bluuebunny/crossref_metadata_2025_split huggingface dataset:
Temperature dependent fracture toughness model for whisker‐reinforced ceramic matrix composites
Authors: Shao Jiaxing , Li Weiguo , Kou Haibo , Deng Yong 
Published: January 2022

AbstractA temperature dependent fracture toughness model for whisker‐reinforced ceramic matrix composites was developed in this study, which considers the effects of matrix fracture toughness, residual thermal stress, crack bridging, crack deflection, and their temperature dependence. Its predicted results were compared with the fracture toughness of six types of whisker‐reinforced ceramic matrix composites at different temperatures, and good agreement between predicted results and experimental results is obtained. Furthermore, based on this model, we systematically analyzed the effects of the volume fraction and aspect ratio of whisker, Young's modulus of matrix and whisker, thermal expansion coefficient difference, stress‐free temperature, the ratio between the fracture energy of matrix and that of interface, on their temperature dependent fracture toughness for the first time. Finally, insights and suggestions which could help to optimize and improve the composite fracture toughness at different temperatures are provided.
Calcium‐silicate‐hydrates/polycarboxylate ether nanocomposites doped by magnesium: Enhanced stability and accelerating effect on cement hydration
Authors: Zhu Hongwei , Zhang Mai , Zou Fubing , Wang Fazhou , Hu Chuanlin 
Published: January 2022

AbstractC‐S‐H/PCE (calcium‐silicate‐hydrates/polycarboxylate ether) nanocomposites have a significant accelerating effect on early hydration and early strength development of cementitious materials. In this study, magnesium ions are doped into C‐S‐H/PCE nanocomposites, and it is found that C‐S‐H/PCE nanocomposites doped by appropriate magnesium ions have much better stability. Besides, the accelerating effects of the modified nanocomposites on early cement hydration also get improved. The doped magnesium ions displace calcium ions and promote the absorption of PCE. Moreover, the incorporation of magnesium ions results in two unique morphologies of nanocomposites, that is, globule and gel. The globules are semi‐crystalline similar to C‐S‐H, while the gels are amorphous and have more branched silicate chains.
Qualitative exploration of nurses' experiences of the COVID‐19 pandemic using the Reconceptualized Uncertainty in Illness Theory: An interpretive descriptive study
Authors: Turgut Yasemin , Güdül Öz Hatice , Akgün Mehtap , Boz İlkay , Yangın Hatice 
Published: January 2022

AbstractAimsTo explore nurses' personal, social and professional experiences in COVID‐19 emergency departments and intensive care units based on the Reconceptualized Uncertainty in Illness Theory.DesignThis study used an interpretive qualitative descriptive design.MethodsOpen‐ended interviews were conducted between August and November 2020 with 21 nurses using interview questions based on the Reconceptualized Uncertainty in Illness Theory. Data were analysed using steps informed by hermeneutic phenomenology and reported using Consolidated Criteria for Reporting Qualitative Research.FindingsData were grouped under five categories with 10 themes based on the Reconceptualized Uncertainty in Illness Theory: ‘antecedents of uncertainty’, ‘appraisal of uncertainty’, ‘coping with uncertainty’, ‘probabilistic thinking’ and ‘formation of a new life perspective’. Nurses reported that they experienced uncertainty about being infected and infecting others with COVID‐19 as well as caring for COVID‐19 patients. Despite the uncertainties related to COVID‐19, nurses were determined to focus on caring for COVID‐19 patients by prioritizing their professional identity and responsibilities. They described feeling motivated by patients' positive feedback, which also increased their professional satisfaction. They realized that caring was therapeutic not only for their patients, but also for them. They experienced empowerment in the care team through active reuse of their prior knowledge and experience and expanded decision‐making roles. They also emphasized that they perceived the COVID‐19 pandemic as a unique experience for their individual and professional growth.ConclusionNurses experienced multiple sources of uncertainty during the COVID‐19 pandemic. To manage uncertainty, they used strategies including focusing on patient care and satisfaction. Additionally, they made sense of their experience by acknowledging individual and professional growth.ImpactThis study has a potential impact to support healthcare policymakers to meet the needs of nurses in possible future pandemics.
Analysis of integrated clinical safety data of tadalafil in patients receiving concomitant antihypertensive medications
Authors: Kloner Robert A. , Kostis John B. , McGraw Thomas P. , Qiu Chunfu , Gupta Alankar 
Published: January 2022

AbstractThis pooled safety analysis assessed the incidence of hypotension‐related treatment‐emergent adverse events (TEAEs) and major adverse cardiovascular events (MACEs) in patients with concomitant use of tadalafil and antihypertensive medications. Data were pooled from seventy‐two Phase II–IV studies conducted on patients with a diagnosis of erectile dysfunction (ED) and/or benign prostate hyperplasia (BPH). Studies were categorized as either All placebo‐controlled studies or All studies. The incidences of hypotension‐related TEAEs and MACEs were analyzed by indication; by use of concomitant antihypertensive medications; and by the number of concomitant antihypertensive medications. A total of 15 030 and 22 825 patients were included in the analyses for All placebo‐controlled studies and All studies, respectively. In the All placebo‐controlled studies, the incidence of hypotension‐related TEAEs and MACEs was ranging between 0.6–1.5% and 0.0–1.0%, respectively, across all indications. Tadalafil was associated with an increase in hypotension‐related TEAEs only in the ED as‐needed group not receiving any concomitant antihypertensive medications (p‐value = .0070); no significant difference was reported between placebo and tadalafil in the groups of patients receiving ≥1 antihypertensive medication (p‐values ≥ .7386). Similarly, no significant differences (p‐values≥ .2238) were observed in the incidence of MACEs between tadalafil and placebo treatment groups, with or without concomitant use of antihypertensive medications, and across all indication categories. In the All studies group, results were similar. The pooled analysis showed no evidence that taking tadalafil alongside antihypertensive medications increases the risk of hypotension‐related TEAEs or MACEs compared with antihypertensive medications alone.
Is dupilumab effective in adult‐onset atopic dermatitis: Real‐life experience of 16 patients
Authors: Erbağcı Ece , Demirel Öğüt Neslihan , Koç Yıldırım Sema , Hapa Fatma Aslı 
Published: January 2022

AbstractBackgroundDupilumab is approved for the treatment of atopic dermatitis (AD). However, there are few studies demonstrating its efficacy and safety, particularly in the treatment of adult‐onset AD.ObjectiveThe aim of this study is to evaluate the real‐life experience regarding the efficacy and safety of dupilumab in the treatment of adult‐onset AD.MethodsThis study is a case series in retrospective design. Patients with the diagnosis of adult‐onset AD, using dupilumab at a standard dose for at least 3 months, were included in the study. Demographic and laboratory data of the cases, data regarding to dupilumab treatment, were recorded. The eczema area severity index (EASI) and the visual analog scale (VAS) for itch were used to evaluate treatment efficacy.ResultsA total of 16 patients, 6 female and 10 male, were included. The median age was 41 years, the median age of the disease onset was 37.5 years, and the median duration of the disease was 90 months. The median duration of the dupilumab treatment was 10.5 months. The mean percent reduction from baseline in EASI score was 85.8 ± 12.2 at 3 months, 90.7 ± 9.3 at 6 months, and 93.1 ± 5 at 12 months. The mean percent reduction from baseline in VAS itch score was 82.2 ± 8.6 at 3 months. Acute vestibular neuritis was developed in one patient during the dupilumab therapy and resolved with anti‐inflammatory therapy.ConclusionDupilumab seems to be highly effective and safe in the treatment of adult‐onset AD. The present study is important as it is the first study to evaluate this patient group specifically.
Symptom clusters, associated factors and health‐related quality of life in patients with chronic obstructive pulmonary disease: A structural equation modelling analysis
Authors: Fei Fei , J Siegert Richard , Zhang Xiaohan , Gao Wei , Koffman Jonathan 
Published: January 2022

AbstractAims and objectivesTo identify symptom clusters and develop a symptom cluster model among people living with chronic obstructive pulmonary disease (COPD).BackgroundThe examination of symptom clusters in COPD patients is an emerging field of scientific inquiry directed towards symptom management. However, no studies have modelled the relationships among symptom clusters, associated factors and health‐related quality of life.DesignA cross‐sectional design with convenience sampling following STROBE guidelines.MethodsData were collected from 450 COPD participants in three university teaching hospitals. Participants were invited to complete a structured questionnaire comprised of a socio‐demographic/clinical questionnaire, Integrated Palliative Care Outcome Scale and Clinical Respiratory Questionnaire. Exploratory factor analysis and confirmatory factor analysis were used to identify symptom clusters. Structural equation modelling was used to examine the proposed model.ResultsThe respiratory related symptom cluster, psychological symptom cluster and cough‐insomnia related symptom cluster were identified. The final model demonstrated a good fit with the data. Gender, stage of disease and monthly income were significant factors associated with symptom clusters. Respiratory related and cough‐insomnia related symptom clusters had a direct negative impact on health‐related quality of life, while the psychological symptom cluster was found to have a direct and indirect negative effect on health‐related quality of life.ConclusionsFinal COPD symptom cluster model should serve as a framework to guide intervention research targeting symptom clusters to improve health‐related quality of life of people living with COPD.Relevance to Clinical PracticeNurses should be especially attuned to identify those at most risk of facing a higher symptom burden in this case those who are female, have advanced stage COPD and/or lower income. During the clinical symptom assessment, nurses should pay attention to the close relationships among symptoms within a cluster to identify any ‘trigger’ symptom that could cause the development or exacerbation of other symptoms.
Friend, foe, or forget ‘em?: The quality of LGBTQ adult sibling relationships
Authors: Reczek Rin , Stacey Lawrence , Dunston Chloe 
Published: January 2022

AbstractObjectiveThe present study aims to understand how LGBTQ adults characterize the quality of their adult sibling ties, and how the type of sibling relationship (e.g., full, step, half, chosen) informs this characterization.BackgroundAn intragenerational conflict‐solidarity‐ambivalence frame is developed to theorize and empirically examine sibling relationships.MethodsDrawing on an intragenerational conflict‐solidarity‐ambivalence frame, we analyze qualitative in‐depth interview data from 67 LGBTQ adults who identify as having a sibling.ResultsThe quality of sibling ties was characterized in three primary ways: solidary, wherein an adult sibling perceived their sibling bond(s) as high quality due to exchanges of social/emotional/financial/instrumental support and connection, including LGBTQ support; conflictual, wherein the adult sibling tie is painful because a sibling is problematic, is unsupportive of an LGBTQ identity, or because a sibling creates conflict in a relationship with a parent; and tangential, wherein the sibling relationship was never bonded, is distanced, or siblings have their “own” families and are thus deemed inconsequential. Only full siblings were typified as conflictual, while all sibling types were solidary. Full, step, and half siblings only are characterized as tangential. Differences in sibling quality across gender and sexuality are discussed.ImplicationsThis study contributes to the growing body of research on the quality of family ties in adulthood, providing further insight into how a socially marginalized group is supported, harmed, or perhaps unfazed by their sibling relationships.
Productive, physiological and nutritional responses of laying hens fed different dietary levels of turmeric powder
Authors: Fawaz Mohamed A. , Südekum Karl‐Heinz , Hassan Hamdy A. , Abdel‐Wareth Ahmed A. A. 
Published: January 2022

AbstractThis study aimed to determine the impact of supplementation of turmeric powder on laying performance, egg quality, nutrient digestibility and some blood metabolites in laying hens. A total of one hundred and twenty Bovans Brown laying hens (55 weeks old) were assigned to one of four treatment diets (n = 30) for 12 weeks including turmeric powder at 0, 2.5, 5 or 7.5 g/kg respectively. The results revealed that egg production, egg weight and egg mass were significantly increased (p < 0.05), and the feed conversion ratio was significantly improved (p < 0.012) with increasing levels of turmeric in the laying hen diet. Egg thickness and Haugh unit were linearly increased (p < 0.01) with increasing supplementation levels. Moreover, compared with the control diet, the levels of turmeric powder supplementation significantly improved nutrient digestibility (p < 0.001). Moreover, the serum metabolic profile revealed that serum total cholesterol, aspartate aminotransferase, creatinine and urea concentrations were linearly decreased with increasing turmeric powder supplementation to hen diets. In conclusion, the inclusion of turmeric powder at 2.5, 5 or 7.5 g/kg diet improved egg production, nutrient digestibility, egg quality and serum metabolic profile and may be used as a feed additive in laying hens' nutrition. However, results indicate that the best improvement was observed when 5 g/kg were supplemented.
Experimental sympatry suggests geographic isolation as an essential reproductive barrier between two sister species ofPedicularis
Authors: Tang Ju , Sun Shi‐Guo , Huang Shuang‐Quan 
Published: January 2022

AbstractAlthough mechanical isolation mediated by shared pollinators has been considered as a classic model of pollinator‐mediated floral isolation inPedicularis, a superdiverse genus in Hengduan Mountains, southwest China, there has been no empirical study of interspecific pollen flow between closely related species. We examined reproductive barriers at six different stages betweenPedicularis cranolophaandPedicularis tricolor, two sister species. The two sister species were geographically isolated from each other based on our field survey and the records of herbarium specimens. Translocation experiments showed that flowering phenology partly overlapped and bumblebee pollinators did not discriminate between flowers of the two species. Bumblebee interspecific moves could mediate interspecific pollination as traced using fluorescent powder, in which pollen analogs placed on one species were transferred to the stigmas of the other species in experimental plots containing both species. Heterospecific pollen tubes grew in the style as well as conspecific pollen in hand‐pollination experiments. Reciprocal hybridization between the two species could produce (partially) viable seeds, suggesting weak post‐pollination barriers. Our results showed that geographic isolation was an important barrier of two species, and the total reproductive isolation between two species was incomplete when without geographical isolation. The formation of Big Snow Mountains could introduce an important pre‐zygotic reproductive barrier between the two sister species ofPedicularis; such geographical isolation could be responsible for allopatric speciation, giving a clue to understanding the rapid radiation on mountain areas.
Bear diets and human–bear conflicts: insights from isotopic ecology
Authors: Falconi Nereyda , Carlo Tomás A. , Fuller Todd K. , Destefano Stephen , Organ John F. 
Published: January 2022

AbstractBears, Ursidae, are considered omnivores, except for giant pandas Ailuropoda melanoleuca and polar bears Ursus maritimus. However, omnivory includes a wide range of dietary variation and trophic positions, making bear dietary ecology unclear. We inferred bear trophic positions from δ15N (‰) values and examined their correlation with diets reported in the literature, including frequency of human–bear conflicts (livestock predation and crop damage incidents). Overall, 15N signatures were consistent with diet estimates. Bear species with higher 15N signatures differed more from each other, including cases of large regional intraspecific variance, than bear species with lower 15N signatures. Bear trophic position and frequency of reports of human–bear conflicts were uncorrelated, suggesting that livestock predation by bears is an opportunistic behaviour rather than a response to food availability dynamics.
Death and Dying in Carceral America: The Prison Hospice as an Inverted Space of Exception
Authors: Sharp Lesley A. 
Published: January 2022

AbstractIn America's prisons, long‐term incarceration carries fears that one could die in prison alone and abandoned. Death by incarceration looms as inescapable for myriad inmates who are terminally ill or “graying” in prison. These realities inform this study of a prison‐based hospice program staffed by male inmate volunteers in a mixed medium/maximum security facility. Of special concern are the experiences of the men who sit by the bedside of others who are dying. I begin with the assumption that prisons loom as states of exception, epitomized by the realities of substandard prison medicine, the devaluation of care as anathema to prison survival, and the persistent neglect of the ill and aging. The ethos and practices associated with inmate‐driven end‐of‐life care demarcate an inverted space of non‐judgmental praxis that simultaneously envelopes the dying man while also instigating self‐reflection, change, and self‐care among inmate hospice volunteers.
Patients' perspectives on medical students' professionalism: Blind spots and opportunities
Authors: Haney Simon , Rowland Paula , Ginsburg Shiphra 
Published: January 2022

AbstractBackgroundResearch has acknowledged the value of patients as essential stakeholders in medical education, yet educators have not adequately incorporated patients' perspectives into medical students' developing professionalism. Our purpose was to explore patients' perceptions of professional behaviour in medical students as a first step to considering patients' potential roles in assessing professionalism.MethodsBuilding on the existing framework of the ‘disavowed curriculum’, we used a constructivist grounded theory approach to interview and analyse data from 19 patients (11 W, 8 M) at one urban hospital. Each participant watched five video scenarios that depict professionally challenging situations commonly faced by medical students, after which they were asked to put themselves in the position of both the patient and the student depicted in each scenario, and to discuss what they felt would be appropriate or inappropriate behaviours from each perspective.ResultsPatients' responses replicated all elements of the disavowed curriculum, including principles of professionalism, the student's affect or internal factors, and potential implications of actions. Their responses reflected avowed, unavowed and disavowed rationales. Participants also identified novel principles, including hide dissension in the ranks, respect privacy, advocate for yourself and have trust in the system. Patients conveyed an understanding of the multiple competing factors students must balance (e.g., providing optimal care while maximising educational opportunities) and appeared to empathise with some of the pressures students face.ConclusionsOur findings point to significant blind spots in previous research based on faculty and student perspectives of professionalism. Knowing what patients perceive as important will allow educational and assessment efforts to be refined to reflect their values. Our work begins the process of understanding how best to include patients in the assessment of medical learners.
One‐Stage Closed Intramedullary Nailing for Delayed Femoral Fracture in Multiple Injured Patients
Authors: Yan Ruijian , Wu Yifan , Qi Yiying , Li Hang , Dong Shurong , Feng Gang 
Published: January 2022

ObjectiveTo tackle the challengeable dilemma of delayed femoral fracture, a technique of fixator‐assisted closed reduction and intramedullary nailing at one stage was introduced herein and its clinical results were investigated.MethodsA retrospective study was conducted on delayed femoral shaft fracture between February 2008 and January 2017. The multiple injured patients aged from 18 to 60 years with delayed femoral fracture was included. All patients were treated by one‐stage internal fixation technique and followed up for more than 1 year. Outcome measures including the operation time, intraoperative blood loss and limb alignment, healing time of fracture, visual analog scale (VAS), and range of knee motion were recorded and evaluated.ResultsA total of 13 patients (16 sides) with a mean injury severity score (ISS) of 32.77 ± 9.98 (range, 19 to 52) participated in the investigation. The median length of time‐after‐fracture was 38 days (range, 21 to 110 days). The average shortening distance of the fracture ends was 35.48 ± 19.24 mm (range, 10.00 to 79.00 mm). The average surgery time was 192.19 ± 29.38 min for unilateral femoral fracture, with blood loss of 587.50 ± 232.02 ml. The postoperative discrepancy of lower limb was 3.87 ± 2.52 mm. No patient had vascular and neurologic complications due to the lengthening. All fractures healed successfully with a mean time of 2.98 ± 0.57 months. The mean VAS and maximal knee flexion were 1.63 ± 1.09 and 131.25° ± 5.32° at final follow‐up, respectively.ConclusionsOur findings indicated that fixator‐assisted closed reduction and intramedullary nailing at one stage is an effective treatment for delayed femoral fracture with satisfactory functional recovery.