bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do we still need a canary in the coal mine for laboratory animal facilities? A systematic review of environmental health monitoring versus soiled bedding sentinels
Authors: LaFollette Megan R. , Clement Caroline S. , Luchins Kerith R. , Manuel Christopher A. , Foley Patricia L. , Hanson Wai H. , Pettan-Brewer Christina , Winn Caroline B. , Garner Joseph P. 
Published: December 2024

Introduction
Despite increasing evidence that Environmental Health Monitoring (EHM) is an effective method to perform rodent colony health surveillance, promotes the 3Rs as a Replacement, is comparable or reduces cost, and demonstrates labor benefits, many research institutions continue to use live Soiled Bedding Sentinels (SBS). Some veterinarians and others responsible for rodent colony health monitoring remain cautious of the evidence supporting this new technology. Therefore, our objective was to perform a formal systematic review to identify, summarize, and evaluate the research on the efficacy of EHM as compared to SBS. This information is essential to establishing recommendations for rodent health monitoring programs.

Methods
We systematically searched and evaluated all articles comparing EHM to SBS identified from PubMed, Web of Science, and CAB abstracts initially on November 12, 2021 with an update on Oct 15, 2023. Our inclusion criteria included publication in a peer-reviewed journal and collection of empirical data on rodent health monitoring alternatives to soiled bedding sentinels. Outcome data was extracted and analyzed via logistic regression and secondary descriptive statistics. Due to the nature of the included studies, no risk of bias assessment was performed. No specific funding was received for this review.

Results
Forty-two peer-reviewed articles passed inclusion criteria for analysis. The design of studies varied substantially but included publications investigating exhaust dust testing (n = 27), sentinel-free soiled bedding (n = 8), and direct colony sampling (n = 24). Based on both logistical regression and descriptive criteria, all types of EHM appear to be superior to soiled bedding sentinels at detecting pathogens, regardless of their taxonomic classification.

Conclusion
Based on these findings, we conclude there is a strong evidence base supporting the replacement of SBS with EHM. Looking forward, we encourage continued research on the detection of existing and emerging pathogens with these technologies and development of best practices for routine rodent health monitoring programs.
The burden of unexpected costs in medical school
Authors: Ball Madeleine , Lam LeAnn , Tigue Megan , Herzberg Simone , Finck Luke 
Published: December 2024

Background
The cost of medical school continues to climb. What has yet to be well-understood are the so-called “unexpected costs” of medical school that, while not explicitly required, are considered paramount to success. This study aims to identify, quantify, and analyze the impacts of these costs of medical school and offer suggestions in alleviating these burdens.

Methods
Medical students across the United States were administered a questionnaire inquiring about the unexpected costs of medical school including test prep materials, clinical supplies, student fees, and the impact of these costs on mental and financial health. In this multi-institutional, cross-sectional survey study, outcomes included total cost, perception of expected vs. actual cost, and impact on well-being.

Results
From January to June 2022, 499 survey responses were collected. The average total additional costs were $4,937, with 83% of respondents stating they spent more during medical school than expected. 51% reported their institutions’ cost of attendance did not accurately predict expenses. These costs were a financial constraint for 68% of students, with a significant increase in constraint for first-generation college students (89% vs 65%, p = 0.02). Financial concerns impacted 65% of students’ mental health and well-being during their medical career, with a significantly increased impact on first-generation college students (85% vs 62%, p = 0.045).

Conclusions
Most students believed the total cost of medical school was significantly more than expected, serving as a source of stress and negatively impacting their mental health. The financial constraints and impact on mental health and well-being were most pronounced for first-generation college students. This study illuminates the importance of improving communication regarding costs outside of tuition and providing support and advocacy to alleviate those costs. Future investigation should further examine how other demographics are impacted by the burden of unexpected costs in medical school.
Effectiveness of interventions for preventing road traffic injuries: A systematic review in low-, middle- and high-income countries
Authors: Akbari Maryam , Heydari Seyed Taghi , Razzaghi Alireza , Vali Mohebat , Tabrizi Reza , Bagheri Lankarani Kamran 
Published: December 2024

Background
Road traffic collisions (RTCs) are the primary cause of death, which usually occur during the most crucial years of life, resulting in significant damage to health, society, and the economy. A wide variety of strategies and policies have been implemented around the world to minimize injuries and fatalities resulting from RTCs. This study aimed to systematically evaluate the effectiveness of interventions to reduce road traffic injuries (RTIs) in low-, middle-, and high-income countries.

Methods
The researchers looked for articles in many databases (PubMed, Web of Science, Google Scholar, Scopus, Embase, PsycInfo, OpenGrey, EconLit, IMEMR, AIM, Cochrane Injuries Group’s specialized register, Transport Research International Documentation (TRID), Transportation Research Information Services (TRIS) Database and the OECD’s Joint Transport Research Centre’s International Transport Research Documentation (ITRD)) about ways to reduce RTIs and included articles published up to December 2023. The study area did not matter; only RTI reduction methods were considered. Two people checked the articles to ensure being relevant and qualified and summarized what they found in the articles.

Results
A total of 852 articles were included in this systematic review. Most interventions were related to legislation (26.4%) and enforcement (17.0%), and the minor interventions were related to social marketing (4.9%) and traffic user safety (2.2%). Regarding income level (based on the latest classification of the World Bank—2020), more than half of the interventions (83.7%) took place in developed and high-income countries. Regarding intervention types, legislative and road safety interventions effectively reduced road traffic crashes by 26% and 16.7%, respectively. The results indicated that interventions in high-income countries were more likely to minimize RTCs than other countries. However, this difference was not statistically significant (p-value = 0.982). Most effective interventions (36.1%) were reported during the Decade of Action for Road Safety (2011–2020).

Conclusion
Current road safety efforts prioritize changing how people behave on the roads (training, laws, enforcement) over making the roads safer. Focusing on fixing the entire system rather than blaming drivers ("system repair") is necessary for a complete picture.
Association between quantitative flow ratio and clinical outcomes in multivessel disease STEMI patients with diabetes mellitus
Authors: Xian Huimin , Luo Xing , Liu Yanzong , Guo Bingchen , Wu JianJun , Yang Fan , Guo Yiyuan , Zhang Ruoxi 
Published: December 2024

Background
Among patients with multivessel disease and ST-elevation myocardial infarction (MVD-STEMI), complete revascularization (CR) has been shown with improved outcomes. However, it is controversial whether diabetes mellitus (DM) status affects the outcomes. Quantitative flow ratio (QFR), as a newer non-invasive tool for identifying functional coronary stenosis and determining the presence of functional CR (FCR), may open up a new perspective for studying the above issues. The aim of this retrospective study was to investigate an association between QFR-based FCR and clinical outcomes in MVD-STEMI patients under DM status.

Methods
A total of 623 patients were included in the final analysis. The patients were divided into nonDM cohort and DM cohort. Within each cohort, patients were further stratified into functional CR (FCR) layer and functional incomplete revascularization (FIR) layer based on QFR assessment. The primary outcomes were 3-year major adverse cardiovascular events (MACEs), encompassing cardiac death, ischemia-driven revascularization (target vessel and non-target vessel), rehospitalization due to unstable angina pectoris, and non-fatal myocardial infarction.

Results
The incidence of MACEs was significantly lower in the FCR layer than in the FIR layer (12.6% vs 24.0%, log-rank P<0.001). In the nonDM cohort, the incidence of MACEs was also lower in the FCR layer than in the FIR layer (9.8% vs 18.5%, log-rank P = 0.032). Similar situations occurred in the DM cohort (16.1% vs 27.9%, log-rank P = 0.017). In addition, the multivariate Cox analysis showed that rSSQFR (QFR-derived residual SYNTAX score) was significantly associated with the increased risk of MACEs in the nonDM cohort (HR (95% CI) = 1.18 (1.10–1.26), P<0.001) and DM cohort (HR (95% CI) = 1.13 (1.09–1.18), P<0.001). ROC analysis showed adding rSSQFR into the model of clinical risk factors yielded a significant improvement in prediction of MACEs, especially in the DM cohort (AUC (95% CI) = 0.747 (0.675–0.819), P = 0.001) than in the nonDM cohort (AUC (95% CI) = 0.697 (0.602–0.791), P = 0.033). Furthermore, additional multivariate Cox analysis showed that rSSQFR was associated with the increased risk of MACEs in patients with moderate lesions (DS of 50%-89%) after procedure (HR (95% CI) = 1.16 (0.11–1.22), P<0.001).

Conclusions
In patients with MVD-STEMI, the incidence of MACEs was lower in FCR than in FIR, and the decrease was particularly significant in the DM cohort. The association between QFR-derived rSSQFR and MACEs was independent of baseline characteristic differences, and rSSQFR provided higher prognostic predictive ability in DM cohort than in nonDM cohort. Additionally, QFR had the additional utility of identifying moderate residual lesions that require revascularization.
Effects of triple semicircular canal plugging on hearing in patients with Meniere’s disease: A systematic review and meta-analysis
Authors: Zhu Jia quan , Kang Li li , Wen Xiao dong , Xiao Jing , Li Yu jie , Li Rong , Liu Hong jun , Wang Hong juan , Qiao Fu yu , Yang Dongbao , Xiang Bin 
Published: December 2024

Introduction
Triple semicircular canal plugging is effective in controlling vertigo in patients with Meniere’s disease, however, whether the rate of causing hearing loss during treatment is still not uniform. This study aimed to evaluate the effects of Triple semicircular canal plugging (TSCP) on hearing in Meniere’s disease (MD) patients.

Methods
Databases Reviewed were PubMed, EMBASE, Scopus, Clinical Trials, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP. The study reported on the duration, follow-up time, hearing loss, and vertigo control outcomes in MD patients evaluated by TSCP. Stata 17 software was used for data analysis and assessing the risk of bias.

Results
This meta-analysis included 367 MD patients from 7 studies. TSCP efficiently alleviated vertigo with a rate of 99% (95% CI: 0.97, 1.00) and had a hearing loss rate of 22% (95% CI: 0.16, 0.28). Subgroup analysis revealed that for hearing loss, the proportion of patients with disease duration more than or less than 12 months was 14% (95% CI: 0.05, 0.26) and 24% (95% CI: 0.19, 0.29), respectively. For vertigo control, the rates were 100% (95% CI: 0.96, 1.00) and 99% (95% CI: 0.97, 1.00), respectively. For hearing loss, the follow-up time of MD patients more than or less than 24 months was 20% (95% CI: 0.07, 0.38) and 23% (95% CI: 0.18, 0.29), respectively. For vertigo control, the rates were 99% (95% CI: 0.95, 1.00) and 99% (95% CI: 0.97, 1.00), respectively. The duration of the disease and follow-up time had no significant impact on hearing loss and vertigo control rates.

Conclusions
TSCP was efficient for vertigo control but with a risk of hearing loss. It could be used as a surgical method for hearing preservation in advanced MD patients.
Investigating the relationship between insulin use and all-cause mortality, breast cancer mortality, and recurrence risk in diabetic patients with breast cancer: A comprehensive systematic review and meta-analysis
Authors: Loktionova Marina V. , Mohammadian Mahdi , Choopani Roya , Kheiri Soleiman , Mohammadian-Hafshejani Abdollah 
Published: December 2024

Background
The co-occurrence of breast cancer and diabetes presents complex clinical challenges, as each condition may influence the progression and management of the other, potentially worsening patient outcomes. This study aims to examine the association between insulin use and the risks of all-cause mortality, breast cancer-specific mortality, and recurrence in diabetic patients with breast cancer.

Methods
A systematic review and meta-analysis were conducted using studies identified from multiple databases, including Web of Science, Scopus, PubMed, Cochrane, Google Scholar, and Embase. The meta-analysis approach was used to estimate the relative risk (RR) of the relationship between insulin use and the risks of all-cause mortality, breast cancer-specific mortality, and recurrence in diabetic patients with breast cancer. Heterogeneity among studies was assessed using statistical tests such as the Chi-square test, I2, and forest plots. Meta-regression and sensitivity analyses were performed to explore sources of heterogeneity. The quality of the included studies was assessed using the Newcastle-Ottawa Scale checklist. Data were analyzed using Stata version 17 (Stata Corp, College Station, Texas).

Results
Data from 22 studies conducted between 2002 and 2023, with a total of 159,674 participants, were analyzed. Nineteen studies were rated as high quality, and three as moderate quality. Diabetic patients with breast cancer who received insulin had a 1.65 (95% CI: 1.36–2.02; P < 0.001; I2 = 89.7%) times higher risk of overall mortality compared to those who did not use insulin. Meta-regression revealed that sample size and study quality were significant contributors to heterogeneity (P ≤ 0.10). Furthermore, insulin use was associated with a 1.22 (95% CI: 1.05–1.42; P = 0.009; I2 = 37.9%) times higher risk of breast cancer-specific mortality. For breast cancer recurrence, insulin use was associated with a 1.45 (95% CI: 1.19–1.77; P < 0.001; I2 = 3.4%) times higher risk. Sensitivity analysis confirmed the stability of the results across all outcomes.

Conclusion
This meta-analysis provides strong evidence that insulin use in diabetic patients with breast cancer is associated with increased risks of overall mortality, breast cancer-specific mortality, and recurrence. These findings underscore the need for careful consideration of insulin therapy in this patient population.
Social support and symptoms of antenatal depression among women screened for gestational diabetes mellitus: A cross-sectional study in Northern Vietnam (the VALID II study)
Authors: Nguyen Ai T. , Nguyen Kien Dang , Minh Le Hieu , Nguyen Thanh D. , W. Meyrowitsch Dan , C. Bygbjerg Ib , Søndergaard Jens , Nguyen Hanh T. T. , A. Vinter Christina , S. Linde Ditte , M. Gammeltoft Tine , Rasch Vibeke 
Published: December 2024

Objectives
This study from Northern Vietnam aims to assess the association between social support and symptoms of depression among pregnant women screened for gestational diabetes mellitus (GDM).

Methods
A cross-sectional study was conducted among 823 pregnant women in Thai Binh, Vietnam. The women were screened for GDM and structured questionnaire were used to collect data on social support factors, GDM factors, and symptoms of depression. The diagnosis of GDM was based on the 2-hour 75-g OGTT according to WHO 2013 criteria. The Edinburg Postpartum Depression Scale (EPDS) with a cut-off of 10 and the Multidimensional Perceived Social Support Scale (MSPSS) were used to assess depression symptoms and perceived social support, respectively. Logistic regression analysis was conducted to measure the associations between social support, GDM-related factors, and symptoms of depression. The relationship between social support score and symptoms of depression was evaluated using Spearman’s correlation. The strength of the associations were measured by adjusted odds ratios (aOR) with 95% confidence intervals (CI).

Results
The prevalence rates of GDM and symptoms of depression were 22.2% (95%CI: 19.4–25.2) and 23.0% (95%CI: 20.1–26.0), respectively. Women who had moved away from their commune of birth and women who reported another person than their husband to be the primary person to confide in had increased odds of depression (aOR = 1.74; 95%CI:1.19–2.56 and aOR = 2.36; 95%CI:1.48–3.75, respectively). A reported lack of social support was strongly associated with increased odds of depression symptoms among both women with gestational diabetes mellitus (aOR = 6.16, 95% CI:2.35–16.12) and without gestational diabetes mellitus (aOR = 2.81; 95%CI: 1.67–4.75). When analysing the correlation between social support and depression symptoms, a negative correlation was found, with decreasing depression scores as the social support score increased.

Conclusion
The prevalence of symptoms of depression was high in our study, and women in Northern Vietnam who feel well-supported socially are less likely to report symptoms of depression. This finding applies both to women with and without GDM.
Do errors in the GHQ-12 response options matter?
Authors: Croak Bethany , Bhundia Rupa , Lamb Danielle , Greenberg Neil , Stevelink Sharon A. M. , Trompeter Nora , Wessely Simon , Rubin G. James 
Published: December 2024

Background
The twelve item General Health Questionnaire (GHQ-12) is a widely used measure of psychological wellbeing. Because there are seven different sets of response options across the twelve items, there is scope for transcription errors to occur when researchers assemble their study materials. The impact of such errors might be more important if they occur in the first set of response options than if they occur later in the questionnaire, once participants have become aware that options to the right of the GHQ-12 response sets always indicate worse wellbeing.

Aims
To test the impact of introducing errors into the first and eighth set of response options for the GHQ-12 that render those response sets partially illogical.

Methods
We used a double-blind randomised controlled trial, pre-registered with Open Science Framework (osf.io/syhwf). Participants were recruited by a market research company from their existing panel of respondents in Great Britain. Participants were randomly allocated to receive one of three versions of the GHQ-12: a correct version (n = 500), a version with a mistake in the first item (n = 502), or a mistake in the eighth item (n = 502). Mistakes replaced ‘better than usual’ (item one) or ‘more so than usual’ (item eight) with ‘not at all.’

Results
We found no differences between the versions in terms of number of participants with possible poor psychological wellbeing (χ2 = 0.32, df = 2, p = 0.85) or in mean GHQ-12 scores for the three groups (F(2, 1501) = 0.26, p = 0.77).

Conclusions
Small deviations from the standard GHQ-12 wording do not have a substantive impact on results.
Differences in workplace violence and health variables among professionals in a hospital emergency department: A descriptive-comparative study
Authors: Cascales-Martínez Andrea , López-Ros Paloma , Pina David , Cánovas-Pallares Juan Manuel , López López Reyes , Puente-López Esteban , Piserra Bolaños Carlos 
Published: December 2024

Introduction
Workplace violence is a relevant social problem due to its high prevalence and serious consequences. A quarter of workplace violence occurs in the healthcare sector. Evidence shows differences among professionals, with emergency department workers being especially vulnerable, presenting a higher risk of suffering mental and physical health problems, as well as threats to their professional and social integrity.

Objective
To explore the frequency with which emergency department professionals are exposed to user violence and violence by their own coworkers; as well as to analyze the differences between different professionals in exposure to violence in the workplace and some of its most studied consequences such as burnout, job satisfaction, engagement, and general health.

Methods
A descriptive comparative study was carried out with a sample of 120 emergency department workers from three hospitals in Alicante. The majority were healthcare professionals (84.2%), women (61.7%), obtaining a mean age of 41.8 years (SD = 10.8). Sociodemographic and occupational variables, user violence, violence among colleagues and superiors, general health, burnout, engagement, and job satisfaction were evaluated.

Results
A high prevalence of both physical and non-physical user violence in the healthcare setting was observed, especially affecting nursing and administrative assistants. In addition, significant differences were identified between professionals in terms of non-physical user violence, burnout, engagement, and job satisfaction. Administrative staff suffer greater non-physical user violence, while nursing assistants show higher levels of engagement. Regarding job satisfaction, nurses report higher intrinsic satisfaction. Medical staff, nurses and nursing assistants show higher levels of extrinsic satisfaction compared to administrative staff.

Discussion
Our results are consistent with other studies in which a relationship between exposure to violence and job satisfaction is observed. In addition, administrative staff appear to be the professionals most exposed to violence from both patients and coworkers. These results provide evidence for future research focused on improving the work environment and health of emergency department professionals.