2HPO4 0.5 g/L, rotation speed 150 r/min, temperature 25 °C, initial pH 8, fermentation time 9 d, inoculation amount 4%, liquid volume 100 mL. The antifungal effect of the optimized strain fermentation dilution was significantly enhanced, and the antifungal rate of R. solani increased from 27.33 to 59.53%, closely aligning with the predicted value of 53.03%. The results of HPLC-MS/MS and transcriptomic analysis revealed that the content of some secondary metabolic active substances in the fermentation broth of KN37 was significantly different from that of the original fermentation broth. Notably, the content of 4- (diethylamino) salicylaldehyde (DSA) was significantly increased by 16.28-fold while the yield of N- (2,4-dimethylphenyl) formamide (NDMPF) was increased by 6.35 times. Transcriptomic analysis further elucidated molecular mechanisms behind these changes with the expression of salicylic acid dehydrogenase (SALD) was significantly down-regulated, which was only 0.48 times compared to that before optimization. This research successfully optimized the fermentation process of strain KN37 providing a strong foundation for the actual production and application of strain KN37 in agriculture.
Racialized migrant women’s discrimination in maternal care: a scoping review
Authors: Arcilla Jasmine Therese , Nanou Alexandra , Hamed Sarah , Osman Fatumo 
Published: January 2025

Abstract

Background
Despite equality and quality being the core of good healthcare, racial and ethnic inequalities continue to persist. Racialized groups, including racialized migrant women, experience various forms of discrimination—particularly during maternal care encounters, where intersectional forms of discrimination may occur. Experiences of discrimination in maternal care have been associated with poor health-seeking behavior and adverse maternal health outcomes. However, research on racialized migrant women’s discrimination in maternal care is limited. This scoping review aims to give an overview of the state of current research on the discriminatory experiences of racialized migrant women when utilizing maternal healthcare and its gaps to ensure equity in global maternal healthcare.

Methodology
This scoping review mapped out all available English-language scientific empirical literature published between 2012 and 2023. All authors agreed on the inclusion criteria. Collecting, charting, and reviewing the included material were done using the 2018 Preferred Reporting Items for reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The search strategy included electronic databases, such as Pubmed, CINAHL, MEDLINE, Web of Science, and PsycInfo.

Results
A total of 57 articles were included and analyzed. The majority were qualitative and conducted in European and North American countries. None of the included article’s aims originally intended to focus on discrimination. However, their findings exposed the many ways racialized migrant women experienced discrimination when using maternal healthcare services—from accessibility problems, non-utilization of interpreters, and untimely and delayed care to disrespect, abuse, and differential care. Racialized migrant women’s discrimination resulted in a lack of agency and being excluded from decision-making.

Conclusions
While the included articles allude to some issues related to discrimination in maternal healthcare experienced by racialized migrant women, this review delineated knowledge gaps warranting discussion. Few articles focus on and conceptualize discrimination from a racialized lens in maternal healthcare. A limited geographical scope in research and knowledge generation on discrimination and racialization exist in this field as does a lack of sufficient articles on discrimination and racism from healthcare personnel. Lastly, many of the existing studies lack an intersectional lens in exploring discrimination in maternal care against racialized migrant women.
In-hospital mortality of patients admitted to the intermediate care unit in hospitals with and without an intensive care unit: a nationwide inpatient database study
Authors: Ohbe Hiroyuki , Kudo Daisuke , Kimura Yuya , Matsui Hiroki , Yasunaga Hideo , Kushimoto Shigeki 
Published: January 2025

Abstract

Background
Intermediate care units (IMCUs) provide care for patients who need more intensive treatment than general wards but less than intensive care units (ICUs). Although the concept of an IMCU requires co-location with an ICU, some hospitals have IMCUs but no ICUs, which potentially worsens patient outcomes. This study aimed to examine the annual trends and care processes, and compare the outcomes of patients admitted to IMCUs in hospitals with and without ICUs using a nationwide inpatient database in Japan.

Methods
This retrospective cohort study was conducted from 2016 to 2022 using the Diagnosis Procedure Combination Database and Hospital Bed Function Reports in Japan. The main exposure was admission to the IMCU in hospitals with and without ICUs. The primary outcome was in-hospital mortality rate in hospitals with and without ICUs that were compared using multilevel logistic regression models adjusted for confounders.

Results
The number of IMCU beds in hospitals without ICUs increased by 59% from 3,388 in 2016 to 5,403 in 2022, and the IMCU beds in hospitals without ICUs represented 38% (n = 5,403/14,185) of all IMCU beds in Japan in 2022. Among the 3,061,960 eligible patients in the IMCUs, 2,296,939 (75%) and 765,021 (25%) were admitted to hospitals with and without ICUs, respectively. Transfer between IMCUs and ICUs occurred for 10.5% (n = 320,938/3,061,960) of patients, with a large variability between hospitals. After adjusting for potential confounders, patients admitted to IMCUs in hospitals without ICUs had significantly higher in-hospital mortality than those in hospitals with ICUs (adjusted odds ratio: 1.15; 95% confidence interval: 1.10–1.20; p < 0.001).

Conclusions
Admission in IMCUs in hospitals without ICUs increased, but was associated with higher in-hospital mortality. These findings suggest that IMCUs should be placed in hospitals with ICUs.
Demographic and historical processes influencing Cochliomyia hominivorax (Diptera: Calliphoridae) population structure across South America
Authors: e Souza Kelly da Silva , de Paula Letícia Chiara Baldassio , de Azeredo-Espin Ana Maria Lima , Torres Tatiana Teixeira 
Published: January 2025

Abstract

Background
In this study, we investigated the genetic variability and population structure of the New World screwworm fly Cochliomyia hominivorax. We tested the hypothesis that the species exhibits a center–periphery distribution of genetic variability, with higher genetic diversity in central populations (e.g., Brazil) and lower diversity in peripheral populations.

Methods
Using microsatellite markers, we analyzed larvae collected from infested livestock across South America. The larvae were collected directly from various wound sites to ensure a broad representation of genetic diversity.

Results
Contrary to our initial hypothesis, the results revealed consistent genetic variability across the species’ distribution, low population differentiation, and no evidence of isolation-by-distance patterns among subpopulations. The genetic analysis indicated an excess of homozygotes, potentially due to the Wahlund effect, null alleles, or selection pressure.

Conclusions
These findings suggest a complex metapopulation structure for C. hominivorax, challenging classical population genetics models. This complexity likely arises from the species’ high dispersal capability and frequent local extinctions followed by recolonization. These results have important implications for the design and implementation of control programs, emphasizing the need for coordinated and large-scale actions rather than isolated initiatives.

Graphical Abstract