bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender, race and ethnicity biases experienced by hospital physicians: an umbrella review to explore emerging biases in the evidence base
Authors: Kendrick Abby , Krishnan Nithya , Baharani Jyoti , Tuttle Janet , Szczepura Ala 
Published: February 2025

ObjectivesTo examine the authorship and content of systematic reviews (SRs) of biases experienced by medical professionals through a gender lens.DesignReview of SRs.Data sourcesWe searched PubMed, Embase, PsycINFO and CINAHL from inception. Searches were conducted in May 2022 and updated in October 2023.Eligibility criteriaReviews of studies reporting biases experienced by hospital physicians at any stage of their careers and in any country. Reviews were included if they used systematic methods to search the literature and synthesise the data. Non-English language publications were excluded.Data extraction and synthesisThe main theme of each eligible review was identified through qualitative thematic analysis. We used NamSor to determine the first/last authors’ gender and computed the proportion of female authors for each review theme.Results56 articles were included in the review. These covered 12 themes related to gender, race and ethnicity bias experienced by physicians at any stage of their careers. The overall proportion of female authors was 70% for first authors and 51% for last authors. However, the gender of authors by theme varied widely. Female authors dominated reviews of research on discrimination and motherhood, while male authors dominated reviews on burnout, mental health and earnings. Only six reviews were identified that included race and ethnicity; 9 out of the 12 first and last authors were female.ConclusionsUnderstanding the potential for a gendered evidence base on biases experienced by hospital physicians is important. Our findings highlight apparent differences in the issues being prioritised internationally by male and female authors, and a lack of evidence on interventions to tackle biases. Going forward, a more collaborative and comprehensive framework is required to develop an evidence base that is fit for purpose. By providing a point of reference, the present study can help this future development.PROSPERO registration numberCRD42021259409; Pre-results.
Investigating the general effects of different types of toluene exposure on the health of workers: an integrative review of the literature
Authors: El-Hagrasy Ahmed Mohsen Abbas , Karrout Ramadan Hani , Mcguinness Alexa Lulu , Albutain Tarek Ziyad Assaf Mousa , Khalifa Dana , Khalil Fatema Mohamed Hasan Ali , Tawash Eman , Alaradi Maryam 
Published: February 2025

ObjectivesThis integrative review aims to evaluate the available empirical and theoretical literature on the effects caused by different types of occupational toluene exposure on the health of workers. We aim to guide future research, legislation, and guidelines with evidence-based recommendations on toluene exposure.DesignAn integrative review of the literature.Data sourcesA systematic search strategy was undertaken across five electronic databases; PubMed, Scopus, Medline, CINAHL and ScienceDirect. Furthermore, grey literature was incorporated through hand-searching databases, Google Scholar, open-access engines and Google Advanced Search tool, among other tools.Eligibility criteriaStudies investigating the effects of occupational toluene exposure between 2010 and July 2023 were included. Inclusion criteria included full-text English articles, workers aged 18–65, and studies with co-exposures to benzene, toluene, ethylbenzene and xylene or volatile organic compound if direct findings to toluene were reported. Notable exclusion criteria were non-human studies, pregnant women, paediatric and geriatric populations, and studies addressing toluene abuse and not occupational exposure.Data extraction and synthesis27 studies met the eligibility criteria and were appraised using the Mixed Methods Appraisal Tool. Data were systematically extracted, guiding the synthesis of various themes, namely acute exposure effects, chronic exposure effects, short-term effects, long-term effects, low-dose effects, high-dose effects and reversible versus irreversible effects.ResultsThe review demonstrated that occupational toluene exposure impacts health differently depending on the nature and context of the exposure. Effects can arise in both acute and chronic scenarios, with outcomes that vary by duration, dose and whether the effects are reversible or irreversible.ConclusionsThe results demonstrate that toluene exposure can cause a wide range of effects based on the type of occupational toluene exposure. These findings can be used to update current guidelines on the recommended threshold limit for toluene exposure. Furthermore, strategies such as implementing mandatory personal protective equipment, improving ventilation and educating workers on the risks of toluene exposure can be put in place to mitigate the risks.
Driving under the influence of opioids in 2024: a narrative review of science and pandemic policy updates
Authors: Kirsch Colin , Wintergalen Patrick , Cohen Steven P , Mirzadeh Zaman , Farber S Harrison , Wilhelmi Brian G 
Published: February 2025

Background/ImportanceDriving under the influence of drugs (DUID) refers to operating a vehicle after consuming drugs or medications other than alcohol that impair the ability to drive safely. There is no consensus on legal limits for drug intoxication while driving in the USA. Balancing the benefits of prescription medications, such as opioids, with traffic safety remains an ongoing public health challenge.ObjectiveThis article examines DUID policy and provides recommendations for policy improvement and unification grounded in scientific evidence on opioid-related impairment and driving risks.Evidence reviewA literature review of epidemiologic data, psychomotor effects, and public policy related to opioid use and driving was conducted. A total of 38 epidemiological studies, 21 studies on psychomotor effects, and pertinent laws and policies were reviewed.FindingsEpidemiological data reveal an increasing prevalence of opioid-positive drivers and an association between opioid use and elevated risk of motor vehicle collisions. Psychomotor studies show mixed results, with some indicating impairment in opioid users and others suggesting minimal effects on driving ability. State laws regarding DUID remain heterogeneous, with trends toward expanded testing powers, lower impairment thresholds, and limitations on prescription-based defenses. The lack of standardized opioid testing limits and inconsistent policy approaches across states hinder effective management of opioid-related impaired driving.ConclusionsA balanced public health approach can reduce opioid-involved crashes through education, prevention, enhanced enforcement tools, and rehabilitation. In drafting future DUID laws, policymakers must analyze evolving opioid research when balancing the pain relief of opioids with public roadway safety.
Association of hyponatremia with outcomes after geriatric trauma: a systematic review and meta-analysis
Authors: Naaseh Ariana , Tohmasi Steven , Stoll Carrie , Luo Chongliang , Yaeger Lauren H , Hoofnagle Mark H , Colditz Graham A , Spruce Marguerite W 
Published: February 2025

BackgroundTrauma is a major cause of mortality in the elderly population. Hyponatremia is the most common electrolyte imbalance in geriatric patients and has been demonstrated to be a risk factor for altered cognition, low bone density, falls, and death. We systematically and critically reviewed the literature to ascertain the association between hyponatremia and geriatric trauma outcomes.MethodsWe searched seven databases for articles published from inception to October 2023. Studies included reported on geriatric trauma, hyponatremia, and clinical outcomes. Two investigators independently reviewed 6535 abstracts, 235 full-text articles, and critically appraised each study. Study details, patient characteristics, and outcomes were independently extracted by two reviewers. Data quality assessment was performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Publication bias was assessed using funnel plot-based methods. A meta-analysis of risk ratios (RR) was performed using the random effects method.ResultsFour retrospective cohort studies involving 11 894 geriatric patients were included. Among these, 492 (21.4%) were classified as trauma patients due to a fall and 1806 (78.6%) were classified as a trauma patient due to the presence of a fracture. In total, 2298 (19.3%) patients were classified as hyponatremic (125–135 mmol/L) while 9596 (80.7%) were classified as normonatremic. The pooled RR for in-hospital mortality for hyponatremic patients was 2.23 (95% CI 1.51 to 3.74) with high heterogeneity across the studies (I2=82.17%).ConclusionsGeriatric trauma patients presenting with hyponatremia appear to have an increased risk of in-hospital mortality. Given this association, national trauma registries should consider collecting serum sodium values for geriatric patients and providers should work to address hyponatremia as a possible contribution to falls. Given the paucity of published literature on this topic, there is a need for prospective studies evaluating the association between hyponatremia and geriatric trauma outcomes.Level of evidenceLevel III, systematic review with meta-analysis
Predicting Diabetes with Federated Learning: A Digital Twin and Medical Fog-based IoT Framework
Authors: Mishra Kaushik , Ghugar Umashankar , Rajareddy Goluguri , Sahoo Kshirasagar , Bhoi Sourav , Bhuyan Monowar , Gandomi Amir 
Published: February 2025

In today's world, maintaining good health has become increasingly paramount. The global prevalence of diabetes has surged due to the stress of modern life and unhealthy dietary habits. Detecting diabetes at an early stage has become imperative. Leveraging advancements in Cloud and Fog computing, we can create an Internet-enabled Medical Fog framework that incorporates Machine Learning (ML) techniques to predict and diagnose diabetes at its inception. This early prediction and diagnosis would enable remote medical assistance for individuals living far from immediate medical facilities. The Internet of Medical Things allows patient data to be gathered via sensors, analyzed using ML techniques, and stored in the Cloud, providing direct access for healthcare professionals. Therefore, the current study introduces a Digital Twin (DT)-enabled Internet of Medical Fog framework, supported by Federated Learning (FL) and the SaJAYA-ANFIS ML approach for diabetes prediction. FL ensures patient data privacy is upheld while fostering a seamless, intelligent healthcare ecosystem that bridges the gap between patients and doctors through DT. Data collection begins at the Internet of Things (IoT) layer through sensors, followed by processing at the Fog layer, comprising diverse computing nodes with specific pre-processing tools and the SaJAYA-ANFIS model for diabetes prediction. Predicted outcomes are then stored in the Cloud for analysis by medical professionals. The proposed framework addresses privacy concerns through Federated Learning (FL). The proposed method has been validated with a UCI diabetes dataset and compared with state-of-the-art FL-supported ML and DT-supported ML techniques for various performance metrics (Accuracy, Precision, Specificity, Recall and Fβ-measure). The results demonstrate that our method outperforms other baselines, achieving 93.5% accuracy and 92% Fβ-measure, respectively.
Fog computing, Cloud computing, Healthcare
Caregiver Strain in Children with Attention Deficit Hyperactivity Disorder: A Cross-Sectional Study
Authors: Chandrakar Alka , Karthik Selvaraj M , Sathianathan R  , Udayakumar N  , Natrajan S  
Published: February 2025

Background: Attention Deficit Hyperactivity Disorder (ADHD) is among the most prevalent psychiatric disorders observed in children, which causes significant caregiver burden in terms of psychological, emotional, physical, and financial status. The current study correlates the severity and subtypes of ADHD with caregiver strain in children with ADHD. Methods: A cross-sectional study in which 40 caregivers of children with ADHD were assessed using a semi-structured proforma, Caregiver Strain Questionnaire (CSQ), and Vanderbilt ADHD Diagnostic Parent Rating Scale (VADPRS). Results: The mean global score of caregiver strain in this study was suggestive of moderate caregiver burden. The combined subtype of ADHD was the most common (42.5%) and had the greatest mean score of severity in this study, but it caused the least caregiver burden ( P < .05). The inattentive subtype of ADHD was causing the greatest caregiver strain in all the domains of strain (objective, subjective externalized, and subjective internalized) [ P < .05]. Most of the children had co-morbid psychiatric conditions (67.5%), of which oppositional defiant disorder was the commonest (60%) and caused significant caregiver strain in all the domains ( P value even up to <.01 and <.001 for some domains). Conclusion: The severity of caregiver burden is influenced by the subtype of ADHD and the existence of co-morbid psychiatric conditions. Applying such findings in routine clinical practice can be more helpful for improving the overall well-being of the child and the caregiver.
In silico study of selected alkaloids as dual inhibitors of β- and γ-secretases for Alzheimer's disease
Authors: Onifade Isreal Ayobami , Umar Haruna Isiyaku , Aborode Abdullahi Tunde , Awaji Aeshah A. , Jegede Ifeoluwapo Deborah , Adeleye Bunmi Helen , Fatoba Dorcas Oladayo , Bello Ridwan Opeyemi , Fakorede Sodiq , Idowu Nike 
Published: February 2025

Background Alzheimer's disease (AD) has become common as the number of aged people increases making it as a socioeconomic problem lately. To date, no success is recorded for disease-modifying therapies for AD but only drugs for symptomatic relief exist. Research has been centered on the role of amyloid-β on the pathogenesis of AD, which has led to the development of drugs that target Aβ (β- and γ-secretase inhibitors) to reduce the amount of Aβ formed. However, the existing β and γ-secretase inhibitors were associated with harmful side effects, low efficacy, and inability to cross the blood-brain barrier. Objective This study therefore used in silico approach to predict the inhibitory properties of alkaloids as potential drug targets against AD. Methods Thus, in this current study, 54 alkaloids from the PhytoHub server (phytohub.eu), and two approved drugs were docked against β-secretases. Additionally, galantamine and 5 alkaloids with the utmost binding potential with β-secretase were subjected to pharmacokinetics evaluation and docked against γ-secretase. Results From the result, 5 compounds displayed for both docking periods, with demissidine, solasodine, tomatidine, and solanidine having better BE than the control drugs. Based on the pharmacokinetics evaluation, 4 compounds possessed good pharmacokinetic evaluation and biological activities than galantamine. Conclusions This study suggests that demissidine, solasodine, tomatidine, and solanidine are promising dual inhibitors against β- and γ-secretase proteins in silico. However, there is an urgent need to carry out in vitro and in vivo experiments on these new leads to validate the findings of this study.
Overlap in the diagnostic criteria of frontotemporal dementia syndromes with parkinsonism
Authors: Heikkinen Sami , Katisko Kasper , Haapasalo Annakaisa , Portaankorva Anne , Hartikainen Päivi , Solje Eino 
Published: February 2025

Background Differentiating neurodegenerative diseases can be difficult in the clinical setting. This study examines the overlap of diagnostic criteria between frontotemporal dementia (FTD) syndromes with parkinsonism [e.g., corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), behavioral variant frontotemporal dementia (bvFTD)] and Parkinson's disease (PD). Objective To explore the diagnostic overlap in patients with FTD syndromes with parkinsonism and PD. Methods Patient records from 2751 individuals at a tertiary neurological care center were reviewed, resulting in 112 bvFTD, 38 PSP, and 15 CBS patients. Clinical features and diagnostic criteria fulfillment were assessed. Results Significant overlap in diagnostic criteria fulfilment was found: 42 bvFTD and 22 PSP patients met possible CBS criteria, 6 bvFTD patients met possible PSP criteria, and 4 met criteria for all three conditions. Higher cerebrospinal fluid levels of phosphorylated tau and tau were observed in the bvFTD group compared to PSP (p = 0.009, p = 0.002). The Mini-Mental State Examination score also differed between bvFTD and PSP (p = 0.020), and between PSP and CBS (p = 0.047). Neuroimaging showed substantial heterogeneity. Conclusions The study reveals significant overlap in diagnostic criteria among FTD syndromes with parkinsonism, underscoring the need for more precise diagnostic criteria. Improved biomarkers could support differential diagnosis and enhance clinical trial design. Common cerebrospinal fluid biomarkers used in Alzheimer's disease diagnostics may provide additional support in the differential diagnosis.
Prevalence and correlates of the head turning sign in mild cognitive impairment and dementia due to neurodegenerative, chronic cerebrovascular, and mixed etiologies
Authors: Aiello Edoardo Nicolò , Curti Beatrice , De Luca Giulia , Trombi Marta , Maranzano Alessio , Poletti Barbara , Silani Vincenzo , Ticozzi Nicola , Verde Federico 
Published: February 2025

Background The head turning sign (HTS) consists in the patient turning his/her head towards the accompanying person in search for support when being asked questions. Although the HTS is known to be associated with cognitive impairment, previous investigations were biased towards Alzheimer's disease (AD) or did not differentiate between diverse dementia etiologies; moreover, little is known about the specific cognitive correlates of the HTS. Objective To assess the prevalence and clinical correlates of the HTS in patients with mild cognitive impairment (MCI) and dementia of various etiologies. Methods The HTS was recorded during the Mini-Mental State Examination (MMSE) in 232 MCI/dementia patients with the following etiological classification: AD ( N = 121); frontotemporal lobar degeneration (FTLD; N = 24); Lewy body disease (LBD; N = 11); vascular ( N = 29); mixed ( N = 47). Results The overall prevalence of the HTS in the whole cohort was 27.6%. Albeit being descriptively higher in dementia (29.9%) versus MCI (22.7%), as well as descriptively lower in FTLD and LBD than in remaining subgroups, no significant association was detected between the HTS and either MCI/dementia status or etiology. HTS + patients were older and more frequently females, also reporting lower MMSE scores and differing from HTS- ones on Temporal and Spatial Orientation and Constructional Praxis sub-scores. An association between the HTS and lower MMSE scores was found in patients with MCI but not in those with dementia. Conclusions In patients with cognitive impairment due to diverse causes, the HTS might occur regardless of MCI versus dementia status and across different etiologies. MCI patients displaying the HTS might have more severe cognitive deficits.
Early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler
Authors: Choudhary Sushil Kumar , Datta Vikram , Sunda Urmila , Chhapola Viswas 
Published: February 2025

Objective: To evaluate the early neurobehavioral outcome in preterm small for gestational age neonates with increased pulsatility index in antenatal umbilical artery Doppler. Method: A prospective cohort study was conducted at a tertiary care neonatal unit in India. 30 preterm SGA neonates born to mothers with increased pulsatility index (> 95th centile) were enrolled and compared with 30 SGA neonates with normal pulsatility index (<95th centile). These neonates were followed up to 40 weeks of post-menstrual age. They were evaluated by NAPI score of MDV (Motor development-vigor) and AO (Alertness orientation) at 40 weeks. Result: The mean NAPI score of MDV (Motor development- vigor) in neonates born to mothers with pulsatility index ≥95th percentile in umbilical artery Doppler was 58.59 ± 11.28 as compared to 61.73 ± 10.24 in another group (p-value 0.263) and mean difference (95%CI) was 3.14(2.42-8.71). The mean NAPI score of AO (Alertness-orientation) in the exposed group was 54.47 ± 10.19 as compared to 56.36 ± 9.07 in the unexposed group (p-value 0.44) and mean difference (95%CI) was 1.89 (3.1-6.88). Conclusion: Preterm, SGA neonates born to mothers with high pulsatility index in umbilical artery Doppler had low neurodevelopmental scores as compared to neonates with normal PI.
Investigating the molecular mechanisms of deltamethrin resistance in Musca domestica populations from Saudi Arabia
Authors: Alzabib Ali A. , Al-Sarar Ali S. , Abobakr Yasser , Saleh Amgad A. 
Published: February 2025

Abstract

Background
The house fly, Musca domestica L., is a global insect pest that poses serious health risks by carrying pathogens to humans and animals. Pyrethroid (PYR) insecticides have been widely used to control agricultural pests and disease vectors. Multiple reports have documented house fly resistance to PYR insecticides.

Methods
In this study, we assessed the resistance levels of M. domestica populations collected from slaughterhouses in Riyadh, Jeddah, and Taif, Saudi Arabia, against the PYR insecticide deltamethrin (DM). We also examined the genetic mutations in the voltage-sensitive sodium channel (Vssc) and P450 genes of the collected field flies and analyzed the correlation between these detected genetic mutations and the levels of DM resistance.

Results
The house fly field populations showed very high levels of resistance to DM, with resistance ratio (RR) values of 625-, 256-, and 107-fold for Jeddah, Taif, and Riyadh, respectively. Three VSSC resistance alleles, kdr (T929 + 1014F), kdr-his (T929 + 1014H), and 1B (929I + 1014F), along with the susceptible allele (T929 + L1014) were identified in the Saudi house fly populations. The super-kdr allele (918 T + 1014F) and type N (D600N + M918T + L1014F) were not detected in Saudi house fly populations. Type 1B was the most dominant VSSC resistance allele, followed by kdr and kdr-his, in both field populations and the surviving flies exposed to DM. The resistance CYP6D1v1 allele of P450 was detected in slaughterhouse house fly populations of Riyadh, Jeddah, and Taif, with frequencies of 71%, 58%, and 60%, respectively. The VSSC resistance alleles exhibited a positive correlation with the resistance levels to DM; conversely, the CYP6D1v1 displayed a negative correlation with DM resistance levels.

Conclusions
In general, the Saudi house fly populations exhibited high genetic diversity, with three VSSC resistance alleles identified in slaughterhouse populations. The Vssc mutations appear to be the principal mechanism of DM resistance in Saudi house fly field populations. This study is the first report on the Vssc and CYP6D1 mutations associated with PYR resistance in M. domestica field populations from Saudi Arabia.

Graphical Abstract