bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of a Double Reverse Traction Repositor versus a Traction Table for the Treatment of Intertrochanteric Femur Fractures: A Comparative Study
Authors: Yan Mingming , Kuang Letian , Ni Jiangdong , Ding Muliang , Wang Junjie , Huang Jun , Song Deye 
Published: May 2021

ObjectiveThe aim of the present study was to compare the clinical results for unstable femoral intertrochanteric fractures treated with a double reverse traction repositor (DRTR) and those treated using a traction table with the Asia proximal femoral nail antirotation (PFNA‐II).MethodsA retrospective study was performed including 95 patients with AO/OTA type 31‐A2 and 31‐A3 unstable femoral intertrochanteric fractures who underwent DRTR or traction table‐facilitated PFNA‐II nailing from April 2015 to December 2018 in our traumatic center. Demographics, duration of operation, blood loss, part loading time after surgery, fracture healing time, and early and late complications were assessed. Clinical and radiological outcomes were collected to compare the differences between the two groups.ResultsA total of 95 unstable intertrochanteric fracture patients treated with the PFNA‐II were analyzed. Of these cases, 56 patients were treated with a DRTR and the other 39 patients were treated using a traction table to achieve fracture reduction. No patients died during surgery and hospitalization. There were no significant differences in respect to demographics and fracture characteristics of cases enrolled. The total operative time was significantly longer in the traction table group than in the DRTR group (72.5 ± 6.1 min for the traction table and 63.0 ± 4.1 min for the DRTR group, P < 0.001). No significant differences were observed in intraoperative blood loss and duration of hospitalization. The periods of follow up ranged from 12 to 31 months among all patients. At the last follow up, the Harris hip score (HHS) in the DRTR group was excellent in 10 patients (17.9%), good in 36 (64.3%), fair in 8 (14.3%), and poor in 2 (3.6%). These scores were comparable to those in the traction table group, which were: excellent in 8 patients (20.5%), good in 24 (61.5%), fair in 6 (15.4%), and poor in 1 (2.6%). Regarding the radiological evaluation, excellent rates of reduction rate were achieved in 39 cases (69.6%) in the DRTR group, which was comparable to 19 cases (48.7%) in the traction table group. In addition, the mean fracture healing time after surgery was 20.6 ± 2.3 weeks in the DRTR group and 21.4 ± 3.4 weeks in the traction table group, which did not reach a significant difference (P = 0.18). During the follow up, 6 cases of thigh pain, 4 cases of deep vein thrombosis, and 1 case of fracture of the anterior superior iliac spine were reported in the DRTR group. In the traction table group, there were 2 cases of deep vein thrombosis and 3 cases of thigh pain.ConclusionWhen using the PFNA‐II for unstable intertrochanteric fractures, the DRTR was superior to the traction table in respect to operative time and duration of patient position, despite an additional ipsilateral anterior superior iliac spine (ASIS) incision and drilling of the ASIS and the femur condyle.
Chinese adolescents’ sexual and reproductive health education: A quasi‐experimental study
Authors: Ma Xing , Yang Yuanyuan , Chow Ka Ming , Zang Yuli 
Published: May 2021

AbstractObjectiveThis study investigated the effectiveness of an interactive sexual and reproductive health education program in aspects of knowledge, attitudes, and self‐efficacy among adolescents.DesignQuasi‐experimental study underpinned by social cognitive theory.SampleA stratified cluster sample of 469 students from the two‐branch middle school in a city in eastern China who were assigned to the experimental (n = 233) and control (n = 236) groups.MeasurementsStudents’ sexual knowledge, attitudes, and refusal self‐efficacy were assessed before (T0), immediately after (T1), and 1 month after the intervention (T2), respectively.InterventionStudents in the experimental group received two 40‐min sessions of the educational program while the control group received the usual mode of sexual and reproductive health education.ResultsCompared with the control group, students in the experimental group acquired more sexual knowledge (p < .01), and developed more positive sexual attitudes (p < .05) and stronger sexual self‐efficacy (p < .05) across the study period.ConclusionsThe proposed sexual and reproductive health education program incorporating various interactive activities was effective and could be used for school‐based implementation led by nurses and other health care workers.
Relationships influencing caring in first‐line nursing leadership: A visual hermeneutic study
Authors: Solbakken Rita , Bondas Terese , Kasén Anne 
Published: May 2021

AbstractAimTo explore and interpret relationships that influence caring in nursing leadership, in the context of Nordic municipal health care, from first‐line nurse managers’ perspectives.Design and methodWe chose a visual hermeneutic design. A three‐stage interpretation process outlined by Drew and Guillemin, based on Rose, was used to analyse drawings and the following reflective dialogue from three focus groups, with a purposive sample of 11 first‐line nurse managers. The study was conducted from February to May 2018.ResultsThe findings demonstrated that first‐line nurse managers struggled to balance their vision with administrative demands. Caring for patients implied caring for staff; however, they often felt as if they were drowning in contradictory demands. First‐line nurse management could be a lonely position, where the first‐line nurse managers longed for belonging based on increased self‐awareness of their position within an organisation. Superiors’ support enabled first‐line nurse managers’ in their primary aim of caring for patients.ConclusionFirst‐line nurse managers showed deep roots to their identities as nurses. Caring for patients included caring for staff and was their main concern, despite demanding reforms and demographic changes affecting leadership. Superiors’ support was important for FLNMs’ self‐confidence and independence in leadership, so the first‐line nurse managers can enact their vision of the best possible patient care. This study adds knowledge of the significance of caring in nursing leadership and the caritative leadership theory.ImpactIn order to recognise FLNMs as vulnerable human beings and provide individual confirmation and support, a caring organisational culture is needed. FLNMs need knowledge based on caring and nursing sciences, administration and participation in formal leadership networks. These findings can serve as a foundation for developing educational programmes for nurse leaders at several organisational levels.
Developing eHealth in neonatal care to enhance parents’ self‐management
Authors: Strand Annica Sjöström , Johnsson Björn , Hena Momota , Magnusson Boris , Hallström Inger Kristensson 
Published: May 2021

AbstractBackgroundDischarge from a neonatal care unit is often experienced as a vulnerable time for parents. By communicating through digital technology, it may be possible to improve the support for parents and thereby make the transition from hospital to home less stressful.AimTo develop an eHealth device supporting the transition from hospital to home for parents with a preterm‐born child in Sweden using participatory design.MethodEmploying a framework of complex interventions in health care using participatory design. Parents of preterm‐born infants and professionals at a neonatal department identified specific technical requirements for an eHealth device to be developed in the context of neonatal care and neonatal home care. The prospective end‐users – parents and professionals – were continuously involved in the process of designing solution prototypes through meetings, verbal and written feedback, and interviews. The interviews were analysed using thematic analysis.ResultsTechnical development was carried out with the perspectives of professionals and parents in mind, resulting in an eHealth application for computer tablets. The findings from the interviews with the parents and professionals revealed three categories: The tablets felt secure, easy to use and sometimes replaced visits to hospital and at home.ConclusionThe use of participatory design to develop an eHealth device to support a safe transition from hospital to home can benefit parents, the child, the family, and professionals in neonatal care.
Sedimentological and carbonate isotope signatures to identify fluvial processes and catchment changes in a supposed impact ejecta‐dammed lake (Miocene, Germany)
Authors: Zeng Lingqi , Ruge Dag B. , Berger Günther , Heck Karin , Hölzl Stefan , Reimer Andreas , Jung Dietmar , Arp Gernot 
Published: May 2021

AbstractThe identification and distinction of fluvial from lacustrine deposits and the recognition of catchment changes are crucial for the reconstruction of climate changes in terrestrial environments. The investigated drill core succession shows a general evolution from red–brown claystones to white–grey marlstones and microcrystalline limestones, which all have previously been considered as relict deposits of an impact ejecta‐dammed lake, falling within the mid‐Miocene Climate Transition. However, recent mammal biostratigraphic dating suggests a likely pre‐impact age. Indeed, no pebbles from impact ejecta have been detected; only local clasts of Mesozoic formations, in addition to rare Palaeozoic lydites from outside of the study area. Lithofacies analysis demonstrates only the absence of lacustrine criteria, except for one charophyte‐bearing mudstone. Instead, the succession is characterized by less diagnostic floodplain fines with palaeosols, palustrine limestones with root voids and intercalated thin sandstone beds. Carbonate isotope signatures of the mottled marlstones, palustrine limestones and mud‐supported conglomerates substantiate the interpretation of a fluvial setting. Low, invariant δ18Ocarbreflects a short water residence time and highly variable δ13Ccarbindicates a variable degree of pedogenesis. Carbonate87Sr/86Sr ratios of the entire succession show a unidirectional trend from 0.7103 to 0.7112, indicating a change of the solute provenance from Triassic to Jurassic rocks, identical to the provenance trend from extraclasts. The increase in carbonate along the succession is therefore independent from climate changes but reflects a base‐level rise from the level of the siliciclastic Upper Triassic to the carbonate‐bearing Lower to Middle Jurassic bedrocks. This study demonstrates that, when information on sedimentary architecture is limited, a combination of facies criteria (i.e. presence or absence of specific sedimentary structures and diagnostic organisms), component provenance, and stable and radiogenic isotopes is required to unequivocally distinguish between lacustrine and fluvial sediments, and to disentangle regional geological effects in the catchment and climate influences.
A giant lacustrine flood‐related turbidite system in the Triassic Ordos Basin, China: Sedimentary processes and depositional architecture
Authors: Chen Peng , Xian Benzhong , Li Meijun , Liang Xiaowei , Wu Qianran , Zhang Wenmiao , Wang Junhui , Wang Zhen , Liu Jianping 
Published: May 2021

AbstractTurbidites have been regarded as an important sedimentary infilling component in both oceans and lakes, but limited studies have been performed on the mechanisms governing the initiation and development of lacustrine turbidite systems. The present study offers unique insight into the controls and potential extent of ancient lacustrine turbidite systems by an investigation of the Triassic Ordos Lake, where a large turbidite system had been traced across >25 653 km2. This article shows by comparison that the Triassic Ordos Lake turbidite system is larger than all known modern and ancient lacustrine counterparts. The exceptionally large intracontinental sag basin provided a relatively unconfined environment for the development of the turbidite system, explaining its vast extent. Extraordinary flood events formed during the Carnian Pluvial Episode facilitated continuous sediment supply into the turbidite system, supporting its accumulation. Lacustrine flood‐related turbidity currents travelled as sediment‐laden turbulent flows, showing an increase in the proportion of suspended‐load deposits and a decrease in the proportion of bed‐load deposits downstream from the river mouth. Five architectural elements have been revealed, reflecting a distinctive assemblage of erosional bedforms and depositional bedforms in channel‐lobe systems, and their recognition criteria were established. This study changes the traditional understanding of lacustrine turbidite systems, generally interpreted as having smaller sizes, and demonstrates likewise in the lacustrine realm, that extreme flood events can generate a world‐class deep‐water turbidite system, which can even be comparable with its submarine counterparts. This study also confirms that the combination of low‐gradient slopes and a long‐lived, mixed‐load, prograding fluvial feeder system can produce exceptionally large‐scale deep‐lake flood‐related turbidites. Furthermore, it has implications for the prediction of facies and reservoir quality in ancient lacustrine turbidite systems.
Extracorporeal photopheresis to attenuate decline in lung function due to refractory obstructive allograft dysfunction
Authors:   The EPI Study Group, Hage Chadi A. , Klesney‐Tait Julia , Wille Keith , Arcasoy Selim , Yung Gordon , Hertz Marshall , Chan Kevin M. , Morrell Matt , Goldberg Hilary , Vedantham Suresh , Derfler Mary Clare , Commean Paul , Berman Keith , Spitznagel Ed , Atkinson Jeff , Despotis George 
Published: May 2021

AbstractBackgroundThis study was designed to prospectively evaluate the efficacy of extracorporeal photopheresis (ECP) to attenuate the rate of decline of FEV1 in lung transplant recipients with refractory bronchiolitis obliterans. Due to an observed higher than expected early mortality, a preliminary analysis was performed.Study Design and MethodsSubjects from 10 lung transplant centres were assigned to ECP treatment or to observation based on spirometric criteria, with potential crossover for those under observation. The primary endpoint of this study was to assess response to ECP (i.e., greater than a 50% decrease in the rate of FEV1 decline) before and 6 months after initiation of ECP. Mortality was also evaluated 6 and 12 months after enrolment as a secondary endpoint.ResultsOf 44 enrolled subjects, 31 were assigned to ECP treatment while 13 were initially assigned to observation on a non‐random basis using specific spirometric inclusion criteria (seven of the observation patients subsequently crossed over to receive ECP). Of evaluable patients, 95% of patients initially assigned to treatment responded to ECP with rates of FEV1 decline that were reduced by 93% in evaluable ECP‐treated patients. Mortality rates (percentages) at 6 and 12 months after enrolment was 32% and 41%, respectively. The most common (92%) primary cause of death was respiratory or graft failure. Significantly (p = 0.002) higher rates of FEV1 decline were observed in the non‐survivors (−212 ± 177 ml/month) when compared to the survivors (−95 ± 117 ml/month) 12 months after enrolment. In addition, 18 patients with bronchiolitis obliterans syndrome (BOS) diagnosis within 6 months of enrolment had lost 38% of their baseline lung function at BOS diagnosis and 50% of their lung function at enrolment.ConclusionsThese analyses suggest that earlier detection and treatment of BOS should be considered to appreciate improved outcomes with ECP.
Clinical Techniques: When and how to do a myringotomy – a practical guide
Authors: Cole Lynette , Nuttall Tim 
Published: May 2021

A myringotomy is a surgical incision made in the tympanic membrane (TM). This gives access to the middle ear for sampling, flushing and instilling topical therapy. It should be considered whenever the TM is intact and there is clinical evidence of otitis media, abnormal TMs and/or abnormal diagnostic imaging. Samples should be collected for cytological investigation and culture, and then the external ear should be cleaned and dried (if required). Myringotomies should be performed under general anaesthesia and, wherever possible, using a video otoscope; the enhanced view and instrument ports facilitate the technique and reduce the risk of complications. The myringotomy incision should be made in the caudoventral quadrant of the TM using an appropriately sized urinary catheter to collect samples and flush the middle ear cavity. A thorough understanding of the anatomy, technique and potential ototoxicity of topical therapy is needed to minimize the risk of neurological and other complications. The TM usually heals within 35 days if kept free of infection.
Limited Enhancement of Subatmospheric Boiling on Treated Structured Surfaces With Biphilic Pattern
Authors: Shen Biao , Iwata Naoki , Hidaka Sumitomo , Takahashi Koji , Takata Yasuyuki 
Published: May 2021

Abstract
Boiling heat transfer suffers deteriorations under subatmospheric conditions, which can be attributed to a shortage of viable nucleation sites at declining pressures. In this work, the possibility of enhancing low-pressure saturated boiling of water using a combination of wettability patterning and structural modifications was experimentally explored. The copper test surface, comprised of an array of circular “dimples” (0.3 mm in depth, 0.5 mm in diameter, and 3.0 mm in pitch), was spray-coated by polytetrafluoroethylene (PTFE) coatings so as to form a matching biphilic pattern with the surface cavities. The resulting dimpled biphilic surface showed appreciable heat transfer enhancement—with a maximum 60% increase of the average heat transfer coefficient of nucleate boiling compared with a flat biphilic surface—down to about 9.5 kPa. Further lowering the pressure to 7.8 kPa, however, was found to lead to diminished performance gains. The visualization study of the bubble departure dynamics revealed signs of additional vapor trapping of the hydrophobic-coated cavities, which can induce uninterrupted bubble regeneration with zero waiting time and explain the qualified enhancement of subatmospheric boiling. Thanks to a potential secondary pinning of contact line inside the hydrophobic cavities, incomplete bubble detachment could prevail at somewhat lower pressures than was otherwise possible without the dimple structure, leaving behind significantly more vapor residues. However, the vapor-trapping capacity was found to decrease with pressure, which provided clues with regard to the reduced efficacy of the surface at even lower pressures.
Erosion Wear Characteristics of Tee Tubes With Gas–Solid Two-Phase Flow
Authors: Zhang J. , Zhang Hao , Liu Yang , Zhang Chuan 
Published: May 2021

Abstract
Pressure manifold is prone to failure caused by cuttings and gravels included in the underground natural gas and shale gas. In particular, the tee tubes are one of the most easily failed components. In order to study the erosion wear mechanism of tee tubes. T-tube, Y-tube, and y-tube pressure manifolds are systematically studied. The results show that structure and gas inlet affect the tube's field distribution and erosion. After gas shunts (separated flow), high-pressure areas are concentrated on junction and downstream, while high-pressure areas are concentrated downstream after the gas conflates (sink flow). Erosion area and particle trajectory of the tee tubes under the effect of shunting and confluence are analyzed. Overall erosion of Y-tube is the most severe. Taking erosion wear degree into account, y-tube is a better choice.
Neuromuscular Fatigue After Long-Duration Adventure Racing in Adolescent Athletes
Authors: Birat Anthony , Garnier Yoann M. , Bourdier Pierre , Dupuy Alexis , Dodu Alexandre , Grossoeuvre Claire , Dupont Anne-Charlotte , Blazevich Anthony J. , Rance Mélanie , Morel Claire , Nottin Stéphane , Ratel Sébastien 
Published: May 2021

Purpose: To characterize the acute effects of a long-duration adventure race on knee extensor (KE) fatigue and the knee functional ratio in adolescent athletes. Methods: Twenty trained male adolescents (aged 14–17 y) performed an adventure race of 68.5 km. Maximal voluntary isometric contraction (MVIC) KE and knee flexor torques were measured before and immediately after the race. Central and peripheral components of neuromuscular fatigue were quantified from the maximal voluntary activation level and the doublet peak torque (Tw100), respectively. The peak eccentric knee flexor torque to concentric KE torque ratio was also measured to determine functional ratio. Results: The race completion time was 05:38 (00:20) hours. Significant reductions in MVICKE (−14.7%, P < .001) and MVICKF (−17.0%, P < .01) were observed after the race. Voluntary activation level decreased by 8.3% (P < .001) while Tw100 remained unchanged. Peak eccentric knee flexor torque decreased 16.0% (P < .001) while peak concentric KE torque did not change. This resulted in a significant reduction in functional ratio (−12.0%, P < .01). Conclusion: The adventure race induced a moderate fatigue, which was mainly explained by central factors without significant peripheral fatigue. However, particular attention should be paid to the knee muscular imbalance incurred by the race, which could increase the risk of ligament injury in adolescent athletes.
Bibliography of published COVID-19 in children literature
Authors: Stilwell Philippa Anna , Munro Alasdair P. S. , Basatemur Emre , Talawila Da Camara Nishanthi , Harwood Rachel , Roland Damian 
Published: May 2021

BackgroundThe COVID-19 pandemic is the biggest worldwide health challenge in this century. Research concerning the role of children in the spread of SARS-CoV-2, and investigating the clinical effects of infection in children, has been vital. This paper describes the publication trend for pertinent scientific literature relating to COVID-19 in children during the first 6 months of the pandemic.MethodsA comprehensive search of preprint and published literature was conducted daily across four databases (PubMed, Scopus, Ovid-Embase and MedRXiv) between 1 January 2020 and 30 June 2020. Titles and abstracts were screened against predefined inclusion and exclusion criteria.FindingsOver the study period, a total of 45 453 papers were retrieved, of which 476 met our inclusion criteria. The cumulative number of children described in included publications totalled (at most) 41 396. The median number of children per paper was 6 (IQR 1–33). Nearly one-third of papers (30.2%) reported on a single child, and a further 28.3% reported on between 1 and 9 children. Half of all the publications originated from Asia.InterpretationOur prospective bibliographic analysis of paediatric COVID-19 publications demonstrated a steady increase in the number of papers over time. Understanding and policy evolved with new information that was gathered over the course of the study period. However, over half of publications were individual case reports or small case series, which may have had a limited contribution to advancement of knowledge. During a pandemic, literature should be interpreted with great caution, and clinical/policy decisions should be continually reviewed in light of emerging evidence.