bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Nationally Representative Study of the Hardening Hypothesis Among Educational Groups Over Four Decades
Authors: Ruokolainen Otto , Piirtola Maarit , Korhonen Tellervo , Rahkonen Ossi , Härkänen Tommi 
Published: April 2023

Abstract

Introduction
As smoking prevalence has decreased, there has been debate about “hardening” (smokers are more resistant to established tobacco control measures) or “softening” (smokers are more responsive to interventions) of the remaining smoking population. Despite growing evidence to reject the “hardening” hypothesis, there is lack of long-term population-based studies to test this hypothesis by educational level.

Aims and Methods
Repeated cross-sectional population-based surveys during 1978–2014 and in 2018 were utilized. The target population consisted of ~5000 25–64-year-old Finns annually. The data included 109 257 respondents of which 53 351 ever-smoking individuals were included in the analyses. Response rates varied between 84% and 43%. Five hardening indicators considering smoking frequency, intensity and smoking cessation were used as the dependent variables. The main independent variable was study year (time). Statistical analyses were based on regression models using restricted cubic splines by educational level.

Results
Contrary to the hardening hypothesis, hardening indicators showed softening over time among all educational groups. However, educational groups differed from each other. Compared with the highly educated, the quit ratio was lower, number of cigarettes per day (CPD) was higher, the proportions of daily smokers among current smokers and heavy smokers among daily smokers were higher among the less educated.

Conclusions
In accordance with growing evidence, also the Finnish smoking population has “softened” over time. Although the change has been predominantly in the same direction for all educational groups, the rate of change has been stronger among the highly educated, highlighting the continued burden of smoking among the less educated.

Implications
Even though “softening” of smoking has occurred, lighter smoking also poses health risks. Therefore, tobacco control policies and cessation services should be developed and targeted to a greater extent also for people who smoke less than daily and for those who smoke fewer CPD. Furthermore, interventions should focus on special requirements of the lower educational groups to promote health equity.
Human Capital Development Factors and Black Adolescent Tobacco and Cannabis Use
Authors: Jacobs Wura , Lu Wenhua , McDonald Andrea , Yang Joshua S 
Published: April 2023

Abstract

Introduction
This study examined the association of four domains of human capital development (cognitive development, social and emotional development, physical health, and mental health) and exclusive and concurrent tobacco and cannabis use (TCU) among black youth.

Aims and Methods
Nationally representative annual cross-sectional data for black adolescents (12–17 years; N = 9017) in the National Survey on Drug Use and Health 2015–2019 were analyzed. Analyses examined the influence of human capital factors (cognitive development, social and emotional development, physical health, and mental health) on exclusive and concurrent TCU.

Results
In total, 50.4% were males; prevalence of 12-month tobacco use fluctuated insignificantly between 5.6% and 7.6% across survey years. Similarly, prevalence of 12-month cannabis use remained relatively stable around 13%, with no significant linear change. Prevalence of concurrent TCU also fluctuated insignificantly between 3.5% and 5.3%. Investment in cognitive development decreased the odds of tobacco (aOR = 0.58, p &lt; .001), cannabis (aOR = 0.64, p &lt; .001), and concurrent tobacco and cannabis (aOR = 0.58, p &lt; .001) use. Similarly, investment in social and emotional development reduced the odds of tobacco (aOR = 086, p &lt; .001), cannabis (aOR = 0.83, p &lt; .001), and concurrent tobacco and cannabis (aOR = 0.81, p &lt; .001) use. Good physical health reduced the odds of tobacco (aOR = 0.52, p &lt; .1), cannabis (aOR = 0.63, p &lt; .05), and concurrent TCU (aOR = 0.54, p &lt; .05). Major depressive episodes increased the likelihood of cannabis use (aOR = 1.62, p &lt; .001).

Conclusions
Investment in cognitive, social, and emotional aspects of human capital development, and physical health among black youth is protective against TCU. Efforts to sustain human capital development among black adolescents may contribute to reducing TCU disparities.

Implications
This is one of few studies to examine human capital development factors and their associations with TCU among black youth. Efforts to eliminate tobacco/cannabis-related disparities among black youth should also invest in social, emotional, cognitive, and physical health development opportunities.
L-Ascorbic acid metabolism and regulation in fruit crops
Authors: Liao Guanglian , Xu Qiang , Allan Andrew C , Xu Xiaobiao 
Published: April 2023

Abstract
L-Ascorbic acid (AsA) is more commonly known as vitamin C and is an indispensable compound for human health. As a major antioxidant, AsA not only maintains redox balance and resists biological and abiotic stress but also regulates plant growth, induces flowering, and delays senescence through complex signal transduction networks. However, AsA content varies greatly in horticultural crops, especially in fruit crops. The AsA content of the highest species is approximately 1,800 times higher than that of the lowest species. There have been significant advancements in the understanding of AsA accumulation in the past 20 years. The most noteworthy accomplishment was the identification of the critical rate-limiting genes for the 2 major AsA synthesis pathways (L-galactose pathway and D-galacturonic acid pathway) in fruit crops. The rate-limiting genes of the former are GMP, GME, GGP, and GPP, and the rate-limiting gene of the latter is GalUR. Moreover, APX, MDHAR, and DHAR are also regarded as key genes in degradation and regeneration pathways. Interestingly, some of these key genes are sensitive to environmental factors, such as GGP being induced by light. The efficiency of enhancing AsA content is high by editing upstream open reading frames (uORF) of the key genes and constructing multi-gene expression vectors. In summary, the AsA metabolism has been well understood in fruit crops, but the transport mechanism of AsA and the synergistic improvement of AsA and other traits is less known, which will be the focus of AsA research in fruit crops.
Schaffer, Sherlock and Shaddai
Authors: Symonds Hezki 
Published: April 2023

AbstractAccording to Schaffer, most of the controversial entities that ontologists debate exist. Schaffer calls this view permissivism and he defends it by appealing to easy arguments for the existence of the entities in question. Schaffer presents several easy arguments, but his easy argument for fictional characters and his easy argument for God play a crucial role in his defence of permissivism. In this paper, I argue that Schaffer doesn’t have the resources to defend his easy argument for fictional characters or his easy argument for God. So, his defence of permissivism fails.
Promoting narrative CVs to improve research evaluation? A review of opinion pieces and experiments
Authors: Bordignon Frédérique , Chaignon Lauranne , Egret Daniel 
Published: April 2023

Abstract
As the academic community has become increasingly concerned about the drifts of research evaluation, mostly researchers’ evaluation, because of the overreliance on metrics, many expert groups have made recommendations to improve the way researchers should be evaluated. In this study, we focus on the recommendation to use narrative curriculum vitae (CVs). We review 28 opinion pieces and 7 experiments to better understand what a narrative CV can refer to, and to explore whether the narrative function that is specific to this kind of CV is proving effective in response to the concerns raised by evaluation practices. A close reading of these documents reveals the conceptual basis of the narrative CV and the problems it is intended to solve; we propose five commonly reported features of the narrative CV: avoid lists, contextualize achievements, fight metrics, enlarge the spectrum of contributions taken into consideration and foster diversity and inclusion. But the promoters of the narrative CV pay little to investigate how the narrative feature itself can lead to any benefits. However, the feedback collected from both applicants and evaluators is quite positive. Regardless of whether it is justified or not, the enthusiasm aroused by the implementation of this new type of CV undeniably has the advantage of opening up the debate, raising awareness and calling to question the bad practices and biases that exist in the researchers’ assessment processes. The narrative nature of the CV is, in the end, just a pretext for raising interest and working towards the adoption of good practices.
Sexual dysfunctions in breast cancer patients: evidence in context
Authors: Vizza Riccardo , Capomolla Elisabetta Maria , Tosetto Livia , Corrado Giacomo , Bruno Valentina , Chiofalo Benito , Di Lisa Francesca Sofia , Filomeno Lorena , Pizzuti Laura , Krasniqi Eriseld , Sanguineti Giuseppe , Villa Alice , Giannini Andrea , Kayal Ramy , Stranges Vincenzo , Tomao Silverio , Botti Claudio , Tomao Federica , Barba Maddalena , Vizza Enrico , Ciliberto Gennaro , Vici Patrizia 
Published: April 2023

Abstract

Introduction
In breast cancer patients, endocrine therapy may exert a negative impact on sexual functioning in both genders, with potentially relevant consequences concerning quality of life and treatment adherence. The availability of effective interventions to maintain and/or restore sexual health in breast cancer patients is a key issue to a research agenda.

Objectives
To summarize and critically discuss the most updated and qualitatively relevant literature on the therapeutic approach to sexual impairment in breast cancer patients, with a focus on patients treated with endocrine therapy.

Methods
We searched PubMed from its inception to February 2022 for observational and intervention trials including participants with sexual dysfunctions. We were particularly interested in studies of breast cancer patients with sexual dysfunctions while undergoing endocrine therapy. We developed a search strategy with the aim of maximizing the number of articles considered for screening and potential inclusion.

Results
Forty-five studies were selected: 3 observational and 42 intervention studies. Thirty-five studies were exclusively focused on female breast cancer populations. We could not identify studies exclusively focused on or also including male breast cancer patients. Overall, in female patients, the available armamentarium encompasses vaginal lubricants, moisturizers, estrogens, dehydroepiandrosterone, CO2 laser, ospemifene, and counseling. None of these interventions has been demonstrated to completely solve sexual dysfunctions when singularly considered. More favorable outcomes have come from the combination of different therapies.

Conclusion
In female breast cancer, future research is oriented toward the gain of evidence on combined therapies and long-term data on safety issues on the most promising interventions. The lack of evidence on sexual disturbances in male breast cancer patients remains a major concern.
The need for good practice in the application of mechanistic constructs in hazard and risk assessment
Authors: Meek M E (Bette) , Wikoff Daniele 
Published: April 2023

Abstract
A series of recent and proposed workshops address the interface between key characteristics and mechanistic pathway descriptions (adverse outcome pathways and mode of action) to identify commonalities and potential for complementary application. Informed by different communities, these constructs have collective potential to increase confidence to support the application of mechanistic data in hazard assessment. This forum article summarizes concepts, introduces evolving understanding, and invites future collaboration to contribute to better common understanding and development of good practice in the use of mechanistic data in hazard assessment.
Along with cyclic electron flow and non-photochemical quenching, water-to-water cycle is involved uniquely in alleviating Zn stress-caused photodamage in Melia azedarach
Authors: Huang XinHao , Xu Hongyang , Yu Zhimin , Che Yanhui , Kang Hui , Zhu Fan 
Published: April 2023

Abstract
Zinc (Zn) is a widespread industrial pollutant that has detrimental effects on plant growth and development. Photoprotective properties ensure plant survival during stress by protecting the photosynthetic apparatus. This occurs via numerous mechanisms, including non-photochemical quenching (NPQ), cyclic electron flow (CEF) and the water-to-water cycle (WWC). However, whether and how Zn stress affects the photoprotective properties of plants to enhance the tolerance of Zn toxicity remains unknown. In this study, we treated Melia azedarach plants with different Zn concentrations ranging from 200 to 1000 mg kg−1. We then analyzed the activities of two leaf photosynthetic pigment components—photosystems I and II (PSI and PSII)—and the relative expression levels of their subunit genes. As expected, we found that Zn treatment decreases photosynthesis and increases photodamage in M. azedarach leaves. The Zn treatments exacerbated a variety of photodamage phenotypes in photosystem activities and altered the expression levels of key photosystem complex genes and proteins. Furthermore, our results demonstrated that PSI was more seriously damaged than PSII under Zn stress. Subsequently, we compared differences in photodamage in the NPQ, CEF and WWC photoprotection pathways under Zn stress and found that each exerted a protective function again photodamage under 200 mg kg−1 Zn stress. The NPQ and CEF may also play major protective roles in the avoidance of irreversible photodamage and helping to ensure survival under higher (i.e., 500 and 1000 mg kg−1) levels of Zn stress. Thus, our study revealed that NPQ- and CEF-based photoprotection mechanisms are more effective than WWC in M. azedarach upon Zn stress.
Factors Associated With the Development of a Confirmed Fracture-Related Infection
Authors: Solasz Sara , Merrell Lauren , Ganta Abhishek , Konda Sanjit , Egol Kenneth A. 
Published: April 2023

Objectives:
To identify factors associated with the development of fracture-related infection (FRI) in patients who have undergone operative fixation of their fracture.

Design:
Retrospective study.

Setting:
Academic medical center.

Patients/Participants:
Patients with peripheral extremity long-bone fractures and shoulder and pelvic girdle fractures who underwent operative repair. This included patients who had undergone fixation inside and outside of our institution.

Intervention:
Chi-square, Fisher exact testing, analysis of variance (ANOVA), and t tests were used for analysis of data, as appropriate. Binomial logistic regression analysis was performed to determine risk factors of FRI.

Main Outcome Measurements:
Demographics, fracture location, injury mechanism, open wound status, and wound complication type.

Results:
One hundred ninety-three patients comprised the FRI cohort. Of those with confirmed signs of FRI, 36 (18.7%) had wound breakdown to bone or implant, 120 (62.1%) had a sinus track, and 170 patients (88.1%) had the confirmed presence of microorganisms in deep tissue samples obtained during operative intervention. Factors associated with development of an FRI were as follows: higher BMI; being of Black and Hispanic race; higher American Society of Anesthesiologists class; history of tobacco, alcohol, and drug use; and fractures of the lower extremity (foot, tibia, and femur/pelvis). The results of binary logistic regression demonstrated that treatment at an urban level I trauma center and drug use positively predicted the development of FRI.

Conclusion:
Our results demonstrate that higher BMI; being of Black or Hispanic race; higher American Society of Anesthesiologists; history of tobacco, alcohol, and drug use; and fractures of the foot, tibia, and femur/pelvis are all factors associated with development of FRI.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Use of Computed Tomography Angiography to Predict Complications in Tibia Fractures: A Multicenter Retrospective Analysis
Authors: Mihas Alexander K. , Prather John C. , Alexander Bradley K. , Boateng Isaac B. , Moran Thomas E. , Turnbull Lacie M. , Allen Andrew , Vise Healy , Kammire Maria S. , Moreno Andres F. , McGwin Gerald , Chen Andrew T. , Talerico Michael T. , Obremskey William T. , Weiss David B. , Bergin Patrick F. , Spitler Clay A. ,   For the Southeastern Fracture Consortium
Published: April 2023

Objectives:
To assess the ability of computed tomography angiography identified infrapopliteal vascular injury to predict complications in tibia fractures that do not require vascular surgical intervention.

Design:
Multicenter retrospective review.

Setting:
Six Level I trauma centers.

Patients and Intervention:
Two hundred seventy-four patients with tibia fractures (OTA/AO 42 or 43) who underwent computed tomography angiography maintained a clinically perfused foot not requiring vascular surgical intervention and were treated with an intramedullary nail. Patients were grouped by the number of vessels below the trifurcation that were injured.

Main Outcome Measurements:
Rates of superficial and deep infection, amputation, unplanned reoperation to promote bone healing (nonunion), and any unplanned reoperation.

Results:
There were 142 fractures in the control (no-injury) group, 87 in the one-vessel injury group, and 45 in the two-vessel injury group. Average follow-up was 2 years. Significantly higher rates of nerve injury and flap coverage after wound breakdown were observed in the two-vessel injury group. The two-vessel injury group had higher rates of deep infection (35.6% vs. 16.9%, P = 0.030) and unplanned reoperation to promote bone healing (44.4% vs. 23.9%, P = 0.019) compared with controls, as well as increased rates of any unplanned reoperation compared with control and one-vessel injury groups (71.1% vs. 39.4% and 51.7%, P < 0.001), respectively. There were no significant differences in rates of superficial infection or amputation.

Conclusions:
Tibia fractures with two-vessel injuries were associated with higher rates of deep infection and unplanned reoperation to promote bone healing compared with those without vascular injury, as well as increased rates of any unplanned reoperation compared with controls and fractures with one-vessel injury.

Level of Evidence:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Seven-year Outcomes of Adolescent Forearm Fractures Treated With Plate Fixation
Authors: Folkman Matthew J. , Ren Bryan O. , Maheshwer Bhargavi , Klyce Walter B. , Mistovich R. Justin 
Published: April 2023

Background:
Pediatric forearm fractures are common injuries and can sometimes require surgical treatment. Few studies have evaluated the long-term outcomes of pediatric forearm fracture plating. We evaluated long-term functional outcomes and satisfaction in children with forearm fractures treated with plate fixation.

Methods:
We performed a single-institution case series at a pediatric level 1 trauma center. Inclusion criteria were: patients with radius and/or ulna diaphyseal fractures, index surgery at 18 years of age or younger, plate fixation, and a minimum of 2 years follow-up. We surveyed patients with the QuickDASH outcome measure and supplemented this with functional outcomes and satisfaction questions. Demographics and surgery characteristics were obtained from the electronic medical record.

Results:
A total of 41 patients met the eligibility criteria, of whom 17 completed the survey with a mean follow-up of 7.2 ± 1.4 years. The mean age at index surgery was 13.1 ± 3.6 years (range, 4 to 17), with 65% males. All patients reported at least one symptom, with aching (41%) and pain (35%) occurring most frequently. There were 2 complications (12%), including one infection and one compartment syndrome treated with fasciotomy. Hardware removal occurred in 29% of patients. There were no refractures. The mean QuickDASH score was 7.7 ± 11.9, with an occupation module score of 1.6 ± 3.9 and a sports/performing arts module score of 12.0 ± 19.7. The mean surgery satisfaction was 92% and scar satisfaction was 75%. All patients returned to prior activities and 88% reported a return to their preoperative baseline level of function.

Conclusions:
Plate fixation for pediatric forearm fractures achieves osseous union but not without the potential for long-term sequelae. All patients reported residual symptoms 7 years later. Scar satisfaction and return to baseline function were imperfect. Patient education for long-term outcomes of surgery is essential, especially in the transition to adulthood.

Level of Evidence:
Level IV, therapeutic study.
Socioeconomic Deprivation and its Associations With Follow-up Compliance After In Situ Pinning of Slipped Capital Femoral Epiphysis
Authors: Batley Morgan G. , Lenart Jana , Sankar Wudbhav N. 
Published: April 2023

Background:
Slipped capital femoral epiphysis (SCFE) is a common cause of hip pain in adolescents and is most often treated by in situ screw fixation. Orthopaedic follow-up is critical after treatment for SCFE due to risks of complications and subsequent contralateral slip. Recent studies have shown that socioeconomic deprivation is associated with decreased fracture care compliance, but no studies have explored this relationship with SCFEs. The study aims to determine the relationship between socioeconomic deprivation and SCFE follow-up care compliance.

Methods:
This study included pediatric patients treated with in situ pinning of SCFE between 2011 and 2019 at a single tertiary-care urban children’s hospital. Demographic and clinical information were obtained from electronic medical records. The Area Deprivation Index (ADI) was used to quantify the socioeconomic deprivation of each. Outcome variables included patient age and status of physeal closure at the most recent appointment, in addition to the length of follow-up (mo). Statistical relationships were evaluated using nonparametric bivariate analysis and correlation.

Results:
We identified 247 evaluable patients; 57.1% were male, and the median age was 12.4 years. Most slips were stable (95.1%) and treated with isolated unilateral pinning (55.9%). Median length of follow-up was 11.9 months (interquartile range, 4.95 to 23.1) with median patient age at final visit of 13.6 years (interquartile range, 12.4 to 15.1). Only 37.2% of patients were followed until physeal closure. The mean ADI spread in this sample was similar to the national distribution. However, patients in the most deprived quartile were lost to follow-up significantly earlier (median, 6.5 mo) than those in the least deprived quartile (median, 12.5 mo; P<0.001). Throughout the entire cohort, there was a significant, inverse relationship between deprivation and follow-up length (r

s(238)= −0.3; P<0.001), with this relationship most pronounced in the most deprived quartile.

Conclusions:
In this sample, ADI spread was representative of national trends, and the incidence of SCFE was distributed evenly across deprivation quartiles. However, follow-up length does not mirror this relationship; increased socioeconomic deprivation is associated with an earlier loss to follow-up (often well before physeal closure).

Level of Evidence:
Level II—retrospective prognostic study.