bluuebunny/crossref_metadata_2025_split huggingface dataset:
Defensive tail displays in dice snakes (Natrix tessellata) are influenced by colour morph and sex
Authors: Bjelica Vukašin , Milićević Mihailo , Lazić Ana , Ðoković Katarina , Golubović Ana 
Published: April 2023

Abstract
Defensive tail displays are common in squamates; however, the factors underlying the occurrence of such displays are rarely studied. We tested 268 adult dice snakes (Natrix tessellata) in a population with three colour morphs, exploring the effects of morph, sex, body size, tail length and temperature on the occurrence of tail waving in two stages of the antipredator response. When captured, the blotched morph tail waved the most, followed by melanistic then green morphs. Males displayed tail waving during post-capture immobility more often than females, possibly due to sexual dimorphism in tail length and/or fleeing speed. The occurrence of tail waving was low in response to a researcher as a “predator” (∼2.6% on capture; ∼6.8% during immobility), however the occurrence of this behaviour during encounters with real predators might be different. Large sample size is crucial for revealing fine scale effects on rare behaviours such as tail waving.
Socioeconomic Status and Cochlear Implant Usage: A Datalogging Study
Authors: Awad Daniel R. , Castaño Johnathan E. , McCoy Jennifer L. , Levy Rena , Oberlies Nicholas R. , Shaffer Amber D. , Kitsko Dennis J. , Jabbour Noel , Chi David H. 
Published: April 2023

Objective: To evaluate the associations between proxy measures of socioeconomic status (SES) and usage of cochlear implants. Study Design: Retrospective case series. Methods: Usage outcomes were measured among patients with a cochlear implant and data logging at a tertiary care children’s hospital between 2002 and 2017. Time per day with cochlear implant turned on, coil off, and listening to speech in noise and speech in quiet were extracted from audiology records, averaging right and left ear usage for those with bilateral implants. Associations between cochlear implant usage and demographic factors such as insurance type and median household income for zip code were assessed. Results: There were 142 total patients; 74 had bilateral usage data. Mean on air time was 10.76 hours (SD: 4.4). Those with private insurance had 1.2 hour more on air time/day ( P = .047) and 0.9 hour more quiet time/day ( P = .011) compared to those with public insurance. Younger age at last visit was associated with increased speech in quiet ( B = −.08; 95% CI: −0.12-[−0.05], P < .001) and coil off ( B = −0.06; 95% CI: −0.11-[−0.02], P = .006). Younger age at implant was associated with longer duration since last data logging visit ( B = −10.46; 95% CI: −18.41-[−2.51], P = .010), more daily use (on air; B = −0.23; 95% CI: −0.43-[−0.03], P = .026), and increased time spent listening to speech in noise ( B = −0.07; 95% CI: −0.14-[−0.01], P = .024). No other significant associations between datalogging output and each proxy SES factor were found. Conclusions: Lack of private insurance and older age at implantation decreased access to binaural hearing for children and young adults with cochlear implants.
The mediating effect of family health on the relationship between health literacy and mental health: A national cross-sectional survey in China
Authors: Wang Dan , Sun Xinying , He Feiying , Liu Chenxi , Wu Yibo 
Published: April 2023

Background: Mental health problems significantly affect people’s well-being and result in a huge health burden. Health literacy and family health are critical to reducing people’s mental health problems. However, limited studies have addressed their complex interaction. Thus, this study aims to elucidate the mediating effect of family health on the relationship between health literacy and mental health. Methods: A national cross-sectional study based on multistage random sampling was conducted from July 10 to Sep 15, 2021, in China. Information about the public’s health literacy, family health, and the level of three common mental health problems (depression, anxiety, and stress) was collected. A structural equation model (SEM) was applied to explore the mediating effect of family health on the relationship between health literacy and mental health. Results: A total of 11,031 participants were investigated. Approximately 19.93 and 13.57% of participants experienced moderate or severe depressive and anxiety symptoms, respectively. The SEM showed that health literacy was directly associated with mental health, with higher health literacy resulting in lower levels of depression (coefficient: −0.018, p = .049), anxiety (coefficient: −0.040, p < .001), and stress (coefficient: −0.105, p < .001). In addition, family health played a significant mediating effect ( p < .001) between health literacy and mental health, contributing to 47.5, 70.9, and 85.1% of the total effect of health literacy on personal stress, anxiety, and depression, respectively. Conclusions: This study revealed that the improvement of health literacy is directly and indirectly associated with less likelihood of people’s mental health problems via family health. Thus, future mental health interventions should be integrated and targeted both at individual level and the family level.
Interpreting digital governance at the municipal level: Evidence from smart city projects in Belgium
Authors: Esposito Giovanni , Terlizzi Andrea , Guarino Massimo , Crutzen Nathalie 
Published: April 2023

This article adopts an interpretive approach to investigate how local policy-makers portray and justify their own visions of digital governance initiatives at the municipal level. Our investigation focuses on smart city projects submitted by various Belgian municipalities in the framework of the ‘Intelligent Territory’ call for proposals initiated in 2019 by the Walloon Region. We use Boltanski and Thévenot’s theory of orders of worth and combine quantitative and qualitative content analysis to categorize the different justifications elaborated by municipal governments. The empirical results point to the polysemic nature of the smart city concept and highlight the diversity of opportunities offered by smart city policies according to municipal policy-makers. Overall, our study contributes to the understanding of the varieties of interpretations underpinning the construction of digital governance initiatives. It therefore supports the argument according to which there is no one-size-fits-all approach to smart city policies as local policy-makers may attribute different meanings to them and may formulate place-based ICTs solutions to what they perceive as the most pressing problems of their territories. Points for practitioners Smart city projects can be used by governing authorities as instruments to achieve a variety of policy goals Examples of policy goals are to boost local economic development, to improve the effectiveness of municipal service provision, to strengthen social bonds across local community members, to promote the ecological preservation of urban environments and to improve the collaboration between citizens and public administrations Local governments can adaptively use smart technologies as instruments to overcome multiple place-based environmental, social and economic problems Local governments should frame smart urban technologies as means to solve different societal problems and achieve different policy goals – rather than an end per se
Baicalin Magnesium Salt Exerts an Antitumor Effect in HepG2 Hepatoma Cells
Authors: Dongshuai Xia , Yong You , Yaxian Gao , Shuo Wang , Yachun Guo , Tao Jiang , Cuizhe Liu , Hongru Song 
Published: April 2023

Background Scutellaria baicalensis is an important medicinal plant used in China. Several compounds have been extracted from S. baicalensis using modern techniques. Baicalin, an active ingredient of S. baicalensis, is widely used clinically. However, its clinical use is limited owing to poor oral bioavailability and intestinal absorption. Objectives To evaluate the anti-tumor effect of baicalin magnesium salt (BA-MG, a novel magnesium salt form of baicalin with superior water solubility) on the human hepatocellular carcinoma cell line, HepG2. Materials and Methods Seven groups were established, including three dosages of BA-MG (200, 250, and 300 µg/mL), baicalin, dimethyl sulfoxide (DMSO) (negative control), magnesium sulfate (negative control), and control groups. Cell proliferation was determined using the cell counting kit-8 (CCK-8) assay. Cell cycle and apoptosis were detected by flow cytometry. Cell migration was determined using a cell scratch assay. Protein expression was determined using western blotting. Results In vitro, BA-MG inhibited proliferation, reduced cell cloning and migration abilities, induced cell cycle arrest, and promoted apoptosis of HepG2 cells (all p < 0.05). The effects of baicalin and BA-MG on proliferation and migration, cell cycle, and apoptosis may be attributed to decreasing the expression of Bcl-2, ROCK-1, proliferating cell nuclear antigen (PCNA), and cyclin E, as well as increasing the expression of Bax and caspase-9. The efficacy of BA-MG is superior to that of baicalin at the same dose. Conclusion BA-MG showed superior effects on inhibiting cell proliferation and inducing apoptosis in liver cancer cells.
China’s Smoke-free Policies in Public Place and the Smoking Cessation Status of Smokers
Authors: Wen Jing , Shang Wenlu , Ding Yong , Qiao Hui , Li Jiangping 
Published: April 2023

INTRODUCTION Smoking remains a major health risk factor and China is the world’s largest consumer of tobacco. Smoke-free policies in public places are a powerful weapon in tobacco control. Therefore, the aim of this study was to assess the association between smoke-free policies in public places and smoking cessation among smokers in China from 2012 to 2020. METHODS In this study, we assessed the impact of smoke-free public places policies on smoking cessation situation among smokers aged 16 years and older. We do this by conducting a difference-in-differences analysis using data from the China Family Panel Study (CFPS) 2012-2020. FINDINGS By 2020, about 60.2% of the cities were covered by partial smoke-free policies and about 38.5% by comprehensive smoke-free policies. Based on the results of the study, we found that the medium-term effect model (Model 2, 2012:2016; Model 3, 2012:2018) of the impact of partial smoke-free policies on smoking cessation was not statistically significant using 2012 as the study baseline; the short-term effect model (Model 1; 2012:2014; P< .01) and the long-term effect model (Model 4; 2012:2020; P< .05) were statistically significant; the effect of a comprehensive smoke-free policy on smoking cessation (Model 5; 2012:2020; P<.05) was statistically significant. CONCLUSION China’s existing comprehensive smoke-free policies have had a modest impact on smoking cessation among the smoking population, and a strong, comprehensive national smoke-free law is urgently needed to achieve greater public health outcomes. IMPLICATIONS Smoke-free policies are an important intervention to influence smoking behavior. This study demonstrates that comprehensive smoke-free policies in public places in China can effectively influence smoking behavior and show long-term trends in smoke-free behavior, while also reflecting the need to promote comprehensive smoke-free policies. This study provides a basis for the implementation of comprehensive smokefree policies into law and also provides a basis for policy makers.
Strès ak Pwoblèm Pap Janm Fini: Deciphering migration-related stress from the perspectives of Haitian immigrants in Florida
Authors: Fanfan Dany , Rodríguez Carmen , Stacciarini Jeanne-Marie R. 
Published: April 2023

Relocating and starting a new life in a foreign country may entail a constellation of new stressors for Haitian immigrants; thus, research that enhances our understanding of how this vulnerable population contextualizes migration-related stress is necessary. The objectives of this study were to: (a) identify what factors are associated with migration-related stress, and (b) describe which and why specific migration-related stressors were most significant from the perspective of those suffering from high migration-related stress post migration via the stress proliferation lens of the stress process model. In this mixed-methods, sequential, explanatory pilot study, first-generation Haitian immigrants ( N = 76) were recruited to operationalize migration-related stress, using the Demands of Immigration Scale (DIS). Participants ( n = 8), who scored 25 or higher on the DIS, completed an in-depth audio-recorded follow-up interview that consisted of open-ended questions and a stressor-ranking questionnaire. Descriptive statistics, Pearson correlations, multiple linear regression (quantitative), and thematic analysis with a double-coded approach (qualitative) were employed to analyze the data. Female gender, older age, English fluency, and migration after the age of 18 years were associated with higher migration-related stress. However, only gender and English fluency predicted migration-related stress. In interviews, participants ranked five migration-related stressors as most stressful: language barriers, financial strains, loss of social networks, family conflicts, and exposure to discrimination/stigma. A nuanced depiction of migration-related stressors and proliferation mechanisms of migration-related stress may help identify areas where support and preventive efforts should be directed to improve social integration, stress levels, and mental well-being among immigrants.
Bentall Procedure to Repair Acute Type a Aortic Dissection in Pregnant Marfan Syndrome Woman With Preservation of Pregnancy
Authors: Shahzamani Mehran , Shirvani Fahimeh , Tavakoli Nader , Sedighi Mohsen 
Published: April 2023

Background: Acute aortic dissection is the most common life-threatening disorder classically presenting with tearing chest pain radiating to the back yet can have deceiving clinical presentations. Case presentation: The patient was a 22-year-old pregnant woman (gravida 6, para 4, abortion1) at 26 weeks of gestation. She was a known case of Marfan syndrome who developed acute type A aortic dissection during pregnancy. Repair of aortic dissection was done through the Bentall procedure with a composite mechanical valved conduit while Fetal heart rate (FHR) was simultaneously monitored during surgery. Three months after surgical repair, the newborn was delivered via cesarean, and both mother and baby survived without any complications. Conclusions: In this case, we demonstrated that repair of type A aortic dissection can be done in pregnant women with preservation of fetus in the uterus through close cooperation among all members of a multi-disciplinary team.
Heterogeneity of asthma–chronic obstructive pulmonary disease (COPD) overlap from a cohort of patients with severe asthma and COPD
Authors: Choi Joon Young , Rhee Chin Kook , Yoo Kwang Ha , Jung Ki-Suck , Lee Jae Ha , Yoon Hyoung Kyu , Ra Seung Won , Lee Myung Goo , Jo Yong Suk 
Published: April 2023

Background: A considerable proportion of patients have features of both asthma and chronic obstructive pulmonary disease (COPD) simultaneously, called asthma–COPD overlap (ACO). Objectives: The aim of this study was to identify heterogeneity of ACO from a cohort of patients with severe asthma and COPD using the same diagnostic criteria. Design: We used the International Severe Asthma Registry (ISAR) and the Korean COPD Subgroup Study (KOCOSS) to evaluate clinical characteristics of ACO from each cohort. Methods: We classified subjects into four groups: (1) pure severe asthma, (2) ACO from the severe asthma cohort, (3) ACO from the COPD cohort, and (4) pure COPD. ACO was defined by satisfying extreme bronchodilator response (BDR) >15% and 400 ml and/or blood eosinophil count ⩾300 /µL in patients aged 40 years or older and post-BD forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7. Results: The ACO group had 25 (23%) of 111 in the ISAR cohort and 403 (23%) of 1781 in the KOCOSS cohort. The ACO from the COPD cohort was older with more males and more smokers, but had similar degree of airflow limitation compared with the ACO from the severe asthma cohort. ICS-containing inhaler treatment was prescribed for all severe asthma subjects, but only for 43.9% of ACO subjects from the COPD cohort. Compared with patients having pure severe asthma, the risk for exacerbation was comparable in ACO either from severe asthma or COPD cohort [adjusted odds ratio (aOR): 1.54, 95% CI: 0.22–10.95 or aOR: 2.15, 95% CI: 0.59–7.85]. Conclusion: The prevalence of ACO was similar in severe asthma and COPD cohorts applying identical diagnostic criteria. ACO from the severe asthma cohort was similar to ACO from the COPD cohort in terms of lung function and exacerbation risk.
Medial placement of trapezoid tunnel leads to higher reduction loss in acute acromioclavicular joint dislocation treated with anatomic coracoclavicular fixation
Authors: Rojas J Tomás , Oyarzún Andrés , Muñoz J Tomás , García de la Pastora Diego , Canals Andrea , Viacava Alejandro , Carreño Hector , Águila Raúl 
Published: April 2023

Aim To analyze the association between clavicular tunnel positioning and postoperative reduction loss in patients with acute acromioclavicular (AC) joint dislocation treated with anatomic coracoclavicular (CC) fixation using double clavicular tunnels. Methods A retrospective review of patients with AC joint dislocation, treated with anatomic CC fixation using double clavicular tunnels, was conducted. Patients with pre-operative, immediate post-operative, and final follow-up Zanca-view X-rays were included. On each X-ray, the obtained measures included: distance from lateral border of clavicle to trapezoid and conoid tunnels, distance between tunnels, clavicle length, and CC distance of affected and un-affected sides. Loss of reduction was calculated as CC distance difference between immediate and final post-operative X-rays. Association between reduction loss and tunnel positioning was analyzed. Results Conoid, trapezoid and tunnel ratios were 24% ± 4, 15% ± 3, and 9% ± 2, respectively. Significant reduction loss was seen in 21(45.7%) patients. Significantly higher probabilities of reduction loss were associated with trapezoid tunnels placed medial to 24 mm (30.8% vs 65.0%, OR 4.2 (IC95%: 1.2–14.4), p: 0.024) or 15% of the clavicle length (32.1% vs 66.7%, OR 4.2 (IC 95%: 1.2–14.9), p: 0.025). Conclusions Trapezoid tunnels placed medial to 24 mm or 15% medial to clavicle length could lead to higher probabilities of significant reduction loss. These findings support the importance of clavicular tunnels’ proper placement for decreasing significant reduction loss.
Estimates of Golf-Related Upper Extremity Injuries in the United States: A 10-Year Epidemiology Study (2011-2020)
Authors: Twomey-Kozak John , Boadi Prince , Rodriguez Kate , Whitlock Keith , O’Donnell Jeff , Magill Jack , Anakwenze Oke , Klifto Christopher 
Published: April 2023

Background: Golf is one of the most popular sports in the United States (US) and is played by participants of all ages and skill level. Given the popularity and sport-specific demands on the upper torso, golf poses a considerable risk for upper extremity (UE) injuries. Therefore, the aim of the current study was to (1) determine the incidence rate of UE golf injuries presenting to emergency departments (EDs) in the US, (2) determine the most commonly injured body parts and mechanisms of injury, and (3) compare current injury epidemiology with previous trends in the literature. Hypothesis: Male sex, bimodal age extremes (young and elderly), and utilization of golf carts (vs walking) are associated with a higher incidence of golf-related UE injuries. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: The National Electronic Injury Surveillance System (NEISS) is a statistically validated injury surveillance system that collects data from ED visits as a representative probability sample of hospitals in the US. We queried the NEISS for the years 2011 to 2020 to examine the following variables for golf-related UE injuries: sociodemographic, diagnosis, body part, and mechanism of injury. Results: From 2011 to 2020, there were a total of 1862 golf-related UE injuries presenting to participating EDs, which correlates to an estimated 70,868 total injuries. Overall, male golf players were disproportionately affected (69.2%) versus female golf players (30.8%) and the most commonly injured age groups were those aged >60 and 10 to 19 years. The most common injuries included fractures (26.8%), strains/sprains (23.4%), and soft tissue injuries (15.9%). The joints injured most frequently were the shoulder (24.8%), wrist (15.6%), and joints in the hand (12.0%). The most common mechanisms of injury were cart accidents (44.63%), falling/tripping (29.22%), and golf club swinging/mechanics (10.37%). Conclusion: Golf-related UE injuries can be acute or due to chronic overuse. Male athletes >60 years of age were the population most commonly presenting to the ED with a golf-related injury. Further, the shoulder, forearm, and wrist were most commonly injured. These findings are consistent with previous epidemiological trends in the literature. Interventions to reduce the incidence of injury should be sport-specific and focus primarily on equipment and golf cart safety and swing modification to optimize the biomechanical function of the UEs. Clinical Relevance: Our findings indicate that golf-related injury prevention programs should target UE injuries, particularly among young (<19) and older (>60 years) golfers with poor swing mechanics.