bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the differences in Mean Age at Menarche (MAM) among adolescent girls in rural and urban Nigeria: a systematic review
Authors: Okagbue Hilary I. , Samuel Olugbemisola W. , Nzeribe Emmanuella C. , Nto Sunday E. , Dahunsi Olukayode E. , Isa Muhammad B. , Etim John , Orya Evelyn E. , Sampson Sidney , Yumashev Alexey V. 
Published: December 2024

Abstract
Introduction
Globally, there has been a decline in the age of menarche; the decline is higher in poorer countries than in richer ones. The measurement of the decline was based on the reported mean age at menarche (MAM) across the countries. There is a significant knowledge gap in investigating the generational decline in MAM in low- and median-income countries (LMC). In Nigeria, different studies have reported MAM, but none have attempted to investigate the generational shift in the reported MAM in girls residing in rural and urban areas. This review sought to understand if there is a rural-urban disparity in the MAM.

Methods
Documents were searched in the relevant bibliometric database and Population intervention, comparison(s) and outcome (PICO) framework were used as eligibility criteria for extracting data from the documents based on some inclusion and exclusion criteria. The population are adolescent schoolgirls in rural and urban settlements in Nigeria. The comparator is the age of menarche of urban versus rural adolescent schoolgirls in Nigeria, while the mean age at menarche (MAM) is the outcome. Data quality assessment was done to critically appraise the included studies and enhance. Data were synthesized using narrative review, descriptive and inferential statistics.

Results
Ten articles were included in the study, following the PRISMA framework. The overall mean evaluation of the risk of bias in the individual studies included in the review was computed to be 88%. Generally, there seems to be a decline in the age at menarche from 1976 to 2023. The rural MAM is higher than the urban MAM, and the gap between the two appears to be narrowing. The t-test showed no statistically significant mean differences between the rural and urban mean age at menarche (T = 2.1009, p value = 0.4679). The mean menarcheal age for girls in rural and urban areas is 13.44 and 13.04, respectively. There is a strong positive correlation between the rural and urban MAMs (Pearson = 0.93, p < 0.001). The Gaussian kernel estimated a bimodal distribution for rural girls, where they are most likely to experience menarche at 11 and 13 years, respectively, while urban girls are most likely to experience menarche at 13 years. In both locations, the incidence of menarche decreases just after the peak at 13 years.

Conclusion
Although rural girls have delayed menarche, there is no statistically significant mean difference between the age at menarche reported for rural and urban areas in Nigeria. Interventions in the form of counseling and reproductive education are recommended. The review provides a strong foundation for further research and policy development aimed at improving the health and well-being of adolescent girls in Nigeria and other similar settings.

PROSPERO Registration
CRD42024529497
Higher body roundness index (BRI) increases infertility among U.S. women aged 18–45 years
Authors: Gong Hongyang , Duan Shuqin , Choi Seok , Huang Shaoqun 
Published: December 2024

Abstract
Objective
Infertility is associated with obesity. The Body Roundness Index (BRI) is a body measurement index related to obesity that more accurately assesses body and visceral fat levels. However, the relationship between BRI and infertility remains unclear. Therefore, this study aims to determine the relationship between BRI and infertility.

Methods
This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018 and included 3,528 women aged 18–45 years. Multivariate logistic regression was employed to investigate the association between BRI and infertility. Restricted cubic spline (RCS) analysis explored the linear or non-linear relationship between BRI and infertility. Interaction analyses were conducted on subgroups to validate the findings. To verify the robustness of the results, we performed several sensitivity analyses, including propensity score matching(PSM) and multiple imputations for missing data. Furthermore, the predictive capabilities of various anthropometric indices—including BRI, weight-adjusted waist index (WWI), body mass index (BMI), and weight—on infertility incidence were assessed using Receiver Operating Characteristic (ROC) curve analysis.

Results
There was a significant positive association between BRI and infertility. After adjusting for covariates, for each unit increase in BRI, there was a 12% increase in the probability of infertility (P < 0.001). This positive correlation persisted when BRI was categorized into quartiles. Moreover, as BRI increased, there was a trend towards higher infertility prevalence (P for trend < 0.001). The dose-response curve indicated a linear association between BRI and infertility, with higher BRI associated with higher infertility risk. The correlation between BRI and infertility persisted in subgroup analysis and multiple imputations. The ROC curve analysis revealed that BRI had a superior predictive capability compared to traditional obesity indices, with an area under the curve (AUC) of 0.618 (95% CI, 0.588–0.648).

Conclusion
The results of this study show a strong positive correlation between BRI and the prevalence of infertility.

Clinical trial number
Not Applicable.
Novel pathogenic variant in a mild case of type B molybdenum cofactor deficiency: case report and literature review
Authors: Kinsinger Morgan , Ivanisevic Jelena , Mithal Divakar S. 
Published: December 2024

Abstract
Background
Molybdenum cofactor deficiency (MoCD) is a rare metabolic disorder caused by pathogenic variants in the highly conserved biosynthetic pathway of molybdenum cofactor (MoCo), resulting in sulfite intoxication. MoCD may present in a clinically severe, fatal form marked by intractable seizures after birth, hyperekplexia, microcephaly and cerebral atrophy, or a later onset form with a more varied clinical course. Three types of MoCD have been described based on the effected gene along the MoCo synthesis pathway: type A (MOCS1); type B (MOCS2 or MOCS3) and type C (GPHN). The MOCS2 gene is bicistronic, encoding the small (MOCS2A) and large (MOCS2B) subunits with an overlapping coding region. This case report describes a patient with the first known variant causative of mild disease in the overlapping bicistronic region (c.263 G > C) and the first ever described in the highly conserved C-terminal glycine-glycine motif of MOCS2A.

Case presentation
The patient developed normally until age 12 months when she presented in the setting of acute illness with developmental regression, low serum uric acid, and MRI with bilateral globus pallidus (GP) injury. Exome sequencing identified a homozygous variant of unknown significance in the MOCS2 gene and the diagnosis of MoCD type B was confirmed by the patient’s low serum uric acid coupled with elevated urine sulfocysteine and associated metabolites, resulting in gene reclassification. Nearly four years after her initial presentation she has demonstrated progress in language and motor domains, consistent with a mild phenotype of MoCD.

Conclusions
The case emphasizes challenges in identifying atypical forms of rare diseases, the importance of exome sequencing to identify mild cases of MoCD, and the ongoing challenges with understanding the MOCS2 gene. While one FDA approved treatment exists for MoCD type A, further research into the mechanisms of phenotype-genotype differences among this patient population may aid in additional therapeutic options for MoCD.
Cultural and religious structures influencing the use of maternal health services in Nigeria: a focused ethnographic research
Authors: Opara Uchechi Clara , Iheanacho Peace Njideka , Petrucka Pammla 
Published: December 2024

Abstract
Background
Cultural and religious structures encompass a set pattern of values, beliefs, systems and practices that define a community's behaviour and identity. These structures influence women's health-seeking behaviour and access to maternal health services, predisposing women to preventable maternal health complications. However, most maternal health policies have focused on biomedical strategies, with limited attention to women’s cultural challenges around childbirth. The overall aim of this paper is to provide a thick description and understanding of cultural and religious structures in Nigeria, their meaning and how they influence women’s use of maternal health services.

Methods
Roper and Shapira’s (2000) focused ethnography comprising 189 h of observation of nine women from the third trimester to deliveries. Using purposive and snowballing techniques, 21 in-depth interviews and two focus group discussions comprising 13 women, were conducted in two Nigerian primary healthcare facilities in rural and urban area of Kogi State. Data was analyzed using the steps described by Roper and Shapira.

Results
Using the PEN-3 cultural model, nine themes were generated. Positive factor, such as the language of communication, existential factor, such as religion, and negative factors, such as the use of prayer houses and lack of women’s autonomy, were either positive or negative enablers influencing women’s use of maternal health services. Additionally, women's perceptions, such as their dependency on God and reliance on cultural norms were significant factors that influence the use of maternal health services. We also found that the use of herbal medicine was a negative enabler of women’s access to facility care. At the same time, family support was also a positive and a negative nurturer that could influence how women use facility care. Finally, factors such as religion, Ibegwu, and male child syndrome were negative nurturers influencing women’s contraceptive use.

Conclusion
Cultural and religious structures are significant factors that could promote or limit women’s use of maternal health services. Further studies are needed to understand culturally focused approaches to enhance women’s use of maternal health services in Nigeria.
Acromioclavicular joint cyst presenting with findings concerning for a soft tissue tumor – a case report
Authors: Schutz John F. , Hamad Christopher D. , Russell Michael D. , Abdeljaber Mahmuod , Nelson Scott D. , Eilber Fritz 
Published: December 2024

Abstract
Case
We present the case of a 73-year-old female with an acromioclavicular joint cyst associated with atypical, exquisite, progressive pain, and imaging findings concerning for neoplastic etiology. She underwent en bloc resection of the trapezium containing this cystic mass and distal clavicle. Surgical pathology demonstrated findings consistent with a large ganglion cyst without evidence of malignancy.

Conclusion
Our case serves to emphasize the importance of stepwise evaluation and appropriate treatment of such cysts while utilizing appropriate principles of oncologic resection in cases where a neoplastic etiology is considered.
Recent advances in sarcoma therapy: new agents, strategies and predictive biomarkers
Authors: Pan Minggui , Zhou Maggie , Xie Lu , Bui Nam , Ganjoo Kristen 
Published: December 2024

AbstractSoft tissue and bone sarcomas are a heterogenous group of uncommon mesenchymal tumors with high unmet needs for novel therapeutic and diagnostic strategies. Despite many challenges that persist, innovative therapeutics are emerging. Here we provide a review of the studies presented at the 2024 American Society of Clinical Oncology annual meeting that were focused on sarcoma. There were many outstanding studies that were reported at the meeting. We begin by discussing the clinical studies on soft tissue sarcoma (STS) that included multiple histology subtypes, followed by highlighting developments in cellular therapy, before delving into specific STS histologic subtypes followed by a section covering the studies that were focused on predictive biomarkers. We conclude by discussing the studies in bone sarcomas. Some of the studies discussed here are likely to be practice changing. Some of the early-phase clinical trials have shown encouraging results.
Re-analysis of data from cluster randomised trials to explore the impact of model choice on estimates of odds ratios: study protocol
Authors: Hemming Karla , Thompson Jacqueline Y. , Taljaard Monica , Watson Samuel I. , Kasza Jessica , Thompson Jennifer A. , Kahan Brennan C. , Copas Andrew J. 
Published: December 2024

Abstract
Background
There are numerous approaches available to analyse data from cluster randomised trials. These include cluster-level summary methods and individual-level methods accounting for clustering, such as generalised estimating equations and generalised linear mixed models. There has been much methodological work showing that estimates of treatment effects can vary depending on the choice of approach, particularly when estimating odds ratios, essentially because the different approaches target different estimands.

Methods
In this manuscript, we describe the protocol for a planned re-analysis of data from a large number of cluster randomised trials. Our main objective is to examine empirically whether and how odds ratios estimated using different approaches (for both primary and secondary binary outcomes) vary in cluster randomised trials. We describe the methods that will be used to identify the datasets for inclusion and how they will be analysed and reported.

Discussion
There have been a number of small comparisons of empirical differences between the different approaches to analysis for CRTs. The systematic approach outlined in this protocol will allow a much deeper understanding of when there are important choices around the model approach and in which settings. This will be of importance given the heightened awareness of the importance of estimands and the specification of statistical analysis plans.
Scoping review of fidelity strategies used in behaviour change trials delivered in primary dental care settings
Authors: Lowers V. , Kirby R. , Young B. , Harris R.V. 
Published: December 2024

Abstract
Background
Primary dental care settings are strategically important locations where randomised controlled trials (RCTs) of behaviour change interventions (BCIs) can be tested to tackle oral diseases. Findings have so far produced equivocal results. Improving treatment fidelity is posed as a mechanism to improve scientific rigour, consistency and implementation of BCIs. The National Institutes of Health Behaviour Change Consortium (NIH BCC) developed a tool to assess and evaluate treatment fidelity in health behaviour change interventions, which has yet to be applied to the primary dental care BCI literature.

Method
We conducted a scoping review of RCTs delivered in primary dental care by dental team members (in real-world settings) between 1980 and 2023. Eligible studies were coded using the NIH BCC checklist to determine the presence of reported fidelity strategies across domains: design, training, delivery, receipt and enactment.

Results
We included 34 eligible articles, reporting 21 RCTs. Fidelity reporting variations were found both between and within NIH BCC domains: strategy reporting ranged from 9.5 to 85.7% in design, 9.5 to 57.1% in training, 0 to 66.7% in delivery, 14.3 to 36.8% in receipt and 13.3 to 33.3% in enactment. The most reported domain was design (M = 0.45), and the least reported domain was delivery (M = 0.21). Only one study reported over 50% of the recommended strategies in every domain.

Conclusions
This review revealed inconsistencies in fidelity reporting with no evidence that fidelity guidelines or frameworks were being used within primary dental care trials. This has highlighted issues with interpretability, reliability and reproducibility of research findings. Recommendations are proposed to assist primary dental care trialists with embedding fidelity strategies into future research.
Medications for opioid use disorders among incarcerated persons and those in the community supervision setting: exploration of implementation issues with key stakeholders
Authors: Kang Augustine W. , Bailey Amelia , Surace Anthony , Stein Lynda , Rohsenow Damaris , Martin Rosemarie A. 
Published: December 2024

Abstract
Introduction
Receipt of medications for opioid use disorder (MOUD) critically reduces opioid-related mortality during the post-incarceration period. Optimal provision of this care to individuals on community supervision (i.e., probation) requires an understanding of this unique and complex system at the local level.

Methods
We conducted in-depth individual interviews with key treatment providers and probation staff (n = 10) involved with the provision of MOUD to individuals on community supervision in the Northeast. Interviews explored perspectives on the provision of MOUD and support services during the community supervision period. Thematic analysis was conducted to describe inductive and deductive codes, subcodes, and themes.

Results
Stakeholders shared diverse attitudes about the benefits and drawbacks of MOUD utilization. The provision of MOUD during the community supervision period was perceived to be influenced by both treatment and probation organizational characteristics, including the structures and values of the agencies. As such, the specific context of the community supervision setting facilitated and impeded MOUD delivery. Persistent challenges to enhancing MOUD delivery to this population remain including widespread MOUD stigma, inter-agency communication issues, and structural barriers to healthcare (i.e., transportation, finances).

Conclusions
There are opportunities to enhance access to evidence-based OUD treatment for persons on community supervision by engaging probation agencies and community treatment staff in systems change.
Biomechanical stability of magnesium plate and screw fixation systems in LeFort I osteotomy: a three-dimensional finite element analysis
Authors: Cho Su-Min , Yang Byoung-Eun , Kim Won-Hyeon , Park Sang-Yoon , On Sung-Woon , Lee Jong-Ho , Byun Soo-Hwan 
Published: December 2024

Abstract
Background
Titanium (Ti–6Al–4 V) is used for fixation in LeFort I osteotomy, a procedure for treating midface deformities. This study assessed the biomechanical stabilities of two Mg alloys (WE43 and ZK60) as biodegradable alternatives and compared them against Ti using finite element analyses. The LeFort I osteotomy procedure was simulated, and various plate and screw configurations were tested. The maximum principal and peak von Mises stresses in the metal plates and bone screws were measured under four load conditions, and the stability was evaluated.

Results
The holes in the Mg screws, as compared with the Ti counterparts, exhibited higher and lower stress levels in the cortical and cancellous bones, respectively. The Mg screws also exhibited a higher fracture risk. The ZK60 plate, as compared with the Ti and WE43 plates, exhibited a lower fracture risk under all load conditions. ZK60 exhibited higher biomechanical stability in terms of maintaining the gap between osteotomy surfaces and lower fracture risk; the osteotomy surfaces with Ti im-plants underwent bone impaction, resulting in gap closure.

Conclusions
Although the Mg implants exhibited better stress distribution, their screw strength requires improvement. Appropriate improvements can promote the use of Mg alloys in bone fixation applications.
Associations of Habitual Skeletal Loading with Bone Changes During the Menopausal Transition: A Follow-up Study
Authors: Suominen Tuuli H. , Rantalainen Timo , Hyvärinen Matti , Kujala Urho M. , Aukee Pauliina , Tammelin Tuija H. , Laakkonen Eija K. , Sipilä Sarianna 
Published: December 2024

ABSTRACT

Purpose
While weight-bearing physical activity (PA) benefits bone health, it remains unclear whether PA can counteract hormone-driven menopausal bone deterioration. This secondary analysis of a population-based prospective follow-up study examined changes in bone health indicators around menopause and evaluated whether accelerometer-measured habitual skeletal loading is associated with these changes.

Methods
A total of 189 initially perimenopausal women without estrogen therapy (mean age 52 [SD 2] years) were followed until they became postmenopausal (mean follow-up time 15 [9] months). Femoral neck bone mineral density (FN BMD) and bone mineral content (BMC) were measured with dual x-ray absorptiometry (DXA). Femoral and tibial shaft volumetric BMD (vBMD), cross-sectional geometry, and stress-strain index (SSI) were assessed using quantitative computed tomography (QCT) in a subset of 61 women. Habitual skeletal loads (mean daily osteogenic index [OI] and low, medium, and high-intensity impact counts) were evaluated with multiple-day free-living accelerometry records. Longitudinal associations of habitual skeletal loads and bone outcomes were analyzed with GEE models.

Results
Consistent decreases were observed in FN BMD and BMC, and femoral and tibial shaft vBMD and SSI (p < 0.001) over the follow-up. Slight decreases over the follow-up were also observed in OI and medium impacts in the full sample, and medium and high impact counts in the subsample (p < 0.05). Medium impacts were associated with tibial shaft vBMD and SSI (β = 0.204, 95% CI [0.018, 0.391] and β = 0.077 95% CI [0.000, 0.154], respectively). High impacts were associated with femoral shaft vBMD (β = 0.186 95% CI [0.006, 0.366]. However, no association was observed between habitual skeletal loads and changes in bone characteristics over the follow-up.

Conclusions
We observed a rather uniform skeletal response to the menopausal transition at all measured bone sites. Positive associations were found between medium and high-intensity impacts and bone characteristics at the femoral and tibial shafts. However, habitual skeletal loading did not seem to counteract bone deterioration during the menopausal transition.
A Warm Environment Reduces Exogenous Glucose Oxidation and Endurance Performance during Cycling with Facing Airflow
Authors: Reynolds Kirsty M. , Funnell Mark P. , Collins Adam J. , Mears Stephen A. , Pugh Jamie N. , James Lewis J. 
Published: December 2024

ABSTRACT

Exercise in warm environments increases thermal/cardiovascular strain and decreases gastrointestinal (GI) integrity and endurance performance. However, laboratory-based studies have provided little to/no facing airflow, potentially exacerbating these effects, particularly for cycling, where convective cooling may be a major contributor to thermal balance.

Purpose
This study investigated the effect of cycling in a warm vs temperate environment with sufficient facing airflow on exogenous glucose use, performance, and GI responses.

Methods
Ten trained male cyclists/triathletes (36 ± 6 y; 55 ± 6 mL/kg/min) completed V̇O2peak and familiarisation trials, and two experimental trials in 19 °C (TEMP) and 32 °C (WARM). Experimental trials involved 2 h cycling at ~50% Wpeak (preload) and an ~15 min time trial (TT) with fan-provided airflow covering the cyclist (preload: ~29 km/h, TT: ~35 km/h). A glucose drink containing [U-13C]-glucose was consumed every 20 min during the preload (72 g/h).

Results
Average 40-120 min (TEMP 0.56 ± 0.13 g/min; WARM 0.48 ± 0.12 g/min; 15%; P = 0.015) and peak (TEMP 0.79 ± 0.18 g/min; WARM 0.68 ± 0.14 g/min; 14%; P = 0.008) exogenous glucose oxidation were reduced in WARM. TT performance was 15% slower in WARM (TEMP 819 ± 47 s; WARM 961 ± 130 s; P = 0.002). GI temperature (P = 0.007), heart rate (P < 0.001), and RPE (P = 0.046) were greater during WARM. GI comfort (P = 0.659) and Intestinal Fatty Acid Binding Protein (IFABP) (P = 0.094) were not different between trials.

Conclusions
These data demonstrate that ability to use glucose provided in drinks was impaired during prolonged cycling in WARM. WARM ambient conditions impaired laboratory-based cycling performance, even with facing airflow approximating outdoor conditions, likely via impairments of thermoregulatory, cardiovascular, and metabolic function.