bluuebunny/crossref_metadata_2025 huggingface dataset:
Brewing sustainability: assessing environmental concerns and consumers’ attitudes towards sustainable craft beer purchase intentions
Authors: Lourenco Carlos Eduardo , Piotto Vinícius
Published: April 2024

Purpose

This study aims to investigate the interplay between environmental concerns, consumer attitudes and their influence on sustainable practices within the craft beer industry, exploring how consumers’ perception of environmental attributes impact their purchase intentions regarding craft beer.

Design/methodology/approach

The study used a quantitative approach, using a self-administered survey instrument comprised 28 Likert-scale items. Data was gathered from a convenience sample of 319 craft beer consumers. Confirmatory factor analysis was conducted to assess the measurement model’s validity and reliability. Subsequently, partial least squares structural equation modeling was used to test the hypothesized relationships.

Findings

This study’s findings challenge established notions within the field, demonstrating that water conservation, carbon footprint reduction, organic farming and local sourcing practices hold significant influence on consumers’ purchase intentions regarding sustainable craft beer. These findings depart from previous research that suggested a less pronounced impact of specific sustainability practices on consumer behavior.

Research limitations/implications

This study contributes to the literature by revealing consumer insights into the environmental implications of craft beer choices, empowering them to make informed purchasing decisions aligned with their sustainability values. However, acknowledging potential limitations, sample size and demographic composition (young adults in Brazil) potentially impact the generalizability of the findings.

Originality/value

This study addresses the understanding of consumer attitudes and priorities regarding environmental sustainability within the craft beer industry. By focusing on the tangibility of specific sustainable attributes the research shows how these practices influence consumer perceptions and purchasing intentions.
Unveiling barriers to Industry 5.0 adoption in supply chains: a DEMATEL approach
Authors: Laddha Seema , Agrawal Anguja
Published: April 2024

Purpose

The objective of this research is to investigate the barriers impacting the integration of Industry 5.0 (I5.0) in supply chain sustainability. By understanding these challenges, this study aims to provide valuable insights that can guide organizations in successfully implementing the transformative potential of I5.0. The ultimate aim is to improve operational efficiency and advocate for sustainable practices within supply chains.

Design/methodology/approach

Research has used industry expert interviews, a comprehensive literature review and the decision-making trial and evaluation laboratory approach for analysis. Industry expert interviews serve to capture first-hand insights from professionals well versed in the field, providing practical perspectives on the barriers to I5.0 adoption.

Findings

This study identifies technological challenges, organizational barriers, regulatory impediments and economic constraints as pivotal factors inhibiting the widespread adoption of I5.0 in supply chain sustainability.

Research limitations/implications

This research serves as a foundation for future investigations into overcoming barriers to I5.0 adoption, guiding scholars and practitioners in refining strategies for successful implementation.

Practical implications

The findings offer practical insights for organizations aiming to adopt I5.0, informing decision-makers on key challenges and facilitating the development of targeted strategies to overcome them.

Social implications

The social implications lie in fostering sustainable business practices through the adoption of I5.0, contributing to environmental responsibility and societal well-being.

Originality/value

This research contributes original insights from practitioners, policymakers and researchers in navigating the complex landscape of I5.0 adoption, ensuring meaningful contributions to both academia and industry.
Intellectual structure on artificial intelligence studies in tourism and hospitality: a bibliometric analysis
Authors: Şengel Ümit , Işkın Merve
Published: April 2024

Purpose

The paper aims to reveal the intellectual structure of studies on artificial intelligence (AI) in the fields of tourism and hospitality. Evaluations regarding the intellectual structure have been made based on co-author, co-word and citation.

Design/methodology/approach

The study is exploratory in nature. The study, using bibliometric analysis, provides a Web of Sciences (WOS) overview. The data has been obtained from the WOS database by coding as “artificial intelligence” and “tourism” and “hospitality.” VOSviewer program has been used to obtain and analyze the data.

Findings

The findings of the research show that studies on the use of AI in tourism and hospitality have become very popular, especially in the last 4 years. The authors of the study are working in the tourism and hospitality fields and have a high h-index. Generally, in current AI studies in tourism, topics such as robot, automation, ChatGPT, technology adoption and mechanical learning are studied. It has also been determined that topics related to the future of destinations and literature reviews are also discussed.

Research limitations/implications

Although this paper examines all studies identified as a result of filtering, the analysis is limited to 195 studies. However, due to the widespread use of AI in tourism-related studies recently, bibliometric analysis has been made with extensive filtering. As studies on the subject become more widespread in the coming years, it would be useful to repeat similar studies by filtering with more specific quotas.

Originality/value

There are a few similar studies on the subject in the field. However, these studies need to be repeated at certain periods. This paper contributes to monitoring the literature of AI studies, which are new to use in tourism and hospitality, and to the formation of a theoretical framework on the subject.
Consumer‐driven evaluation of assistive technology usage and perceived value in people with myositis in Australia
Authors: Cusso Melanie , Cooper Ian , Beer Kelly , Naseri Chiara , Garbellini Simon , Doverty Althea , Corcoran Geoff , Needham Merrilee
Published: April 2024

Introduction

Idiopathic inflammatory myopathies (known as ‘myositis’) are a group of rare sporadic inflammatory muscle disorders that significantly impact function and quality of life. There are no standardised approaches in the use of assistive technologies in myositis. This study was initiated to investigate current use and perceived value of assistive technology (AT) by people with myositis.

Methods

A cross‐sectional online questionnaire (Qualtrics) was designed to capture information regarding AT use and perceived value and demographic information from people with myositis across Australia. The questionnaire was distributed via the Myositis Association of Australia and specialist myositis clinics. Participants were asked to identify which AT items they owned and how frequently the item was used and to rate the ‘usefulness’ of those items. Information was also collected on participants' engagement with health professionals regarding assistive technologies.

Consumer and community involvement

Consumer involvement via the Myositis Research Consumer Panel identified a knowledge gap regarding AT. The questionnaire was designed with consumer input and review.

Results

One hundred two people (102) with myositis completed the questionnaire. One hundred (100) participants owned at least one AT device, with a median of 12.5 items and a maximum of 65 items. The most used devices were associated with toileting, personal care and mobility. Participants rated AT devices relating to environmental support, sleeping, seating and body support as most useful. There was a positive correlation between disease duration and number of devices used (r2 = 0.248, p = 0.012). Majority of participants (75.5%) were interested in talking to health professionals about AT; however, only 50% had done so.

Conclusion

AT device usage is high among people with myositis, with most items deemed to be useful. Greater occupational therapy input into recommendations and potential funding options may improve knowledge and access to AT.
Burden and outcomes of postpartum haemorrhage in Nigerian referral‐level hospitals
Authors: Adebayo Tajudeen , Adefemi Ayodeji , Adewumi Idowu , Akinajo Opeyemi , Akinkunmi Bola , Awonuga David , Aworinde Olufemi , Ayegbusi Ekundayo , Dedeke Iyabode , Fajolu Iretiola , Imam Zainab , Jagun Olusoji , Kuku Olumide , Ogundare Ezra , Oluwasola Timothy , Oyeneyin Lawal , Adebanjo‐Aina Damilola , Adenuga Emmanuel , Adeyanju Alaruru , Akinsanya Olufemi , Campbell Ibijoke , Kuti Bankole , Olofinbiyi Babatunde , Salau Qasim , Tongo Olukemi , Ezekwe Bosede , Lavin Tina , Oladapo Olufemi T. , Tukur Jamilu , Adesina Olubukola
Published: April 2024

Objective

To determine the prevalence of primary postpartum haemorrhage (PPH), risk factors, and maternal and neonatal outcomes in a multicentre study across Nigeria.

Design

A secondary data analysis using a cross‐sectional design.

Setting

Referral‐level hospitals (48 public and six private facilities).

Population

Women admitted for birth between 1 September 2019 and 31 August 2020.

Methods

Data collected over a 1‐year period from the Maternal and Perinatal Database for Quality, Equity and Dignity programme in Nigeria were analysed, stratified by mode of delivery (vaginal or caesarean), using a mixed‐effects logistic regression model.

Main outcome measures

Prevalence of PPH and maternal and neonatal outcomes.

Results

Of 68 754 women, 2169 (3.2%, 95% CI 3.07%–3.30%) had PPH, with a prevalence of 2.7% (95% CI 2.55%–2.85%) and 4.0% (95% CI 3.75%–4.25%) for vaginal and caesarean deliveries, respectively. Factors associated with PPH following vaginal delivery were: no formal education (aOR 2.2, 95% CI 1.8–2.6, P < 0.001); multiple pregnancy (aOR 2.7, 95% CI 2.1–3.5, P < 0.001); and antepartum haemorrhage (aOR 11.7, 95% CI 9.4–14.7, P < 0.001). Factors associated with PPH in a caesarean delivery were: maternal age of >35 years (aOR 1.7, 95% CI 1.5–2.0, P < 0.001); referral from informal setting (aOR 2.4, 95% CI 1.4–4.0, P = 0.002); and antepartum haemorrhage (aOR 3.7, 95% CI 2.8–4.7, P < 0.001). Maternal mortality occurred in 4.8% (104/2169) of deliveries overall, and in 8.5% (101/1182) of intensive care unit admissions. One‐quarter of all infants were stillborn (570/2307), representing 23.9% (429/1796) of neonatal intensive care unit admissions.

Conclusions

A PPH prevalence of 3.2% can be reduced with improved access to skilled birth attendants.
Advancements in enhancing resistant starch type 3 (RS3) content in starchy food and its impact on gut microbiota: A review
Authors: Feng Hongyan , Cheng Bo , Lim Jongbin , Li Baoguo , Li Cheng , Zhang Xiaowei
Published: April 2024

Resistant starch type 3 (RS3), often found in cooked starchy food, has various health benefits due to its indigestible properties and physiological functions such as promoting the abundance of gut beneficial microbial flora and inhibiting the growth of intestinal pathogenic bacteria. However, it is challenging to develop starchy food with high RS3 content. This review aims to provide a detailed overview of current advancements to enhance RS3 content in starchy food and its effects of RS3 on gut microbiota. These approaches include breeding high‐amylose cereals through gene editing techniques, processing, enzyme treatments, storage, formation of RS3 nanoparticles, and the incorporation of bioactive compounds. The mechanisms, specific conditions, advantages, and disadvantages associated with each approach and the potential effects of RS3 prepared by different methods on gut microbiota are summarized. In conclusion, this review contains important information that aims to provide guidelines for developing an efficient RS3 preparation process and promote the consumption of RS3‐enriched starchy foods to improve overall health outcomes.
Post‐lockdown burden of road injury involving hospitalisation in Victoria, Australia: A statewide, population‐based time series analysis
Authors: Lim Andy
Published: April 2024

Objectives

Ever since COVID‐19, short‐term changes in transport injury patterns have been observed. The aim is to examine both the initial and the enduring impact of government lockdown and the pandemic on road injuries requiring hospitalisation and road fatalities.

Methods

Time series analysis of Transport Accident Commission (TAC) claims involving hospitalisation and fatalities in Victoria, Australia, from July 2016 to May 2023, including lockdown (March 2020 to October 2020) and post‐lockdown (November 2020 onwards).

Results

A total of 46 450 TAC claims were included. Average claims during the pre‐pandemic period were 652/month. Lockdown restrictions were associated with a statistically significant fall in monthly claims (−255, 95% confidence interval [CI] = −315 to −194, P < 0.01). This was consistent across road users, days of the week, hours of the day, injury severity, sex and central versus rural locations. The post‐lockdown period had a statistically significant reduction in monthly claims to 76% (95% CI = 67–84) of pre‐pandemic levels (−158, 95% CI = −213 to −102, P <0.01). This was consistent across all subgroups except bicyclist injuries, which remained constant (−8, 95% CI = −16 to 0, P = 0.05). There was a significant upward trend in the fatality‐to‐claim ratio post‐lockdown (0.001, 95% CI = 0–0.001, P <0.01).

Conclusion

Road injury requiring hospitalisation decreased significantly during governmental lockdown and has returned to three‐quarters of pre‐pandemic levels (except bicyclist injuries that have remained constant), but there is an increasingly disproportionate number of fatalities. This represents a new baseline of injury burden for EDs and hospitals that manage trauma patients.
Positive effect of peptide‐calcium chelates from Grifola frondosa on a mouse model of senile osteoporosis
Authors: Xiong Yu , Li Jing‐Ru , Peng Pei‐Zhi , Liu Bin , Zhao Li‐Na
Published: April 2024

Calcium supplementation has been shown to be efficacious in mitigating the progression of senile osteoporosis (SOP) and reducing the incidence of osteoporotic fractures resulting from prolonged calcium shortage. In this study, Grifola frondosa (GF) peptides‐calcium chelate were synthesized through the interaction between peptide from GF and CaCl2. The chelation reaction was shown to involve the participation of the amino and carboxyl groups in the peptide, as revealed by scanning electron microscope, Fourier‐transform infrared, and ultraviolet spectrophotometry. Furthermore, a mouse model of (SOP) induced by d‐galactose was established (SCXK‐2018‐0004). Results demonstrated that low dosage of low‐molecular weight GF peptides‐calcium chelates (LLgps‐Ca) could significantly improve serum index and pathological features of bone tissue and reduce bone injury. Further research suggested that LLgps‐Ca could ameliorate SOP by modulating the disrupted metabolic pathway, which includes focal adhesion, extracellular matrix receptor interaction, and PI3K‐Akt signaling pathway. Using Western blot, the differentially expressed proteins were further confirmed. Thus, calciumchelating peptides from GF could serve as functional calcium agents to alleviate SOP.
Current and ideal living arrangements and supports for Canadian adults with fetal alcohol spectrum disorder (FASD)—Part I: Perspectives from adults with FASD
Authors: Gault Siann , Gnat Lauren , Fletcher Paula C. , Kirst Maritt , MacDonald Robert , Morton Ninomiya Melody E.
Published: April 2024

Background

Adults with fetal alcohol spectrum disorder (FASD) can thrive with lifelong support in daily living activities. Previous research examining living support for adults with FASD has heavily relied on caregiver reports rather than lived experiences, which can undermine opportunities for self‐determination. In this study, we examined the perspectives of adults with FASD to better understand: (1) the ways in which they are supported with daily life activities; and (2) their ideal future living arrangements and supports.

Methods

This article presents findings from the perspective of adults with FASD as part of a broader project involving both adults with FASD and the caregivers who support them. Interviews were conducted with four Canadian adults with FASD who live in housing with supportive services and seven adults with FASD who live at home with the support of caregivers. Framework analyses, a structured approach to analyzing qualitative data, were used to examine participants' perspectives.

Results

In addition to providing support for previous findings, participants provided novel information regarding: (1) their daily living supports; (2) positive and negative aspects of their arrangements; and (3) ideal living environments and supports.

Conclusions

This study offers insight into participants' perspectives regarding their living support, which is critical to inform housing and aid in self‐determination. Areas of support outlined by participants can be used to begin conversations regarding the support required in housing arrangements for adults with FASD.
The impact of religious identification on national identification and engagement in collective action to support Rohingya refugees: A comparison between Australia and Malaysia
Authors: Berndsen Mariette , Thomas Emma F. , Tee Eugene Y. J.
Published: April 2024

Research comparing how people engage in collective action in different nations to promote justice for disadvantaged groups is scarce. We investigated the effects of national identification (glorification/attachment) and religious identification across two nations (Australia, N = 358 and Malaysia, N = 300) on collective action to support Rohingya refugees of the 2017 refugee crisis. Specifically, we tested whether the relationship between national identification and collective action would be moderated by religious identification, and whether the latter would be moderated by nation. As glorification is associated with prejudice against other groups within the nation, we predicted and found support for the hypothesis that glorification of Australian identity would be a negative predictor of collective action, regardless of religion. In contrast, we hypothesized that in the Malaysian context, glorification and collective support would be shaped by religious (Islamic) identity which represented a social category shared by Malays and Rohingya refugees. Results showed that only when Malays identified with Islam, the relationship between glorification and collective support was positive. Unexpectedly, attachment and identification with Christianity or no‐religion inhibited collective support in the Australian context. The findings challenge commonly held views about glorification and attachment and enhance insight in cross‐national solidarity in a world of increasing global interdependence.
Pursuing Opacity: Geographies of Visibility in the Western Mediterranean
Authors: Martínez José Ciro
Published: April 2024

The Moroccan and Spanish governments pursue the visibility of people and things. They observe and survey in order to codify, catalogue, classify, and calculate. Rather than trace the contours of such projects, this paper seeks to provoke a more sustained engagement with modes of errantry that confound their logics of command and control. Building on more than 18 months of multi‐sited ethnography, it explores how marginalised communities navigate unequal geographies of visibility. To do so, I revisit the work of Édouard Glissant and some of his interlocutors to contemplate fluctuating vectors of opacity amongst communities living in hashish trafficking hubs. Frequently stigmatised as violent criminals and indolent freeloaders—their itineraries effaced—inhabitants of La Atunara (Spain) and the central Rif (Morocco) grapple with detection and wrestle with capture. This paper explores these positionings without reading them as disarray or disorder but as purposeful refusals worthy of political reflection.
Pulmonary diseases in patients with classical Hodgkin lymphoma relative to a matched background population: A Danish national cohort study
Authors: Vandtved Julie Haugaard , Øvlisen Andreas Kiesbye , Baech Joachim , Weinrich Ulla Møller , Severinsen Marianne Tang , Maksten Eva Futtrup , Jakobsen Lasse Hjort , Glimelius Ingrid , Kamper Peter , Hutchings Martin , Specht Lena , Dahl‐Sørensen Rasmus , Christensen Jacob Haaber , El‐Galaly Tarec C.
Published: April 2024

Late toxicities can impact survivorship in patients with classical Hodgkin lymphoma (cHL) with pulmonary toxicity after bleomycin‐containing chemotherapy being a concern. The incidence of pulmonary diseases was examined in this Danish population‐based study. A total of 1474 adult patients with cHL treated with ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) or BEACOPP (bleomycin, vincristine, etoposide, doxorubicin, cyclophosphamide, procarbazine and prednisone) between 2000 and 2018 were included along with 7370 age‐ and sex‐matched comparators from the background population. Median follow‐up was 8.6 years for the patients. Patients with cHL had increased risk of incident pulmonary diseases (HR 2.91 [95% CI 2.30–3.68]), with a 10‐year cumulative risk of 7.4% versus 2.9% for comparators. Excess risks were observed for interstitial lung diseases (HR 15.84 [95% CI 9.35–26.84]) and chronic obstructive pulmonary disease (HR 1.99 [95% CI 1.43–2.76]), with a 10‐year cumulative risk of 4.1% and 3.5% respectively for patients. No excess risk was observed for asthma (HR 0.82 [95% CI 0.43–1.56]). Risk factors for interstitial lung diseases were age ≥60 years, the presence of B‐symptoms and low albumin. These findings document a significant burden of pulmonary diseases among patients with cHL and emphasize the importance of diagnostic work‐up of pulmonary symptoms.
Being close or being alone: How Social ostracism affects solitude preference
Authors: Pang Cheng , Wang Tulips Yiwen , Lin Jiali
Published: April 2024

Social ostracism refers to the phenomenon of being excluded from social interactions and not being accepted by society. While previous research has examined its impact on prosocial and antisocial behaviour, few studies have investigated how individuals respond to ostracism by seeking solitude. Therefore, our study aims to explore the association between social ostracism and solitude seeking as well as the potential psychological mechanisms involved. We conducted three studies involving 488 Chinese students (59% female) and found that (a) long‐term ostracism experiences positively correlated with preference for solitude, (b) short‐term ostracism did not immediately lead to solitude seeking but increased the desire to establish new connections with others and (c) hostile assessment and negative emotions played a chain mediation role in the relationship between social ostracism and solitude seeking. These findings provide new insights and empirical evidence for understanding the relationship between social ostracism and solitude‐seeking.
International study of 24‐h movement behaviors of the early years (SUNRISE): A pilot study from Iran
Authors: Zarghani Najmeh Hamzavi , Jafari Zahra , Amini Fereshteh , Marashi Seiedeh Zahra , Ghaffarifar Saeideh , Ghofranipour Fazlollah , Baghbanian Mahroo , Okely Anthony D.
Published: April 2024

Background

This study examined the proportion of Iranian children who met the World Health Organization (WHO) Guidelines for physical activity, sedentary behaviour and sleep for children under 5 years. Additionally, it investigated the feasibility and acceptability of the methods to be used in the SUNRISE study.

Methods

This pilot study was conducted among 83 children aged 3 and 4 years in preschools and health care centres in Iran, in 2022. Physical activity, sedentary behaviour and sleep (ActiGraph wGT3x‐BT); fine and gross motor skills (validated activities); and executive functions (the Early Years Toolbox) were assessed.

Results

Only four (4.8%) children met all recommendations of the WHO guidelines. The proportion of children who met MVPA, TPA, screen time, restrained sitting and sleep were 44.6%, 38.6%, 19.3%, 38.6% and 65.1%, respectively. Fifty‐two (62.6%) children wore the ActiGraph for at least three full days. A total of 97.6%, 95.1% and 91.5% of children completed anthropometric, EF and motor skill assessments, respectively.

Conclusion

This pilot study was feasible and acceptable among Iranian children. Regarding the low proportion of children who met the WHO guidelines, it is recommended that long‐term and practical strategies be developed to promote healthier lifestyles among preschool children in Iran.
FontCLIP: A Semantic Typography Visual‐Language Model for Multilingual Font Applications
Authors: Tatsukawa Yuki , Shen I‐Chao , Qi Anran , Koyama Yuki , Igarashi Takeo , Shamir Ariel
Published: April 2024

Acquiring the desired font for various design tasks can be challenging and requires professional typographic knowledge. While previous font retrieval or generation works have alleviated some of these difficulties, they often lack support for multiple languages and semantic attributes beyond the training data domains. To solve this problem, we present FontCLIP – a model that connects the semantic understanding of a large vision‐language model with typographical knowledge. We integrate typography‐specific knowledge into the comprehensive vision‐language knowledge of a pretrained CLIP model through a novel finetuning approach. We propose to use a compound descriptive prompt that encapsulates adaptively sampled attributes from a font attribute dataset focusing on Roman alphabet characters. FontCLIP's semantic typographic latent space demonstrates two unprecedented generalization abilities. First, FontCLIP generalizes to different languages including Chinese, Japanese, and Korean (CJK), capturing the typographical features of fonts across different languages, even though it was only finetuned using fonts of Roman characters. Second, FontCLIP can recognize the semantic attributes that are not presented in the training data. FontCLIP's dual‐modality and generalization abilities enable multilingual and cross‐lingual font retrieval and letter shape optimization, reducing the burden of obtaining desired fonts.
Prognostic utility of blood inflammation biomarkers before and after treatment on the survival of patients with locally advanced non‐small cell lung cancer undergoing stereotactic body radiotherapy
Authors: Fang Fang , Jia Zhen , Xie Hongliang , Cao Yangsen , Zhu Xiaofei , Yang Xiao Yu , Guo Xueling , Zhang Huojun
Published: April 2024

Background and Objective

The neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) were significant and succinct indicators of systemic inflammation. We assessed the influence of stereotactic body radiotherapy (SBRT) on NLR and PLR in patients with locally advanced non‐small cell lung cancer (LA‐NSCLC).

Methods

We reviewed the medical data of patients with LA‐NSCLC who underwent SBRT between 1 January 2013 and 31 December 2018. NLR and PLR values recorded at pre‐ and post‐SBRT were examined. We assessed the correlation between pre/post‐SBRT NLR and PLR and survival outcomes. The decision tree evaluation was conducted using Chi‐square automatic detection.

Results

In total, 213 patients were included in the study with a median follow‐up duration of 40.00 (ranging from 5.28 to 100.70) months. Upon dichotomization by a median, we identified that post‐SBRT NLR > 5.5 and post‐SBRT PLR > 382.0 were negatively associated with shorter overall survival (OS). In the multivariate assessment, post‐SBRT PLR > 382.0 was the only factor. Based on post‐SBRT PLR, tumor locations, and tumor stage, we categorized patients into low, medium, or high‐risk groups.

Conclusions

Post‐SBRT PLR > 382.0 correlated with survival in patients undergoing SBRT. The decision tree model might play a role in future risk stratification to guide the clinical practice of individualized SBRT for LA‐NSCLC.
Clinical characteristics of persistent or recurrent pneumonia combined with airway malacia in children
Authors: Li Zhuxia , Zhang Xinxing , Sun Huiquan , Hao Chuangli , Shao Xuejun , Xu Jun , Zhang Xin , Wang Yuqing
Published: April 2024

Objective

The aim of this study is to investigate the clinical characteristics and pathogens involved in persistent or recurrent pneumonia combined with airway malacia in children.

Methods

We retrospectively reviewed the information of children hospitalised with persistent or recurrent pneumonia, including clinical presentations, laboratory examination results and pathogens.

Results

A total of 554 patients were admitted, 285 (51.44%) of whom were found to have airway malacia. There were 78 (27.37%), 166 (58.25%) and 41 (14.39%) patients with mild, moderate and severe malacia, respectively. Patients with airway malacia were younger than those without malacia (6.0 vs. 12.0 months, p < 0.01) and were more likely to present with wheezing (75.07%), fever (34.39%), dyspnoea (28.77%), cyanosis (13.68%) and wheezing in the lungs (78.95%). The incidence of preterm delivery, oxygen therapy, paediatric intensive care unit (PICU) admission and mechanical ventilation was higher, and the hospital stay (11.0 vs. 10.0 days, p = 0.04) was longer in these patients than in those without malacia. Patients with severe airway malacia were more likely to undergo oxygen therapy, PICU admission, mechanical ventilation and have multiple malacia than were those with mild or moderate malacia. Mycoplasma pneumoniae (30.18%) was the most common pathogen.

Conclusion

Severe airway malacia likely aggravates conditions combined with pneumonia. The proportion of multisite malacia was greater in severe airway malacia patients.
Closing the gaps in self‐management for young adults with spina bifida: Sociodemographic, condition‐specific, and neuropsychological factors
Authors: Holbein Christina E.
Published: April 2024

This commentary is on the original article by Ridosh et al. on pages 1329–1339 of this issue.
Calculating functional diversity metrics using neighbor‐joining trees
Authors: Cardoso Pedro , Guillerme Thomas , Mammola Stefano , Matthews Thomas J. , Rigal Francois , Graco‐Roza Caio , Stahls Gunilla , Carlos Carvalho Jose
Published: April 2024

The study of functional diversity (FD) provides ways to understand phenomena as complex as community assembly or the dynamics of biodiversity change under multiple pressures. Different frameworks are used to quantify FD, either based on dissimilarity matrices (e.g. Rao entropy, functional dendrograms) or multidimensional spaces (e.g. convex hulls, kernel‐density hypervolumes), each with their own strengths and limits. Frameworks based on dissimilarity matrices either do not enable the measurement of all components of FD (i.e. richness, divergence, and regularity), or result in the distortion of the functional space. Frameworks based on multidimensional spaces do not allow for comparisons with phylogenetic diversity (PD) measures and can be sensitive to outliers.

We propose the use of neighbor‐joining trees (NJ) to represent and quantify FD in a way that combines the strengths of current frameworks without many of their weaknesses. Importantly, our approach is uniquely suited for studies that compare FD with PD, as both share the use of trees (NJ or others) and the same mathematical principles.

We test the ability of this novel framework to represent the initial functional distances between species with minimal functional space distortion and sensitivity to outliers. The results using NJ are compared with conventional functional dendrograms, convex hulls, and kernel‐density hypervolumes using both simulated and empirical datasets.

Using NJ, we demonstrate that it is possible to combine much of the flexibility provided by multidimensional spaces with the simplicity of tree‐based representations. Moreover, the method is directly comparable with taxonomic diversity (TD) and PD measures, and enables quantification of the richness, divergence and regularity of the functional space.
On feeling unable to continue as oneself
Authors: Ratcliffe Matthew
Published: April 2024

This paper sets out a phenomenological account of what it is to feel unable to continue as oneself. I distinguish the feeling that a particular identity has become unsustainable from a sense that the world has ceased to offer the kinds of possibilities required to sustain any such identity. In feeling unable to continue as oneself, possibilities may remain for carrying on in practically meaningful ways but not as who one is or was. I reflect on the kinds of self and feeling involved in such experiences, emphasizing the essential openness of self‐experience to transformative possibilities and the dynamic structure of feeling. To illustrate and further develop my approach, I turn to experiences of grief.
Clinical prediction models for treatment outcomes in newly diagnosed epilepsy: A systematic review
Authors: Ratcliffe Corey , Pradeep Vishnav , Marson Anthony , Keller Simon S. , Bonnett Laura J.
Published: April 2024

Up to 35% of individuals diagnosed with epilepsy continue to have seizures despite treatment, commonly referred to as drug‐resistant epilepsy. Uncontrolled seizures can directly, or indirectly, negatively impact an individual's quality of life. To inform clinical management and life decisions, it is important to be able to predict the likelihood of seizure control. Those likely to achieve seizure control will be able to return sooner to their usual work and leisure activities and require less follow‐up, whereas those with a poor prognosis will need more frequent clinical attendance and earlier consideration of epilepsy surgery. This is a systematic review aimed at identifying demographic, clinical, physiological (e.g., electroencephalographic), and imaging (e.g., magnetic resonance imaging) factors that may be predictive of treatment outcomes in patients with newly diagnosed epilepsy (NDE). MEDLINE and Embase were searched for prediction models of treatment outcomes in patients with NDE. Study characteristics were extracted and subjected to assessment of risk of bias (and applicability concerns) using the PROBAST (Prediction Model Risk of Bias Assessment Tool) tool. Baseline variables associated with treatment outcomes are reported as prognostic factors. After screening, 48 models were identified in 32 studies, which generally scored low for concerns of applicability, but universally scored high for susceptibility to bias. Outcomes reported fit broadly into four categories: drug resistance, short‐term treatment response, seizure remission, and mortality. Prognostic factors were also heterogenous, but the predictors that were commonly significantly associated with outcomes were those related to seizure characteristics/types, epilepsy history, and age at onset. Antiseizure medication response was often included as a baseline variable, potentially obscuring other factor relationships at baseline. Currently, outcome prediction models for NDE demonstrate a high risk of bias. Model development could be improved with a stronger adherence to recommended TRIPOD (Transparent Reporting of a Multivariable Prediction Model for Individual Prognosis or Diagnosis) practices. Furthermore, we outline actionable changes to common practices that are intended to improve the overall quality of prediction model development in NDE.
Multilineage involvement in KMT2A‐rearranged B acute lymphoblastic leukaemia: cell‐of‐origin, biology, and clinical implications
Authors: Aypar Umut , Dilip Deepika , Gadde Ramya , Londono Dory M , Liu Ying , Gao Qi , Geyer Mark B , Derkach Andriy , Zhang Yanming , Glass Jacob L , Roshal Mikhail , Xiao Wenbin
Published: April 2024

Aims

B lymphoblastic leukaemia/lymphoma (B‐ALL) is thought to originate from Pro/Pre‐B cells and the genetic aberrations largely reside in lymphoid‐committed cells. A recent study demonstrated that a proportion of paediatric B‐ALL patients have BCR::ABL1 fusion in myeloid cells, suggesting a chronic myeloid leukaemia (CML)‐like biology in this peculiar subset of B‐ALL, although it is not entirely clear if the CD19‐negative precursor compartment is a source of the myeloid cells. Moreover, the observation has not yet been extended to other fusion‐driven B‐ALLs.

Methods and results

In this study we investigated a cohort of KMT2A‐rearranged B‐ALL patients with a comparison to BCR::ABL1‐rearranged B‐ALL by performing cell sorting via flow cytometry followed by FISH (fluorescence in situ hybridization) analysis on each of the sorted populations. In addition, RNA sequencing was performed on one of the sorted populations. These analyses showed that (1) multilineage involvement was present in 53% of BCR::ABL1 and 36% of KMT2A‐rearranged B‐ALL regardless of age, (2) multilineage involvement created pitfalls for residual disease monitoring, and (3) HSPC transcriptome signatures were upregulated in KMT2A‐rearranged B‐ALL with multilineage involvement.

Conclusions

In summary, multilineage involvement is common in both BCR::ABL1‐rearranged and KMT2A‐rearranged B‐ALL, which should be taken into consideration when interpreting the disease burden during the clinical course.
Thioredoxin promotes the regeneration and binding of elastic fibre and basement membrane
Authors: Tohgasaki Takeshi , Nishizawa Shino , Yu Xingyu , Kondo Shinya , Ishiwatari Shioji
Published: April 2024

Objective

Thioredoxin (TRX), a ubiquitous protein with strong antioxidant activity, decreases in the skin with age. A decrease in TRX is expected to induce cellular senescence, chronic inflammation, and degeneration and loss of extracellular matrix (ECM), such as collagen and elastin within the skin. In this study, we investigated the effects of TRX addition to excised skin or skin models to understand the role of TRX on cells and ECM within the skin.

Methods

To evaluate its effect on skin cells, we cultured a three‐dimensional (3D) skin model in a medium containing TRX. The mRNA expression levels of proteins related to elastic and collagen fibres and the basement membrane were determined. Furthermore, 3D imaging and computational analysis were performed to evaluate the effect of TRX on the elastic fibres and extending COL VII structures in excised human skin after coculturing with TRX for 1, 4, 5 and 6 days.

Results

Thioredoxin application to a 3D skin model upregulated elastin, COLI and COLVII mRNA expression. Applying TRX to the excised skin increased the number of linear elastic fibres. This effect of TRX demonstrated a daily increment in a dose‐dependent manner. Thioredoxin extended the fibrous structure of COL VII into the dermis, expanding its colocalization region with elastic fibres. These structural effects were confirmed using 3D imaging and computational methods.

Conclusion

Thioredoxin elongates elastic fibres from the dermis to the basement membrane and extends the COL VII structure from the basement membrane to the dermis in excised human skin. These findings suggest the potential of TRX to protect the skin against age‐related alterations such as wrinkles and sagging.
Measuring an audit quality climate among employees
Authors: Kritzinger Johanna Alida , Barac Karin
Published: April 2024

The International Standard on Quality Management requires, among other things, that audit firm leadership promotes a quality‐oriented culture in firms. We add a novel contribution to the audit quality literature by developing an instrument to measure the audit quality climate in audit firms. Our data consisted of perceptions of non‐executive employees at large South African audit firms and the Auditor‐General of South Africa. Instrument development followed a rigorous scale development process, beginning with the adaptation of a widely used organizational climate measure to explore audit quality at employee level. Exploratory factor analysis determined six audit quality climate dimensions. Confirmatory factor analysis provided evidence of construct validity. The six dimensions of our audit quality climate measurement instrument fit into the three types of culture currently identified in audit firms. The findings of our study are a starting point to develop an acceptable audit quality climate scale for employees in audit firms.
FG‐4592 protected haematopoietic system from ionising radiation in mice
Authors: Wang Yuedong , Cheng Ying , Zhang Pei , Huang Daqian , Zhai Xuanlu , Feng Zhenlan , Fang Duo , Liu Cong , Du Jicong , Cai Jianming
Published: April 2024

Ionising radiation exposure can lead to acute haematopoietic radiation syndrome. Despite significant advancements in the field of radioprotection, no drugs with high efficacy and low toxicity have yet been approved by the Food and Drug Administration. FG‐4592, as a proline hydroxylase inhibitor, may play an important role in radioprotection of the haematopoietic system. Mice were peritoneal injected with FG‐4592 or normal saline. After irradiation, the survival time, body weight, peripheral blood cell and bone marrow cell (BMC) count, cell apoptosis, pathology were analysed and RNA‐sequence technique (RNA‐Seq) was conducted to explore the mechanism of FG‐4592 in the haematopoietic system. Our results indicated that FG‐4592 improved the survival rate and weight of irradiated mice and protected the spleen, thymus and bone marrow from IR‐induced injury. The number of BMCs was increased and protected against IR‐induced apoptosis. FG‐4592 also promoted the recovery of the blood system and erythroid differentiation. The results of RNA‐Seq and Western blot showed that the NF‐κB signalling pathway and hypoxia‐inducible factor‐1 (HIF‐1) signalling pathway were upregulated by FG‐4592. Meanwhile, RT‐PCR results showed that FG‐4592 could promote inflammatory response significantly. FG‐4592 exhibited radioprotective effects in the haematopoietic system by promoting inflammatory response and targeting the NF‐κB, HIF signalling pathway.
From not knowing to doing: An interprofessional approach to clinician training in use of Goal Attainment Scaling (GAS) as a recovery‐oriented outcome measure in a rural mental health service
Authors: Furlanetto Kate , Khopade Rajlaxmi , Phutane Vivek , Bhat Ravi , Stolee Paul
Published: April 2024

Outcome measurement and feedback are key to quality improvement in healthcare. Goal attainment scaling (GAS) is a tool that could be used to measure outcomes of mental health services delivering recovery‐oriented care. The objective of this prospective study was to evaluate the effectiveness of tailored, interprofessional, multilevel and adaptable GAS training on clinician views, learning, competence, performance and confidence in the use of GAS. Thematic analysis of eight clinician participant views was done using the method proposed by Braun and Clarke (Thematic analysis: a practical guide to understanding and doing, 2022). Four main themes were generated: clinicians found that this type of training is useful, GAS influenced the way they thought about their roles in goal setting and recovery‐oriented care and COVID‐19 pandemic impacts. Furthermore, clinicians' skills to set scalable GAS goals with consumers and clinician confidence in using GAS improved. The results of this study show a positive impact of tailored, interprofessional, multilevel and adaptable training supporting development of clinician skills in the GAS process. The training design had a favourable effect on clinician views, learning, competence, performance and confidence of GAS as a recovery‐oriented outcome measure. The approach to GAS training and use of GAS as a recovery‐oriented outcome measure should be considered in response to mental health service reform.
Exploring the multidimensional impact of ICT on academic achievement and mental health: Evidence from a large‐scale survey of higher vocational students in China
Authors: Cai Meng , Luo Han , Meng Xiao , Liu Jiaqi
Published: April 2024

Background

Higher vocational education is an essential part of the higher education system that complements conventional education. In the context of information and communication technology (ICT) development and academic competition, more and more literature has proved the importance of ICT use in educational development (academic achievement and mental health) and the relationship between information literacy and the educational development of higher vocational students.

Objectives

Based on one of the most extensive surveys of higher vocational students, the study combined the Opportunity‐Propensity (O‐P) framework and ecological model to explore the direct effects of different types of ICT use on educational development and the indirect effects from psychological and social factors.

Methods

The data involved 28,956 students from seven higher vocational colleges. The class fixed effect and causal mediation analysis models verified the results.

Results and Conclusion

The results found differential effects of different types of ICT use on academic achievement and mental health. Information literacy ability can improve the academic achievement of higher vocational students, but at the cost of mental health. ICT use not only directly impacts the academic achievement and mental health, but also has an indirect impact through psychological factors represented by self‐efficacy and technostress and social factors represented by social support.

Implications

This study promotes integrating and expanding the O‐P framework and ecological model, enriching the relevant research in ICT use and educational development. Meanwhile, it also provides practical suggestions for realizing rational interventions in ICT use and improving the educational development level of higher vocational students.
Prevalence and risk factors for isolated systolic hypertension among the oldest‐old population in southwestern China: A community‐based cross‐sectional study
Authors: Huang Xiaobo , Qiu Lingli , Wang Tzung‐Dau , Yao Qian , Liu Jianxiong , Xu Ronghua , Zheng Qingkun , Zhang Xingping , Wu Jinhui
Published: April 2024

The prevalence of isolated systolic hypertension (ISH) has doubled between 2002−2005 and 2014 among the oldest‐old population in China. However, the prevalence and characteristics of ISH among the oldest‐old population in southwestern China remain less known. This study aimed to investigate the prevalence of ISH among the oldest‐old population in Chengdu and identify associated factors to provide valuable information for disease etiology and prevention. We recruited 1,312 participants aged over 80 years by using a stratified cluster sampling method between September 2015 and June 2016, from three districts (Jinjiang, Qingyang, and Longquanyi) of Chengdu, the largest city of southwest China. A structured questionnaire, anthropometric data, and blood pressure were collected according to the standard method. Blood pressure was measured three times by using a standardized mercury sphygmomanometer after a 10‐minute seated rest. Of 1312 participants, 53.0% (n = 695) had ISH. The prevalence of ISH in men and women was 54.7% and 51.3%, respectively, with no significant sex difference (P = .222). The prevalence of ISH increased with advanced age in men (P for trend = 0.029), 52.5% for the 80−84 years group, 55.2% for the 85−89 years group, and 70.4% for the 90–98 years group, respectively. Multivariable logistic regression analyses found that drinking (OR = 1.85, 95%CI = 1.26−2.71), being overweight (OR = 1.88, 95%CI = 1.19−2.96), and having a higher heart rate (OR = 0.66, 95%CI = 0.51−0.86) were associated with ISH. Stratified by sex, these three factors remained significant in men. Our work highlights that the burden of ISH is substantial among the oldest‐old population in southwestern China.