bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of Large Area of Deep Wound in the Foot and Ankle with Chimeric Anterolateral Thigh Perforator Flap
Authors: Li Run‐guang , Zeng Can‐jun , Yuan Song , Hu Ji‐jie , Zhang Ping , Chen Yun‐biao , Zhao Shan‐wen , Ren Gao‐hong 
Published: June 2021

ObjectiveTo evaluate the clinical application and surgical efficacy of the chimeric perforator flap pedicled with the descending branch of the lateral circumflex femoral artery and the lateral thigh muscle flap for the reconstruction of the large area of deep wound in foot and ankle.MethodsClinical data of 32 cases who underwent chimeric anterolateral thigh perforator flap to repair the large area of deep wound of the foot and ankle from January 2015 to December 2018 were retrospectively analyzed. The sizes of the defects ranged from 18 cm × 10 cm to 35 cm × 20 cm, with exposed tendon and bone and/or partial defects and necrosis, contaminations, accompanied by different degrees of infection. Following the radical debridement and VSD, chimeric anterolateral thigh perforator flap was employed to repair the deep wounds according to the position, site and deep‐tissue injury of the soft‐tissue defects. The skin flap and muscle flap were fanned out on the wound, and single‐ or two‐staged split‐thickness skin grafting was performed on the muscle flap. The operation time and blood loss were recorded. The survival and healing conditions of the operational site with chimeric anterolateral thigh perforator flap were evaluated post‐operationally. Complications at both recipient site and donor site were carefully recorded.ResultsThe mean time of the operation was 325.5 min and average blood loss was 424.8 mL. Among the 32 cases, two cases developed vascular crisis, which were alleviated with intensive investigation and treatment; Four cases suffered from partial necrosis of the flap or skin graft on the muscle flap or on the residual local wound, which were improved after treatment of further dressing change and skin grafting. Another four cases experienced post‐traumatic osteomyelitis accompanied by bone defect were treated with simple bone grafting or Mesquelet bone grafting at 6–8 months after wound healing. Postoperatively, the wounds were properly healed, and the infection was effectively controlled without sinus tract forming. Overall, all 32 cases received satisfactory efficacy, without influencing subsequent functional reconstruction, and observed infection during the 12–36 months post‐operational follow‐up.ConclusionThe chimeric perforator flap pedicled with the descending branch of the lateral circumflex femoral artery and the lateral thigh muscle flap provides an effective and relative safe procedure for the repair of a large area of deep wound in the foot and ankle, particularly with irregular defect or deep dead space.
Political opportunism and transaction costs in contractual choice of public–private partnerships
Authors: Xiong Wei , Zhong Ninghua , Wang Feng , Zhang Muyang , Chen Bin 
Published: June 2021

AbstractThe New Public Management (NPM) has achieved many successes in public service delivery, but practitioners frequently observed failures in developing and transitional economies. For instance, China's public–private partnerships (PPP) since 2014 have failed to transfer risks to the private sector, to involve private skills and expertise, and to reduce local government's debt. This article claims that PPP failures in China are associated with the contractual type of nonconcessions and the contractual choice is influenced by both political opportunism and transaction costs. Utilizing data of PPP projects in China during 2014–2016, we find that more opportunistic bureaucrats seek to increase projects of nonconcessions, but transaction costs caused by product complexities hinder governments' reliance on nonconcessions. This research extends the core analysis of PPPs in the literature from transaction costs to political opportunism, which widely exists in developing and transitional economies. Thus, our findings partially explain the failure of their NPM practices.新公共管理运动在公共服务供给领域取得了瞩目的成就，但在发展中国家与转型经济体中也经历过挫折。例如，自2014年以来，中国推行的政府与社会资本合作(PPP)模式就未能实现将风险转移到私营部门、引入私营部门的技术和经验及减轻地方政府的债务负担的初衷。正鉴于此，在2017年时，中国财政部对PPP项目进行了大范围的整改。针对这一现象，本文理论分析认为，其主要原因在于地方政府采用了大量非特许经营合同，而该类合同具有低风险、弱运营及政府付费的特征。政府之所以选择此类合同，则基于政治机会主义与交易成本两个方面的考量。进一步，本文基于中国2014–2016年PPP项目的数据，通过实证研究发现:地方主政官员晋升压力越大，其短期拉动GDP增长的动机越强，从而通过非特许经营合同上马的基建项目就越多；但是，项目自身的复杂性会导致非特许经营合同在长期产生高昂的交易成本，从而抑制地方政府上马此类项目。本研究将PPP的研究视角从交易成本拓展到政治机会主义，从而更为全面地阐述了新公共管理运动在转型国家更易遭遇挫折的原因。
The Greek Neuropathic Pain Registry: The structure and objectives of the sole NPR in Greece
Authors: Vadalouca Athina , Alexopoulou‐Vrachnou Evnomia , Rekatsina Martina , Kouroukli Irene , Anisoglou Sousana , Kremastinou Fani , Gabopoulou Zoi , Chloropoulou Panagiota , Micha Georgia , Tsaroucha Athanasia , Siafaka Ioanna 
Published: June 2021

AbstractObjectivesNeuropathic pain (NP) is a complex condition that impairs the patients’ quality of life. Registries are useful tools, increasingly used as they provide high‐quality data. This article aims to describe the Greek Neuropathic Pain Registry (Gr.NP.R.) design, the patients’ baseline data, and real‐world treatment outcomes.MethodsThe Gr.NP.R. collects electronically, stores, and shares real‐world clinical data from Pain and Palliative Care centers in Greece. It is a web‐based application, which ensures security, simplicity, and transparency. VAS, DN4, and Pain Detect were used for pain and NP assessment.ResultsFrom 2016 to 2020, 5980 patients with chronic pain, of cancer or non‐cancer origin, were examined and 2334 fulfilled the NP inclusion criteria (VAS > 5, DN4 > 4, and Pain Detect ≥ 19). At the first visit, the mean age was 64.8 years, 65.5% were female patients, and 97.9% were Greek. The mean (SD) time from pain initiation to visiting the pain clinics was 1.5 (3.8) years. Most patients were undertreated. Following the patients’ registration, the national guidelines were implemented. The majority of the prescribed medications were gabapentinoids (70.2%), especially pregabalin (62.6%), and opioids (tramadol, 55.3%). At visits 1 and 6, mean VAS was 7.1 and 5, and mean DN4 score was 5.6 and 3.5, respectively.ConclusionsThe Gr.NP.R. provides information on the demographics, clinical progress, treatment history, treatment responses, and the drugs of choice for patients with cancer and non‐cancer NP. The collected data may help physicians plan the management of their patients.
Perceptions of romantic partners' responses to disclosures of suicidality
Authors: Love Heather A. , LeFebvre Leah E. , Pederson Joshua R. 
Published: June 2021

AbstractThis mixed‐methods study examines how adults in the United States perceive their romantic partner's response to disclosures of suicidality and how romantic relationship characteristics relate to perceptions of disclosure responses. Participants (N = 30) recruited from Reddit completed a survey using open‐ and closed‐ended questions about disclosing suicidality to a romantic partner. Qualitative findings highlight validating and invalidating disclosure responses. Validating responses include two subthemes: (a) emotional, nondirective support, and (b) instrumental, directive support. Invalidating responses are coded when partners are dismissive or display lack of concern. Meta‐inferences from qualitative and quantitative findings reveal associations between participants who perceive their partners' responses as (in)validating and multiple romantic relationship characteristics. Our findings have implications about supporting individuals struggling with suicidality and their romantic partners.
Inequality and growth in the twenty‐first century
Authors: Luo Weijie 
Published: June 2021

AbstractThis paper analyzes how economic growth can be caused by changes in the income distribution. Persson and Tabellini (1994, The American Economic Review, 84, 600‐621) argue that productivity‐induced income inequality leads to lower growth since distortionary taxes increase and harm capital accumulation. However, this prediction is often challenged empirically. This paper distinguishes between capital income inequality and inequality induced by differences in labor productivity. Greater capital income inequality leads to lower labor tax rates, leading to higher growth. Using data for OECD countries, subsequent growth is found to be positively related to capital income inequality, and negatively related to labor income inequality, as originally conjectured.
Whole‐body vibration preconditioning reduces the formation and delays the manifestation of high‐altitude‐induced venous gas emboli
Authors: Elia Antonis , Eiken Ola , Ånell Rickard , Grönkvist Mikael , Gennser Mikael 
Published: June 2021

New Findings

What is the central question of this study?
Is performing a 30‐min whole‐body vibration (WBV) prior to a continuous 90‐min exposure at 24,000 ft sufficient to prevent venous gas emboli (VGE) formation?

What is the main finding and its importance?
WBV preconditioning significantly reduces the formation and delays the manifestation of high‐altitude‐induced VGE. This study suggests that WBV is an effective strategy in lowering decompression stress.

AbstractRapid decompression may give rise to formation of venous gas emboli (VGE) and resultantly, increase the risk of sustaining decompression sickness. Preconditioning aims at lowering the prevalence of VGE during decompression. The purpose of this study was to investigate the efficacy of whole‐body vibration (WBV) preconditioning on high‐altitude‐induced VGE. Eight male subjects performed, on separate days in a randomised order, three preconditioning strategies: 40‐min seated‐rest (control), 30‐min seated‐rest followed by 150 knee‐squats performed over a 10‐min period (exercise) and 30‐min WBV proceeded by a 10‐min seated‐rest. Thereafter, subjects were exposed to an altitude of 24,000 ft (7315 m) for 90 min whilst laying in a supine position and breathing 100% oxygen. VGE were assessed ultrasonically both during supine rest (5‐min intervals) and after three fast, unloaded knee‐bends (15‐min intervals) and were scored using a 5‐grade scale and evaluated using the Kisman Integrated Severity Score (KISS). There was a significant difference in VGE grade (P < 0.001), time to VGE manifestation (P = 0.014) and KISS score following knee‐bends (P = 0.002) across protocols, with a trend in KISS score during supine rest (P = 0.070). WBV resulted in lower VGE grades (median (range), 1 (0–3)) and KISS score (2.69 ± 4.56 a.u.) compared with control (2 (1–3), P = 0.002; 12.86 ± 8.40 a.u., P = 0.011) and exercise (3 (2–4) , P < 0.001; 22.04 ± 13.45 a.u., P = 0.002). VGE were detected earlier during control (15 ± 14 min, P = 0.024) and exercise (17 ± 24 min, P = 0.032) than WBV (54 ± 38 min). Performing a 30‐min WBV prior to a 90‐min continuous exposure at 24,000 ft both delays the manifestation and reduces the formation of VGE compared with control and exercise preconditioning.
Study on the Segmental Pigging Process for the Wet Gas Gathering and Transportation Pipelines of the Puguang Gas Field
Authors: Liu Wu , Shang Jianfeng , Wang Hongsong , Zhao Donghui , Zou Yu 
Published: June 2021

Abstract
The gathering and transportation pipeline known as Line 1 of Puguang Gas Field has the characteristics of wet gathering and transportation containing high sulfur content, large drops, and liquid loading in low-lying areas. In the process of one pigging operation on the site, the surge volume provided by the no. 1 separator in the master gas gathering station was not effectively utilized and the time intervals for the neighboring pipeline sections were too long. In this paper, we designed several pigging proposals. OLGA was applied to analyze the operating parameter changes for the gathering and transportation pipeline Line 1, which finally determined a reasonable pigging sequence. We designed and selected the “optimal pigging proposal”, which the time duration for the pigging operation of the seven pipeline sections was decreased to 16.91 h. Guided by the “optimal pigging proposal”, the downstream pipeline sections will be challenged by the risks of ice blockage. The ground eddy device was improved in the article, for the purpose of draining liquid loadings in low-lying areas in the Puguang Gas Field and controlling the slug flow. In addition, the application effects of the device were analyzed.
Upper Quarter Y-Balance Test in Collegiate Softball Players: Bilateral Arm Comparison and Influence of Reach Order
Authors: Christian Katelyn M. , Moran Matthew F. 
Published: June 2021

The upper quarter Y-balance test is an upper extremity, closed kinetic chain assessment that requires individuals to reach in three directions while in a three-point plank position. The upper quarter Y-balance test was performed in 22 collegiate softball players (19.95 ± 1.52 years) to determine the (a) differences between throwing and nonthrowing (NT) sides and (b) influence of reach sequence. While stabilizing on the NT side, participants reached significantly further in the inferolateral direction than the throwing side (NT: 83.7 ± 12.2% arm length; throwing: 80.1 ± 10.5% arm length; p = .03; effect size = −0.57). Altering reach sequence significantly influenced medial reach (p < .01, effect size = 0.66) and composite score (p = .017, effect size = 1.03) when stabilizing on the NT side. Asymmetries in upper quarter Y-balance test in collegiate softball players should be interpreted cautiously, and an ordered test sequence should be consistently followed.
Participant education, spousal education and dementia risk in a diverse cohort of members of an integrated health care delivery system in Northern California
Authors: Gilsanz Paola , Mayeda Elizabeth Rose , Eng Chloe W , Meyer Oanh L , Glymour M Maria , Quesenberry Charles P , Whitmer Rachel A 
Published: June 2021

ObjectiveThe role of spousal education on dementia risk and how it may differ by gender or race/ethnicity is unknown. This study examines the association between one’s own education separate from and in conjunction with spousal education and risk of dementia.DesignCohort.SettingKaiser Permanente Northern California (KPNC), an integrated health care delivery system.Participants8835 members of KPNC who were aged 40–55, married and reported own and spousal education in 1964–1973.Primary outcome measureDementia cases were identified through medical records from 1 January 1996 to 30 September 2017.MethodsOwn and spousal education was self-reported in 1964–1973 and each was classified as four indicator variables (≤high school, trade school/some college, college degree and postgraduate) and as ≥college degree versus <college degree. Age as timescale weighted Cox proportional hazard models adjusted for demographics and health indicators evaluated associations between participant education, spousal education and dementia risk overall and by gender and race/ethnicity.ResultsThe cohort was 37% non-white, 46% men and 30% were diagnosed with dementia during follow-up from 1996 to 2017 (mean follow-up=12.7 years). Greater participant education was associated with lower dementia risk independent of spousal education, demographics and health indicators. Greater spousal education was associated with lower dementia adjusting for demographics but became non-significant after further adjustment for participant education. The same pattern was seen for spousal education ≥college degree (not adjusting for participant education HRspousal education≥college degree=0.83 (95% CI: 0.76 to 0.90); adjusting for participant education HRspousal education≥college degree=0.92 (95% CI: 0.83 to 1.01)). These associations did not vary by gender or race/ethnicity.ConclusionIn a large diverse cohort, we found that higher levels of participant’s own education were associated with lower dementia risk regardless of spousal education. An inverse association between spousal education and dementia risk was also present, however, the effects became non-significant after adjusting for participant education.
Prevalence and fluid management of dehydration in children without diarrhoea admitted to Kenyan hospitals: a multisite observational study
Authors: Omoke Sylvia , English Mike , Aluvaala Jalemba , Gathara David , Agweyu Ambrose , Akech Samuel 
Published: June 2021

ObjectivesTo examine the prevalence of dehydration without diarrhoea among admitted children aged 1–59 months and to describe fluid management practices in such cases.DesignA multisite observational study that used routine in-patient data collected prospectively between October 2013 and December 2018.SettingsStudy conducted in 13 county referral hospitals in Kenya.ParticipantsChildren aged 1–59 months with admission or discharge diagnosis of dehydration but had no diarrhoea as a symptom or diagnosis. Children aged <28 days and those with severe acute malnutrition were excluded.ResultsThe prevalence of dehydration in children without diarrhoea was 3.0% (2019/68 204) and comprised 15.9% (2019/12 702) of all dehydration cases. Only 55.8% (1127/2019) of affected children received either oral or intravenous fluid therapy. Where fluid treatment was given, the volumes, type of fluid, duration of fluid therapy and route of administration were similar to those used in the treatment of dehydration secondary to diarrhoea. Pneumonia (1021/2019, 50.6%) and malaria (715/2019, 35.4%) were the two most common comorbid diagnoses. Overall case fatality in the study population was 12.9% (260/2019).ConclusionSixteen per cent of children hospitalised with dehydration do not have diarrhoea but other common illnesses. Two-fifths do not receive fluid therapy; a regimen similar to that used in diarrhoeal cases is used in cases where fluid is administered. Efforts to promote compliance with guidance in routine clinical settings should recognise special circumstances where guidelines do not apply, and further studies on appropriate management for dehydration in the absence of diarrhoea are required.
Effect of Human Development Index and other socioeconomic factors on mortality-to-incidence ratio of lips and oral cavity cancer in Mexican states: an ecological study
Authors: Lara-Carrillo Edith , Herrera-Serna Brenda Yuliana , Conzuelo-Rodríguez Gabriel , do Amaral Regiane Cristina , Aguilera-Eguía Raúl Alberto , Toral-Rizo Victor Hugo 
Published: June 2021

ObjectivesTo assess the association between the Human Development Index (HDI) and covariates on the mortality-to-incidence ratio (MIR) of lips and oral cavity cancer (LOCC) in Mexico.DesignEcological study.SettingData from 32 Mexican states for year 2019.ParticipantsData set of male and female populations from Mexico.ExposuresSocioeconomic conditions based on HDI and covariates related to healthcare system capacity (total health spending per capita, school dropout and ratio of medical personnel in direct contact with patients).Primary and secondary outcome measuresMIR of LOCC by state and sex was calculated from the Global Burden of Disease Study website for year 2019. Data for calculating HDI 2019 by state and covariates were obtained from the National Institute of Statistics and Geography. A multiple regression model was constructed to measure the effects of HDI and covariates on LOCC-MIR.ResultsAmong the states with the highest HDI (>0.780), Colima had the highest aged-standardised rates per 100.000 in men for incidence (5.026) and mortality (3.118). The greatest burden of the disease was found on men, with the highest Men:Women MIR in Colima (3.10) and Baja California Sur (2.73). The highest MIR (>0.65) was found among the states with the lowest HDI (Oaxaca and Chiapas). For each unit of increase of the HDI there was a decrease in the LOCC- MIR of −0.778, controlling for the covariates. The most suitable regression model explained the 57% (F (p): 0.000) of the variance.ConclusionsMen were most affected by LOCC in Mexican states. The highest MIRs of LOCC were found in the states with the highest HDI. But a worse prognosis of the disease, expressed as a higher MIR, is expected in contexts with lower HDI in the country, even with lower MIRs.
Patient-centred infertility care among Arab women experiencing infertility: a qualitative study
Authors: Webair Hana Hasan , Ismail Tengku Alina Tengku , Ismail Shaiful Bahari , Khaffaji Azza Jameel 
Published: June 2021

ObjectiveThe current study aims to define patient-centred infertility care (PCIC) from the perspective of Arab women with infertility.DesignSemistructured in-depth telephone interviews.SettingHospitals providing infertility care, Jeddah, Saudi Arabia.ParticipantsArab women who received infertility treatment during the 6 months preceding the interview at any hospital in Jeddah, Saudi Arabia. Interviews were conducted with Arab women experiencing infertility from January 2017 to December 2018. A purposive sample of 14 women were included in the final analysis with maximum variation.ResultsParticipants highlighted nine important PCIC dimensions. Of these, four were agreed on by all participants: accessibility, minimising cost, information and education, and staff attitudes and communication. The remaining five dimensions were staff competence, physical comfort, privacy, psychological and emotional support, and continuity and coordination of care. The concept of PCIC was related to three major contributors: participants’ demographics, patient experience with infertility care and health-seeking behaviour.ConclusionsThe current study provided nine PCIC dimensions and items, which can guide efforts to improve the quality of infertility care in Arab countries in two ways: first, by raising infertility care providers’ awareness of their patients’ needs, and second, by developing a validated tool based on the dimensions for measuring PCIC from Arab patients’ perspective. Clear differences between the Arab and the European PCIC model were found. Our findings concluded that women continued to exhibit basic unmet needs.