bluuebunny/crossref_metadata_2025_split huggingface dataset:
Confounding-adjustment methods for the causal difference in medians
Authors: Shepherd Daisy A. , Baer Benjamin R. , Moreno-Betancur Margarita 
Published: December 2023

Abstract
Background
With continuous outcomes, the average causal effect is typically defined using a contrast of expected potential outcomes. However, in the presence of skewed outcome data, the expectation (population mean) may no longer be meaningful. In practice the typical approach is to continue defining the estimand this way or transform the outcome to obtain a more symmetric distribution, although neither approach may be entirely satisfactory. Alternatively the causal effect can be redefined as a contrast of median potential outcomes, yet discussion of confounding-adjustment methods to estimate the causal difference in medians is limited. In this study we described and compared confounding-adjustment methods to address this gap.

Methods
The methods considered were multivariable quantile regression, an inverse probability weighted (IPW) estimator, weighted quantile regression (another form of IPW) and two little-known implementations of g-computation for this problem. Methods were evaluated within a simulation study under varying degrees of skewness in the outcome and applied to an empirical study using data from the Longitudinal Study of Australian Children.

Results
Simulation results indicated the IPW estimator, weighted quantile regression and g-computation implementations minimised bias across all settings when the relevant models were correctly specified, with g-computation additionally minimising the variance. Multivariable quantile regression, which relies on a constant-effect assumption, consistently yielded biased results. Application to the empirical study illustrated the practical value of these methods.

Conclusion
The presented methods provide appealing avenues for estimating the causal difference in medians.
A novel patient-derived immortalised cell line of myxofibrosarcoma: a tool for preclinical drugs testing and the generation of near-patient models
Authors: Guerrieri Ania Naila , Bellotti Chiara , Penzo Marianna , Columbaro Marta , Pannella Micaela , De Vita Alessandro , Gambarotti Marco , Mercatali Laura , Laranga Roberta , Dozza Barbara , Vanni Silvia , Corsini Serena , Frisoni Tommaso , Miserocchi Giacomo , Ibrahim Toni , Lucarelli Enrico 
Published: December 2023

Abstract
Background
Myxofibrosarcoma is a rare malignant soft tissue sarcoma characterised by multiple local recurrence and can become of higher grade with each recurrence. Consequently, myxofibrosarcoma represents a burden for patients, a challenge for clinicians, and an interesting disease to study tumour progression. Currently, few myxofibrosarcoma preclinical models are available.

Methods
In this paper, we present a spontaneously immortalised myxofibrosarcoma patient-derived cell line (MF-R 3). We performed phenotypic characterization through multiple biological assays and analyses: proliferation, clonogenic potential, anchorage-independent growth and colony formation, migration, invasion, AgNOR staining, and ultrastructural evaluation.

Results
MF-R 3 cells match morphologic and phenotypic characteristics of the original tumour as 2D cultures, 3D aggregates, and on the chorioallantoic membrane of chick embryos. Overall results show a clear neoplastic potential of this cell line. Finally, we tested MF-R 3 sensitivity to anthracyclines in 2D and 3D conditions finding a good response to these drugs.

Conclusions
In conclusion, we established a novel patient-derived myxofibrosarcoma cell line that, together with the few others available, could serve as an important model for studying the molecular pathogenesis of myxofibrosarcoma and for testing new drugs and therapeutic strategies in diverse experimental settings.
Complications during elective cataract surgery: did the COVID-19 lockdown affect outcomes of ophthalmic surgery?
Authors: Hulsmans Nicky H. , Nuijts Rudy M. M. A. , Zegers Richard H. C. 
Published: December 2023

Abstract
Purpose
One of the many consequences of the COVID-19 pandemic was a worldwide lockdown of ophthalmic surgery procedures for several months in 2020. The present study aims to answer the following question: does an intermission of cataract surgery for two months cause an increase in complication rates?

Methods
In this retrospective clinical chart review, data was taken from Dutch cataract complication registration database that contains pre-, intra- and postoperative information of patients that underwent cataract surgery in the Netherlands. The amount as well as type of complications were extracted before and after the eight weeks surgical intermission period (SIP): six weeks before (SIP-6) and six weeks after this period (SIP+6) for the years 2016–2020.

Results
A significant decrease in complication rates was found between SIP-6 and SIP+6 in 2020. When SIP+6 2020 is compared to SIP+6 2019, a significant reduction is found. Overall, a downward trend in complication rates was observed in the period 2016–2020.

Conclusion
A two-months intermission of performing elective cataract surgery does not cause an increase in complications. In contrast, we observe a reduction of postoperative complications. This implicates that refraining from cataract surgery for two months might not compromise operative skills. The possible downward trend over the years can be partially explained by improved training, education and equipment, as well as an increased use of intracameral antibiotics during operation. Possible explanations for the reduction of complications after lockdown could be decreased time pressure as a consequence of a reduced number of operations at the restart of surgeries, and heightened awareness and cautiousness when resuming the operations.
Prevalence of internet addiction and anxiety, and factors associated with the high level of anxiety among adolescents in Hanoi, Vietnam during the COVID-19 pandemic
Authors: Dien Tran Minh , Chi Pham Thi Lan , Duy Pham Quang , Anh Le Ha , Ngan Nguyen Thi Kim , Hoang Lan Vu Thi 
Published: December 2023

Abstract
Background
The COVID-19 pandemic and the resulting isolation measures created an increase in the usage of smart devices and internet among adolescents. This study aims to estimate the prevalence of internet addiction, the prevalence of high level of anxiety as well as to examine factors associated with the high level of anxiety among adolescents in Hanoi, Vietnam during the COVID-19 pandemic.

Method
Data was collected using respondent-driven sampling and Google online survey forms from a sample of 5,325 school students aged 11–17 in Hanoi between October and December 2021. A short scale consisting of 5 items was used to measure internet addiction and the GAD-7 was used to measure adolescent anxiety level.

Results
The findings revealed that 22.8% and 7.32% of adolescents experienced moderate and severe anxiety. About 32.7% of the study sample exhibited at least three internet addiction indicators. Logistic regression analysis identified significant predictors for high levels of adolescent anxiety. Being female, family experiencing economic difficulties, and exposure to domestic violence were associated with higher risk of anxiety disorder (OR 1.78, 1.45, and 2.89, respectively). Both average daily online time and internet addiction demonstrated gradient association with high level of anxiety.

Conclusion
The prevalence of internet addiction and high level of anxiety were high among adolescents in Hanoi, Vietnam during the COVID-19 pandemic. The study highlights the importance of implementing measures at the family and school levels to promote a balanced and healthy approach to smart device use among adolescents.
A longitudinal analysis of the fluctuation of food stores in Belo Horizonte, Minas Gerais, Brazil
Authors: de Freitas Patrícia Pinheiro , Lopes Mariana Souza , Costa Bruna Vieira de Lima , Sales Denise Marques , de Menezes Mariana Carvalho , Jaime Patrícia Constante , Lopes Aline Cristine Souza 
Published: December 2023

Abstract
Background
Changes in food environments have the potential to affect consumption, nutritional status, and health, and understanding these changes is of utmost importance. This study, therefore, aimed to examine the fluctuation of food stores that sell fruits and vegetables over five years in the health promotion service area of Primary Health Care (PHC) in Belo Horizonte, Minas Gerais, Brazil.

Methods
This was an ecological study that used data from a food environment audit conducted in the realm of Brazilian PHC. Buffers of 1 mile (equivalent to 1600 m) were created around health promotion services to define food environments. All food stores and open-air food markets that sold fruits and vegetables (FV) within this buffer area were considered eligible. The data collection was performed during two periods: the baseline, in 2013, and after five years, in 2018. This study compares the fluctuation by the type of stores and according to the health vulnerability index (HVI).

Results
After 5 years, 35.2% of the stores were stable; 154 stores were closed, and 155 were opened. The stability was greater in low-vulnerability areas, and the fluctuation differed by type of store only for areas with high vulnerability. The number of supermarket decreased in high HVI territories; and local stores, showed greater stability when compared to specialized FV markets.

Conclusions
The differences in store fluctuations according to the vulnerability of areas demonstrate the importance of food supply policies considering the local characteristics to reduce inequities of access to healthy foods.
Femoral nerve palsy as a complication due to COVID-19 coagulopathy and iliopsoas muscle hematoma – case report
Authors: Tutak Sławomir , Bartosz Paweł , Burda Bartosz , Sztwiertnia Paweł , Białecki Jerzy 
Published: December 2023

Abstract
Background
COVID-19 (Coronavirus disease 2019) pandemic is the main medical problem around the world from the end of 2019. We found until now many symptoms of this disease, but one of the most problematic was thrombosis. Wide recommendation on COVID-19 treatment was pharmacological thromboprophylaxis. In some papers we found that clinicians face the problem of bleeding in those patients. Is still unknown that coronavirus could led to the coagulopathy.

Case presentation
We described case report of patient who with COVID-19 disease present femoral nerve palsy caused by the iliopsoas hematoma. There were no deviations in coaguology parameters, patient got standard thromboprophylaxis, besides above probably COVID-19 was risk factor of hematoma formation. Non-operative treatment was applied, thrombophylaxis was discontinued. In the follow up in the radiological exam we saw reduction of the haematoma and patient report decrease of symptoms.

Conclusions
We should assess individually patient with COVID-19 according to thrombosis risk factors. Probably we should be more careful in ordering thrombophylaxis medications in COVID-19 patients.
Anatomic femoral tunnel position in medial patellofemoral ligament reconstruction: anterior versus posterior
Authors: Yoon Kyoung Ho , Park Cheol Hee , Hwang Sung Hyun , Baek Hyunjae , Lee Hee Sung 
Published: December 2023

Abstract
Background
This study aimed to compare the clinical and radiological outcomes of medial patellofemoral ligament reconstruction (MPFLR) between anatomic femoral tunnel positions at anterior and posterior footprints.

Methods
Fifty-seven patients who underwent MPFLR for patellofemoral instability with anterior or posterior femoral tunnels between 2014 and 2021 with at least 2 years of follow-up were retrospectively analyzed. Based on postoperative images, the femoral tunnel positions anterior to the line connecting the adductor tubercle and medial epicondyle were assigned to the anterior group, group A, and those posterior to the line to the posterior group, group P. Thirty-two patients were included in group A (mean age, 22.4 ± 8.8 years), and another 25 patients were included in group P (mean age, 21.1 ± 6.1 years). The International Knee Documentation Committee (IKDC) subjective score, Lysholm score, Tegner activity score, Kujala score, and complications were evaluated. Radiologically, the Caton–Deschamps index (CDI), patellar tilt angle, and patellofemoral osteoarthritis (PFOA) using the Kellgren–Lawrence (KL) scale were evaluated. The patellofemoral cartilage status according to the International Cartilage Repair Society (ICRS) grade, bone contusion, femoral tunnel enlargement, and MPFL graft signal intensity were also evaluated.

Results
All clinical scores significantly improved in both groups (p < 0.01). No differences were noted between the two groups in terms of their preoperative demographic data, postoperative clinical scores (IKDC, Lysholm, Tegner, and Kujala), complications, or radiological findings (CDI, patellar tilt angle, PFOA, bone contusion, femoral tunnel enlargement, and graft signal intensity). The ICRS grade for the medial facet of the patella progressed in group A (30%, p = 0.02) but not in group P (18%, p = n.s.). Additionally, no significant differences were observed in the other compartments of the patellofemoral joint.

Conclusions
The clinical outcomes were significantly improved in both groups; however, MPFLR with anterior femoral tunnel position had worse cartilage status on the medial facet of the patella than the posterior femoral tunnel position.

Level of evidence
Level III.
Increased prevalence of thyroid dysfunction in Tehran – HAMRAH study
Authors: Ghaemmaghami Zahra , Firoozbakhsh Parisa , Gholami Delara , Khodabandelu Sajad , Baay Mohammadreza , Alemzadeh-Ansari Mohammad Javad , Mohebbi Bahram , Hosseini Zahra , Boudagh Shabnam , Pouraliakbar Hamidreza , Pasebani Yeganeh , Rafati Ali , Khalilpour Ehsan , Khalili Yasaman , Arabian Maedeh , Maleki Majid , Bakhshandeh Hooman , Sadeghipour Parham 
Published: December 2023

Abstract
Background
The aim of the current study is to assess the prevalence of different categories of thyroid dysfunction and their associated risk factors among the modern urban population of Tehran, the capital of Iran.

Methods
The present investigation is a sub-study of the HAMRAH study, a population-based prospective study designed to assess the prevalence of traditional cardiovascular risk factors and their changes through a 10-year follow-up. 2228 (61% female) adults aged between 30 and 75 years old and with no overt cardiovascular diseases were selected through a multistage cluster randomized sampling. Blood levels of thyroid-stimulating hormone (TSH), thyroxin (T4), and triiodothyronine (T3) were measured with the aim of assessing the prevalence of abnormal thyroid function status among the modern urban Iranian population, and in order to report the total prevalence of participants with clinical hypo- or hyperthyroidism, the number of individuals taking thyroid-related drugs were added to the ones with overt thyroid dysfunction. A subgroup analysis was also performed to determine the associated risk factors of thyroid dysfunction.

Results
The prevalence of thyroid dysfunction among the total population was 7% (95%CI: 5.9 − 8%) and 0.4% (95% CI: 0.1 − 0.6%) for subclinical and overt hypothyroidism, and 1.6% (95% CI: 1 − 2%) and 0.2% (95% CI: 0 − 0.3%) for subclinical and overt hyperthyroidism, respectively. Clinical thyroid dysfunction was detected in 10.3% of the study population (9.4% had clinical hypo- and 0.9% had clinical hyperthyroidism). In the subgroup analysis, thyroid dysfunction was significantly more prevalent among the female participants (P-value = 0.029).

Conclusions
In the current study, the prevalence of different categories of abnormal thyroid status, and also the rate of clinical hypo- and hyperthyroidism was assessed using the data collected from the first phase of the HAMRAH Study. In this study, we detected a higher prevalence of clinical and subclinical hypothyroidism among the Iranian population compared to the previous studies.
The effect of root canal treatment and post-crown restorations on stress distribution in teeth with periapical periodontitis: a finite element analysis
Authors: Chen ShuoMin , Hong XinHua , Ye ZhangYan , Wu MengHan , Chen Liang , Wu LinMei , Wang Yilin , Chen YuGe , Wu JiaYu , Wang Jun , Zhang QinHui , Wu YuTian , Sun XiaoYu , Ding Xi , Huang ShengBin , Zhao ShuFan 
Published: December 2023

Abstract
Aim
To evaluate the effects of root canal treatment (RCT) and post-crown restoration on stress distribution in teeth with periapical bone defects using finite element analysis.

Methodology
Finite element models of mandibular second premolars and those with periapical bone defects (spherical defects with diameters of 5, 10, 15, and 20 mm) were created using digital model design software. The corresponding RCT and post-crown restoration models were constructed based on the different sizes of periapical bone defect models. The von Mises stress and tooth displacement distributions were comprehensively analyzed in each model.

Results
Overall analysis of the models: RCT significantly increased the maximum von Mises stresses in teeth with periapical bone defects, while post-crown restoration greatly reduced the maximum von Mises stresses. RCT and post-crown restoration slightly reduced tooth displacement in the affected tooth. Internal analysis of tooth: RCT dramatically increased the maximum von Mises stress in all regions of the tooth, with the most pronounced increase in the coronal surface region. The post-crown restoration balances the internal stresses of the tooth and is most effective in periapical bone defect − 20-mm model. RCT and post-crown restoration slightly reduced the tooth displacement in all regions of the affected tooth.

Conclusions
Root canal treatment seemed not to improve the biomechanical state of teeth with periapical bone defects. In contrast, post-crown restoration might effectively balance the stress concentrations caused by periapical bone defects, particularly extensive ones.
Labor markets for health supply chain management in Rwanda: a qualitative study of stakeholder perspectives
Authors: Meier Erin , Brown Andrew N. , McHenry Bridget , Buki Inès K. Gege , Egharevba Michael , Kabatende Joseph 
Published: December 2023

Abstract
Background
Effective supply chains for health products require an adequate, skilled workforce for supply chain management (SCM). Rwanda faces challenges in human resources for SCM, including limited capacity for SCM at different levels. Understanding of the factors influencing the supply of and demand for SCM professionals in Rwanda is necessary to ensure the labor market contains an adequate workforce. This study identifies the perspectives of key stakeholders in the supply chain management sector about the factors influencing the supply of and demand for SCM professionals.

Methods
Data were collected in semi-structured group and one-on-one interviews with 39 key stakeholders involved in the supply chain management labor market between March and April 2019. Interviewees were categorized according to their role in the labor market as system actors, functional actors involved in the supply of SCM workers, and functional actors involved in the demand for SCM workers. Interviewees were asked open-ended questions about factors influencing the demand for and the supply of SCM workers, and recommendations for improvement. Interviews were analyzed thematically. One validation focus group was held and the results were also reviewed by the Ministry of Health in Rwanda.

Results
Stakeholders agreed that skills mismatch between SCM workers’ skills and the competencies jobs require impacts the supply of workers. A lack of career structure for SCM, lack of professional definitions for health supply chain management, and SCM curricula that do not match the needs of the workplace contribute to this gap. The demand for SCM professionals is poorly defined in terms of the numbers of professionals needed and the skills workers require. Financial limitations hinder demand for health SCM professionals.

Conclusions
This study adds to the understanding of factors influencing the SCM labor market in Rwanda by documenting perspectives from government ministries, professional organizations, universities, and employers from SCM organizations. Improving the SCM labor market in Rwanda and the availability of the skilled cadres required for the effective management of health supply chains in Rwanda requires a coordinated effort by the Ministry of Health in Rwanda, private SCM companies, professional associations, education sector, and policy makers.
Single-cell histone chaperones patterns guide intercellular communication of tumor microenvironment that contribute to breast cancer metastases
Authors: Xie Jindong , Deng Wei , Deng Xinpei , Liang Jie-Ying , Tang Yuhui , Huang Jun , Tang Hailin , Zou Yutian , Zhou Huamao , Xie Xiaoming 
Published: December 2023

Abstract
Background
Histone chaperones (HCs) are crucial for governing genome stability and gene expression in multiple cancers. However, the functioning of HCs in the tumor microenvironment (TME) is still not clearly understood.

Methods
Self-tested single-cell RNA-seq data derived from 6 breast cancer (BC) patients with brain and liver metastases were reanalyzed by nonnegative matrix factorization (NMF) algorithm for 36 HCs. TME subclusters were observed with BC and immunotherapy public cohorts to assess their prognosis and immune response. The biological effect of HSPA8, one of the HCs, was verified by transwell assay and wound-healing assays.

Results
Cells including fibroblasts, macrophages, B cells, and T cells, were classified into various subclusters based on marker genes. Additionally, it showed that HCs might be strongly associated with biological and clinical features of BC metastases, along with the pseudotime trajectory of each TME cell type. Besides, the results of bulk-seq analysis revealed that TME cell subclusters mediated by HCs distinguished significant prognostic value for BC patients and were relevant to patients’ immunotherapy responses, especially for B cells and macrophages. In particular, CellChat analysis exhibited that HCs-related TME cell subclusters revealed extensive and diverse interactions with malignant cells. Finally, transwell and wound-healing assays exhibited that HSPA8 deficiency inhibited BC cell migration and invasion.

Conclusions
Collectively, our study first dissected HCs-guided intercellular communication of TME that contribute to BC metastases.