{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:09:09Z","timestamp":1761664149828,"version":"build-2065373602"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001126","name":"Geisinger Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001126","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Cough is a prevalent clinical problem associated with comorbidities and environmental conditions. We seek to highlight the clinically measurable impact of the environment on cough physiology by modeling the incidence and prevalence of seasonal cough as a function of certain environmental factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An IRB\u2010exempt population\u2010based retrospective electronic record review was performed to analyze the incidence and prevalence of cough in an integrated rural healthcare system from January 1, 2021, through December 31, 2023. Using time series methods including dynamic regression models, these data were measured against the seasonal incidence and prevalence of influenza based on data from the Centers for Disease Control (CDC) and air quality metrics including Air Quality Index (AQI) and particulate matter counts (PM10) based on data from the Environmental Protection Agency (EPA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 101,635 patients that met inclusion criteria involving 145,428 medical encounters for cough. There is a positive relationship between the seasonal prevalence and incidence of cough with influenza levels. AQI and PM10 demonstrated seasonality. While these were correlated with each other, we found no association between air quality metrics and the incidence and prevalence of cough. Results were validated within age groups, as each group independently demonstrated these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrates a clear seasonal trend in our rural population in the diagnosis of cough, which also correlated with seasonal trends of influenza, illustrating the significance of seasonal factors in the development of informed healthcare practices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70292","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T06:27:09Z","timestamp":1761287229000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Seasonality in Cough: The Influence of Environmental Physiology"],"prefix":"10.1002","volume":"10","author":[{"given":"Michelle Pistner","family":"Nixon","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences, Biostatistics Core Geisinger Medical Center  Danville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anas","family":"Qatanani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Geisinger Medical Center  Danville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda J.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, Biostatistics Core Geisinger Medical Center  Danville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mudit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Phenomic Analytics and Clinical Data Core Geisinger Medical Center  Danville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6290-3331","authenticated-orcid":false,"given":"Kenneth W.","family":"Altman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Geisinger Medical Center  Danville Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2021.07.022"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.07.029"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30359"},{"key":"e_1_2_8_5_1","unstructured":"U. S. Centers for Disease Control and Prevention \u201cWeekly US Map: Influenza Summary Update \u201dn.d. https:\/\/www.cdc.gov\/fluview\/surveillance\/usmap.html."},{"key":"e_1_2_8_6_1","unstructured":"U. S. Environmental Protection Agency Air Data: Pre\u2010Generated Data Files n.d. https:\/\/aqs.epa.gov\/aqsweb\/airdata\/download_files.html."},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2024","author":"R Core Team","key":"e_1_2_8_7_1"},{"key":"e_1_2_8_8_1","unstructured":"M.O'Hara\u2010Wild R.Hyndman andE.Wang \u201cFable: Forecasting Models for Tidy Time Series \u201d2024 https:\/\/CRAN.R\u2010project.org\/package=fable."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/20.022"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106726"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.02.032"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70292","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T14:55:29Z","timestamp":1761663329000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70292"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/lio2.70292"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70292","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"type":"print","value":"2378-8038"},{"type":"electronic","value":"2378-8038"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-08-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70292"}}