bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting the acceptance of e-government: a systematic review
Authors: Wu Xiaohe , Chong Alain Yee Loong , Peng Yi , Bao Haijun
Published: September 2024

Purpose

This study uses a systematic review to explore the potential causes of previous findings related to e-government acceptance research. By identifying the most frequently used, best, promising or worst factors that affect the acceptance of e-government, this research presents a research agenda for e-government researchers.

Design/methodology/approach

Through conducting a systematic review following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) procedure, this research first selected 109 papers. Subsequently, this research analyzed the predictors and linkages of e-government acceptance by adopting a weight-analysis method proposed by Jeyaraj et al. (2006).

Findings

The results first revealed the five most frequently used predictors and five best predictors of e-government acceptance at a comprehensive level. Furthermore, this study summarized the best predictors affecting the acceptance of e-government from the perspectives of adopter types and e-government stages. The results also illustrated the promising and the worst predictors influencing e-government acceptance.

Originality/value

The contribution of this research is twofold. First, this study identified the linkages between e-government acceptance at the individual and organizational levels and between different e-government development stages. Second, this research provided a research direction that could offer useful insights for future e-government studies.
Leveraging co-teaching in pre-service teacher education to enhance classroom management skills of pre-service teachers in China: effects and implications
Authors: Xu Jianmei , Lu Wei
Published: September 2024

Purpose

This study examines the impact of a novel co-teaching approach, involving collaboration between university instructors and school teachers, on pre-service teachers’ (PSTs) understanding of classroom management skills, addressing the practical challenges that often exceed the university classroom’s scope.

Design/methodology/approach

Using a pooled cross-sectional dataset of 513 students from a Chinese teacher training university, the study employed descriptive statistics, factor analysis and ordinary least squares (OLS) regression analysis. Focus group interviews were also conducted to explore the mechanisms underlying the co-teaching impact.

Findings

The co-teaching team effectively integrates theory with practice, enhancing student engagement and learning outcomes. Most students appreciated the co-teaching format, which positively correlated with their recognition of classroom management and the teaching profession. The success of co-teaching was linked to the authenticity brought by school teachers, including exposure to real-life cases that encouraged PSTs to actively solve educational problems.

Practical implications

Pre-service teacher education benefits from university-school collaboration. Inviting experienced school teachers to co-teach in university classrooms offers an efficient instructional approach, improving students’ learning experiences with less time and effort.

Originality/value

This study empirically demonstrates the utility of co-teaching in pre-service teacher education, particularly within China, enriching the literature on school-university partnerships.
Reclaiming of the heritage name by Peranakan Chinese in the Netherlands and their sense of belonging
Authors: Thio May Ling , Sidarto Linawati
Published: September 2024

Purpose

Looking through an autoethnographical lens, the authors analyse the reclaiming of the heritage name of Indonesian Peranakan Chinese in the Netherlands with regard to their sense of belonging and (translocational) positionality. The discussion is situated in the realm of (post)colonial ties between the country of birth and their current country of residence, against the backdrop of assimilationist policies of President Soeharto’s “New Order” after the regime change following the September 30, 1965, coup attempt (G30S). The authors’ own reflections were studied in combination with interviews, both formal and informal, and desk research to compose a narrative of active memories and stories told. How was the state-imposed name change experienced? Why did they choose to reclaim their Chinese name when applying for Dutch citizenship rendered that opportunity? Where can the affective bonds be found?

Design/methodology/approach

The authors’ own reflections were studied in combination with interviews, both formal and informal, and desk research to compose a narrative of active memories and stories told. How was the state-imposed name change experienced? Why did they choose to reclaim their Chinese name when applying for Dutch citizenship rendered that opportunity? Where do the affective bonds lie?

Findings

The reclaiming of the heritage name has a different resonance in the sense of belonging for different generational cohorts. In the specific post-colonial Dutch context - for the generation of our interviewees and of our parents - it represents an active re-positioning of one’s self as having Chinese ancestry (the name I was born with), not because they wanted to renounce their Indonesian connection but because they were forced to make a choice. For us, the authors, it was more a matter of: because we were raised with this name.

Originality/value

This article is a response to the appeal to expand the scarce literature published on the Peranakan Chinese group in the Netherlands (e.g. Tjiook–Liem, 2017; Van der Meer and Eickhoff, 2017; Ang, 2005; Li, 1999) who live in a fascinating (post)colonial positionality comprising of Chinese ancestry, Indonesian background and the Dutch (new) home country. Studies on this group barely mention the consequences of name change for their belonging (Healy, 2020) and positionality (Anthias, 2012).
Applying systems engineering principles to develop an open source laser based metal powder bed fusion system
Authors: Kjer Magnus Bolt , Nadimpalli Venkata Karthik , Budden Christian Leslie , Pedersen David Bue
Published: September 2024

Purpose

Conventional powder bed fusion systems, with their high costs, proprietary nature and restrictive fees, limit research opportunities. This study aims to unveil an affordable, open-source hardware, open-source software laser-based metal powder bed fusion system. Recognizing the distinction between DIY and open-source hardware is crucial for widespread acceptance.

Design/methodology/approach

The authors present a comprehensive system architecture using object process methodology for functions and architecture, a design structure matrix to model system dependencies and classical technical drawing exploded views for select subsystems. Modularization enables high adaptability, fostering potential adoption.

Findings

The fully open system enables unrestricted research, mirroring common industrial metal laser-based powder bed fusion (L-PBF) systems. While “open” systems are available for purchase, they remain closed-source, lacking source code and technical drawings sharing, hindering contribution and co-development. The authors’ is the pioneering and sole open-source metal L-PBF system, boasting 1,500+ print hours. A series of industrial and academic adopters are currently implementing the system.

Originality/value

The open system, slicer software and controller offer unique process control, supporting multimaterial printing. The authors shared the design on the OpenAM GitHub page under the CERN-OHL-P v2 Open Source Hardware license. While it is functional for additive manufacturing (e.g. aluminum, tool steel, titanium and stainless steel), the entire process chain is actively evolving, ideal for co-development with the additive manufacturing community.
Fatigue research of metro car body based on operational loads
Authors: Jin Xihong , Guo Feng
Published: September 2024

Purpose

The principle of infinite life design currently directs fatigue resistance strategies for metro car bodies. However, this principle might not fully account for the dynamic influence of operational loads and the inevitable presence of defects. This study aims to integrate methods of service life estimation and residual life assessment, which are based on operational loads, into the existing infinite life verification framework to further ensure the operational safety of subway trains.

Design/methodology/approach

Operational loads and fatigue loading spectra were determined through the field test. The material test was conducted to investigate characteristics of the fracture toughness and the crack growth rate. The fatigue strength of the metro car body was first verified using the finite element method and Moore–Kommers–Japer diagrams. The service life was then estimated by applying the Miner rule and high-cycle fatigue curves in a modified form of the Basquin equation. Finally, the residual life was assessed utilizing a fracture assessment diagram and a fitted curve of crack growth rate adhered to the Paris formula.

Findings

Neither the maximum utilization factor nor the cumulative damage exceeds the threshold value of 1.0, the metro car body could meet the design life requirement of 30 years or 6.6 million km. However, three out of five fatigue key points were significantly influenced by the operational loads, which indicates that a single fatigue strength verification cannot achieve the infinite life design objective of the metro car body. For a projected design life of 30 years, the tolerance depth is 12.2 mm, which can underscore a relatively robust damage tolerance capability.

Originality/value

The influence of operational loads on fatigue life was presented by the discrepancy analysis between fatigue strength verification results and service life estimation results. The fracture properties of butt-welded joints were tested and used for the damage tolerance assessment. The damage tolerance life can be effectively related by a newly developed equation in this study. It can be a valuable tool to provide the theoretical guidance and technical support for the structural improvements and maintenance decisions of the metro car body.
Potential thioflavin T false positives in lipomembranous changes in adipocytes during systemic amyloidosis diagnosis
Authors: Kishibe Mari , Umekage Kaori , Nozaki Hiroyoshi , Nakagawa Tomoe , Kanno Kyoko , Manabe Akira , Ishida‐Yamamoto Akemi
Published: September 2024

The diagnosis of systemic amyloidosis relies on the detection of amyloid deposition in the tissue, often utilizing biopsy specimens from the abdominal skin owing to their minimal invasiveness. Several amyloid staining methods, including Congo Red, Direct Fast Scarlet (DFS), and Thioflavin T (ThT), have been employed for visualization. Lipomembranous fat necrosis (LFN) is a non‐specific reaction pattern of adipose tissue to injury, typically derived from blood insufficiency across a wide range of clinical conditions or diseases. It is characterized by the presence of eosinophilic, crenulated, and/or serpiginous membranes in fat lobules. We encountered a patient in whom ThT yielded suspiciously positive results in amyloidosis screening tests. Furthermore, our retrospective observations suggested that ThT staining was positive for LFN, whereas DFS and Congo red staining yielded negative results. The awareness that LFN can result in false‐positive ThT staining during amyloid screening is crucial to avoiding the misdiagnosis of systemic amyloidosis. Furthermore, skin samples should not be collected from areas prone to developing lipomembranous changes. The use of more than two different stains for skin biopsy specimens is recommended.
Self‐organised pattern formation promotes consumer coexistence by fluctuation‐dependent mechanisms
Authors: Guill Christian , Nößler Felix , Klauschies Toni
Published: September 2024

In spatially extended ecosystems, habitat heterogeneity facilitates coexistence of species if each competitor experiences environmental conditions in a particular habitat that provide a growth advantage compared to other species, thereby making it locally competitively superior. If the competitive hierarchy among species is the same everywhere, heterogeneity‐facilitated coexistence is possible provided that superior competitors disperse maladaptively towards unfavourable habitats or if they hedge insufficiently against fluctuating environmental conditions.

We use a generic two‐patch metacommunity model to show that the latter mechanisms also operate in metacommunities with homogeneous habitat quality when heterogeneous biomass distributions emerge from self‐organised pattern formation. The model consists of an abiotic resource, an autotroph producer and two competing heterotroph consumer species of which one is always competitively inferior to the other, irrespective of resource availability.

If the induced biomass patterns are static in time, a lower dispersal rate can allow the inferior competitor to avoid competitive exclusion by retaining most of its biomass in the patch with the higher resource density. However, if the biomass patterns fluctuate spatio‐temporally, the inferior competitor must adopt a higher dispersal rate than the superior competitor to persist. This increased movement enables the inferior competitor to effectively distribute its biomass across space, thereby achieving a higher growth rate during periods of recovery from local population minima.

Strikingly, we find a novel coexistence mechanism that emerges if the competitors differ in their abilities to induce pattern formation. Similar to relative nonlinearity in resource use (based e.g. on a gleaner–opportunist trade‐off), the dominant species modifies the spatial or spatio‐temporal variation in the distribution of the resource in a way that favours its competitor. This prevents competitive exclusion due to differently effective dispersal strategies.

We conclude that while temporal instabilities that cause, for example, predator–prey oscillations are usually regarded as jeopardising species' persistence, spatial instabilities that give rise to self‐organised pattern formation should be interpreted more positively, as they provide a generic mechanisms for maintaining diversity in metacommunities without requiring a priori habitat heterogeneity.

Read the free Plain Language Summary for this article on the Journal blog.
Response of parasitoid communities to insecticide application during a Lymantria dispar outbreak in mixed oak forests
Authors: Wolz Marina , Höcherl Amelie , Hübner Jeremy , Tschorsnig Hans‐Peter , Whitmore Daniel , Leroy Benjamin M. L. , Weisser Wolfgang W. , Mitesser Oliver , Zakharov Evgeny V. , Hebert Paul D. N. , Liebhold Andrew M. , Müller Jörg
Published: September 2024

In the temperate mixed oak forests of Central Europe, outbreaks of insects such as the spongy moth, Lymantria dispar, can cause severe defoliation and insecticide is sometimes applied for their control. Parasitoids, mainly Hymenoptera and Diptera, are among the most diverse and important natural enemies of caterpillars in these forests. However, due to their cryptic lifestyle and taxonomic difficulties, we lack knowledge on the impact of insecticide applications on complex host‐parasitoid networks.

In a large‐scale field experiment, we tested the effect of spraying the lepidopteran‐specific insecticide Mimic (tebufenozide) on the abundance and community composition of both adult and larval parasitoids. We combined morphological identification, DNA barcoding and metabarcoding to identify parasitoids adult or inside caterpillars, both sampled by canopy fogging during an outbreak and two subsequent years. We analysed the abundance of parasitoids, community composition and network specialisation using statistical methods that account for sample incompleteness in host‐parasitoid data.

For adult parasitoid assemblages, we found strong annual effects on abundance, with highest numbers of adult parasitoids occurring in the outbreak year, as well as on annual changes in community composition, but no effect linked to insecticide application. However, the abundance and species number of immature parasitoids revealed negative effects of insecticide application, while community composition was only affected by annual variation.

Coverage‐based network analyses showed a reduction of taxonomic network diversity and network specialisation associated with insecticide application in the first 2 years.

Synthesis and applications: This real‐world experiment shows that parasitoid populations respond immediately to large‐scale outbreaks but only limited to local disturbances. Results indicate that this group of natural enemies exhibits high mobility, enabling them to track host populations across large spatial scales. However, our observation of reduced network specialisation after insecticide application is a warning signal that ecosystem function, and consequently natural pest control services, may be impaired by human interference at the local stand scale.
Pyricularia oryzae enhances Streptomyces griseus growth via non‐volatile alkaline metabolites
Authors: Sugiura Risa , Arazoe Takayuki , Motoyama Takayuki , Osada Hiroyuki , Kamakura Takashi , Kuramochi Kouji , Furuyama Yuuki
Published: September 2024

Chemical compounds that affect microbial interactions have attracted wide interest. In this study, Streptomyces griseus showed enhanced growth when cocultured with the rice blast fungus Pyricularia oryzae on potato dextrose agar (PDA) medium. An improvement in S. griseus growth was observed before contact with P. oryzae, and no growth‐promoting effect was observed when the growth medium between the two microorganisms was separated. These results suggested that the chemicals produced by P. oryzae diffused through the medium and were not volatile. A PDA plate supplemented with phenol red showed that the pH of the area surrounding P. oryzae increased. The area with increased pH promoted S. griseus growth, suggesting that the alkaline compounds produced by P. oryzae were involved in this growth stimulation. In contrast, coculture with the soilborne plant pathogen Fusarium oxysporum and entomopathogenic fungus Cordyceps tenuipes did not promote S. griseus growth. Furthermore, DL‐α‐Difluoromethylornithine, a polyamine biosynthesis inhibitor, prevented the increase in pH and growth promotion of S. griseus by P. oryzae. These results indicated that P. oryzae increased pH by producing a polyamine.
Unveiling the hidden impact: Wildlife roadkill assessment in the Paraguayan Chaco
Authors: Martínez Nicolás , Goossen‐Lebrón Thomas , Bauer Frederick , Espínola Viviana , Ortiz María Belén , Gonçalves Larissa Oliveira
Published: September 2024

The incidence of wildlife roadkill significantly threatens the persistence of wildlife populations and disrupts the ecological functionality of ecosystems. This study investigates the impact of roadkills on wildlife in the Paraguayan Chaco, focusing on a 250‐km segment of Route 9 ‘Dr. Carlos Antonio López’ between Villa Hayes and Pozo Colorado. We conducted a road survey for 15 months and recorded 2338 carcasses, identifying 87 species, with mammals (41.3%), reptiles (32.3%) and birds (19.8%) being the most observed groups. The species most frequently killed included Cerdocyon thous, Caracara plancus, Thamnodynastes hypoconia and Procyon cancrivorus. We also recorded species with conservation concern. Additionally, we estimated mortality rates by accounting for sampling errors such as carcass removal and searcher efficiency, revealing annual roadkill rates of 5183 mammals, 19 402 birds and 5020 reptiles on the 250 km per year. Spatial analysis using Ripley's K statistic and HotSpot Identification highlighted significant variation in roadkill distribution across different taxonomic groups and seasons, with 51 km of road identified as hotspots when analysing all groups together. Notably, there was minimal overlap in hotspot locations between seasons and taxonomic groups, emphasizing the need for targeted mitigation strategies. Our findings challenge previous macroecological assessments suggesting low roadkill rates in Paraguay, underscoring the importance of local studies in accurately assessing ecological impacts. This study provides critical baseline data for conservation efforts and calls for further research to develop and implement effective roadkill mitigation strategies in Latin America, especially in Chaco region.
Toward sustainable smart agriculture in a developing country: An empirical analysis of green firms determinants
Authors: Savastano Marco , Samo Altaf Hussain , Abdullah Uzair , Cucari Nicola
Published: September 2024

The significance of green entrepreneurship in achieving socioeconomic and environmental goals has received widespread recognition in academic literature. However, despite this acknowledgment, the internal and external variables influencing the expansion and sustainability of green agricultural enterprises have not been thoroughly studied and explored in the literature. This research aims to test the theoretical Green Agriculture Support Framework (GASF), suggesting internal and external support elements that, when strategically aligned, foster the growth of green agriculture enterprises, particularly those leveraging technologies and tools associated with Agriculture 4.0. To this end, we utilized survey data collected from managers and employees of green enterprises located in Pakistan. The collected data was analyzed using the structural equation modeling (SEM) method, incorporating the partial least squares (PLS) approach through SmartPLS software. The findings imply that external variables (formal Institutions, Government Support, Culture) have significant impacts on the development of green enterprises and that internal factors (Technology, Talent Management) have somewhat limited impacts. Consequently, policymakers must concentrate on creating strategies and measures to enhance the external environment of an organization, that is, intensive government support, less rigid formal institutions and their policies, entrepreneurial culture, and overall improved economic condition of the country, and be cautious about the internal factors like rigid and outdated technology and talent management policies, that may hinder the development of such enterprises. As a result, using the organismic integration theory (OIT) theoretical lens, this research contributes to the literature by providing empirical evidence on the various internal and external factors that significantly affect the growth of innovative green agriculture enterprises. A thorough understanding of green determinants assists in identifying the areas that require attention of policymakers for the effective growth of the green agricultural sector in an economy, leading to valuable implications for green policies.
Understanding the experiences of older adult participants and individuals involved in the delivery of a physical activity programme based on participatory approaches: A qualitative analysis
Authors: McGowan Laura J. , Davies Amy , French David P. , Devereux‐Fitzgerald Angela , Boulton Elisabeth , Todd Chris , Phillipson Christopher , Powell Rachael
Published: September 2024

Background

The present study aimed to understand the experiences of older adult participants and service deliverers involved in a UK‐based physical activity programme, developed using participatory approaches.

Methods

Focus groups and one‐to‐one interviews were conducted with 34 older adults (aged 55+ years) and 13 service providers. Inductive thematic analysis was conducted, structured using the framework approach.

Findings

Four themes were identified: (1) Co‐designed activities met needs and encouraged attendance; (2) engagement and access of programme activities; (3) enjoyment and perceived benefits of sessions; and (4) support needs of individuals delivering activities. Co‐designed activities appeared to meet participant needs and instil a sense of ownership of the programme. Feeling able to relate to other participants seemed important and of potential relevance to attracting older adults to the programme. Peer support may help to increase confidence in attending sessions; place‐based approaches (using resources in local communities) and a flexible approach to involvement also seemed to facilitate engagement. Enjoyment of the programme appeared to be enhanced through activity variety and opportunity for socializing, with a sense of community being created through the support and encouragement of fellow participants. It was considered important that volunteers had appropriate recognition and ongoing support.

Conclusions

These findings suggest that using participatory approaches may facilitate enjoyment and sustained engagement of older adults. Provision based on local community assets may contribute to sustainability of services. However, providing ongoing support is imperative, requiring further costs and resources over the longer‐term.
Nutritional Considerations of Plant‐Based Diets for People With Food Allergy
Authors: Protudjer Jennifer L. P. , Roth‐Walter Franziska , Meyer Rosan
Published: September 2024

Plant‐based diets (PBD) have been reported throughout history, but are increasingly common in current times, likely in part due to considerable emphasis on climate change and human health and wellness. Many dietary organisations around the world endorse well‐planned, nutritionally adequate PBD, which exclude some or all forms of animal‐based foods. However, special attention must be given to patients who follow PBD and also have food allergy (FA), as avoidance may increase the risk of developing nutritional deficiencies, including poor growth in children, weight loss in adults and vitamin and mineral deficiencies. Given the increasing prevalence of both PBD and food allergen avoidance diets, healthcare providers are likely to counsel patients with FA who also follow a PBD. In this review, an overview of PBD in patients with FA is provided, including recent trends, macro‐ and micronutrient needs, and growth for children and weight gain considerations for adults. With regard to a PBD, special attention should be given to ensure adequate fat and protein intake and improving the bioavailability of several minerals such as iron, zinc, iodine, calcium and magnesium, and vitamins such as A, B2, B12 and D. Although the collective data on growth amongst children following a PBD are varied in outcome and may be influenced in part by the type of PBD, growth must be regularly monitored and in adults weight gain assessed as part of any clinical assessment in those people with FA.
Feasibility of Immediate, Early and Delayed Implant Placement for Single Tooth Replacement in the Premaxilla: A Retrospective Cone‐Beam Computed Tomography Study of 100 Cases
Authors: Ickroth Axelle , Cosyn Jan
Published: September 2024

Aim

To assess the feasibility of immediate (IIP), early (EIP) and delayed implant placement (DIP) for single tooth replacement in the premaxilla on the basis of the complete indication area of each approach in routine practice.

Materials and Methods

Data from 100 patients (59 women, 41 men, all Caucasians) aged between 19 and 81 years old (mean age 51.71) who had been consecutively treated with a single implant in the premaxilla (13–23) in one private periodontal practice were retrospectively collected. Demographic data, diagnostic information and linear measurements were extracted from patient files and CBCTs. The feasibility of IIP, EIP and DIP was assessed for all cases by both authors, based on the following criteria: availability of apical bone, position of the tooth in relation to the morphology of the alveolar process, buccal bone morphology and presence of midfacial recession. The reasons for not being able to perform an approach, and the viable alternatives for each approach were secondary outcomes. DIP was considered to have been preceded by alveolar ridge preservation (ARP).

Results

Ninety‐two patients could be treated by means of IIP, EIP or DIP. In eight patients none of these approaches were possible as they required bone augmentation prior to implant placement. Fifty‐two patients (95% CI: 42%–62%) could by treated with IIP, 58 (95% CI: 48%–67%) with EIP and 88 (95% CI: 80%–93%) with DIP. The feasibility proportions of IIP and EIP were significantly lower than the one of DIP (p < 0.001). All patients who could be treated with IIP could also be treated with EIP or DIP. Lack of apical bone for implant anchorage was the main reason for not being able to perform IIP and EIP. Complete loss of the buccal bone wall and the need for bone augmentation prior to implant placement were the reasons for not being able to perform DIP.

Conclusion

From the results of this retrospective CBCT analysis, DIP is nearly always possible in contrast to IIP and EIP. Therefore, and since it is much easier than IIP and EIP, inexperienced clinicians should mainly focus on ARP and DIP in clinical practice deferring IIP and EIP until more surgical skills have been acquired.
Fisheries Local Action Groups and maritime museums in Spain—An opportunity to enhance the value of fishing culture and heritage
Authors: Miret‐Pastor Lluís , Cervelló‐Royo Roberto , Herrera‐Racionero Paloma , Márquez Escamilla Andrea
Published: September 2024

Although Spain has a long tradition of maritime, naval, and fishing museums, in the last 20 years there has been a boom in museums of this type along the Spanish coast. Paradoxically, this museum boom has coincided with a profound fishing crisis. In order to face the social and economic consequences, Fisheries Local Action Groups (FLAGs) have been established by the EU to support the territorial development of fishing areas, financing projects of various kinds, including sociocultural activities that promote fishery diversification, stimulate fishing tourism, and enhance the value of the rich tangible and intangible heritage linked to fishing. A mixed methods approach has been adopted to characterize fishing and maritime museums that have received European funds and have been supported by FLAGs, and to explore the relationship between the fishing sector and the management of museums. Results confirm the active role played by the FLAGs and the fisheries funds in the creation and consolidation of fisheries museums. However, despite the community‐led local development approach, the fisheries sector still feels alienated from the management of these museums. The benefits, especially the intangible ones, that these museums can bring to fishing communities may be limited by the low level of involvement of the fishing sector.
Continuous ketone monitoring: Exciting implications for clinical practice
Authors: Kong Yee Wen , Morrison Dale , Lu Jean C. , Lee Melissa H. , Jenkins Alicia J. , O'Neal David N.
Published: September 2024

Diabetic ketoacidosis (DKA) is a life‐threatening complication usually affecting people with type 1 diabetes (T1D) and, less commonly, people with type 2 diabetes. Early identification of ketosis is a cornerstone in DKA prevention and management. Current methods for ketone measurement by people with diabetes include capillary blood or urine testing. These approaches have limitations, including the need to carry testing strips that have a limited shelf life and a requirement for the user to initiate a test. Recent studies have shown the feasibility of continuous ketone monitoring (CKM) via interstitial fluid with a sensor inserted subcutaneously employing an enzymatic electrochemical reaction. Ketone readings can be updated every 5 minutes. In the future, one would expect that commercialized devices will incorporate alarms linked with standardized thresholds and trend arrows. Ideally, to minimize the burden on users, CKM functionality should be integrated with other devices used to implement glucose management, including continuous glucose monitors and insulin pumps. We suggest CKM provision to all at risk of DKA and recommend that the devices should be worn continuously. Those who may particularly benefit are individuals who have T1D, are pregnant, on medications such as sodium‐glucose linked transporter (SGLT) inhibitors that increase DKA, people with recurrent DKA, those with T1D undertaking high intensity exercise, are socially or geographically isolated, or those on low carbohydrate diets. The provision of ketone profiles will provide important clinical insights that have previously been unavailable to people living with diabetes and their healthcare professionals.
Changes in insulin utilization in China from 2020 to 2022
Authors: Chen Chen , Liu Xingyu , Zhang Jieqiong , Hu Shuchen , Zhang Jinwei , Liu Xiaoyong , Yang Caijun , Fang Yu
Published: September 2024

Aim

To assess the variation in patterns of use of insulin and other antidiabetic medicines across China, both geographically and over time.

Materials and Methods

Nationally, we calculated the relative change in antidiabetic medicine purchases between the first and last quarters of 2020 through 2022 based on the number of defined daily doses procured per quarter. We used annual data to analyse differences in antidiabetic medicine use and patterns across seven regions of China. Considering large regional variations, we used multifactor linear regression to preliminarily explore the possible factors influencing this variation.

Results

Nationally, the procurement of antidiabetic medicines and insulin increased from 2020 to 2022, while the proportion of insulin among antidiabetic medicines remained stable at approximately 22%. Among all insulins, premixed insulin (human) was ranked first. Of the three subgroups of insulin, analogues were the most preferred and had the largest procurement, but different categories showed different trends in terms of purchases and proporation. Regionally, the growth rate of antidiabetic medicines, the proportion of insulin procurement and the preferred types of insulin across the seven regions were different. Regarding preliminary influencing factors, the level of education and owning a domestically funded producer had a positive effect on insulin procurement.

Conclusions

From 2020 to 2022, the procurement of insulin increased, which may be due to the increased attention for diabetes from the country and residents.However, the proportion of insulin among all antidiabetic medicines was essentially unchanged, while the use of some non‐insulin hypoglycemic drugs increased significantly, especially the SGLT2i and GLP‐1 RA. Given the economic and cultural diversity, Insulin procurement and utilization patterns varied greatly across the regions. Owning domestic enterprises potentially influences the procurement of insulin. Enhancing education to further improve the self‐management of patients with diabetes is essential.
Atrial Adaptations in Athletes Heart
Authors: Stadter Philipp , Keller Karsten
Published: September 2024

Background

Intensive training efforts are associated with hemodynamic changes accompanied by increases in cardiac output and stroke volume related to higher peak oxygen consumption and better athletic performance during exercise. These hemodynamic changes induce an enlargement of cardiac chambers, but also of the atria and may result in an athletes’ heart (AH). Data from large studies about atrial enlargement in AH are sparse.

Methods

Competitive athletes aged ≥18 years, who presented for pre‐participation screening 04/2020–10/2021 were included in this study and stratified for AH (defined as physiologically increased heart volume >13.0 in males and >12.0 mL/kg in females).

Results

Overall, 646 athletes aged ≥18 years (median age 24.0 [20.0/31.0] years; 206 [31.9%] females) were included in our study 04/2020–10/2021; among these, 118 (18.3%) had an AH. The computed absolute heart volume was 969.4 (853.1/1083.0) mL in athletes with AH and 841.3 (707.4/966.3) mL in those without AH (p < 0.001). AH was associated with larger left ventricular mass (206.6 ± 39.0 vs. 182.7 ± 44.2 g, p < 0.001). LA area (15.4 [13.7/18.2] vs. 14.3 [12.0/16.3] cm2, p < 0.001) and RA area (15.8 [13.8/18.6] vs. 14.5 [12.3/17.0] cm2, p < 0.001) were enlarged in AH versus those athletes without AH. The logistic regressions confirmed an independent association of AH on LV mass (OR 1.05 [95% CI 1.04–1.06], p < 0.001). LA area (OR 1.29 [95% CI 1.19–1.39], p < 0.001) as well as RA area (OR 1.28 [95% CI 1.19–1.38], p < 0.001) were afflicted by AH.

Conclusion

An AH is accompanied by significant enlargement of the atria as well as increased cardiac muscle mass.
Understanding Middle Leaders' Distributed Leadership Factors as Necessary and Sufficient Conditions for Fostering Teacher Commitment to Change
Authors: Thien Lei Mee , Chuah Seong Teng , Low Mei Peng
Published: September 2024

This study aims to examine which middle leaders' distributed leadership factors (cohesive leadership team, participative decision‐making, leadership support and leadership supervision) are sufficient and to what degree these four factors are necessary for fostering high teacher commitment to change (TCTC). Data were gathered from 1018 Malaysian primary school teachers. The partial least squares analysis indicated positive relationships between the four middle leaders' distributed leadership factors and TCTC. The necessary condition analysis revealed that cohesive leadership team and participative decision‐making are necessary and sufficient conditions for fostering TCTC. While leadership support and leadership supervision were identified as necessary conditions, they were deemed less important. This study shifts the focus from principal‐centric distributed leadership to middle leaders' distributed leadership. This theoretical shift underscores the unique contributions of middle leaders' distributed leadership in driving TCTC in primary school settings by employing an expanded analytical approach.
Clonal Evolution in 207 Cases of Refractory or Relapsed Acute Myeloid Leukemia
Authors: Murray Graeme F. , Bouligny Ian M. , Ho Thuy , Gor Juhi , Zacholski Kyle , Wages Nolan A. , Grant Steven , Maher Keri R.
Published: September 2024

Clonal evolution (CE) is a driving force behind the development and progression of acute myeloid leukemia (AML). Advances in molecular and cytogenetic assays have improved the depth and breadth of detection of CE in AML, which is defined here as a detected change in cytogenetic or molecular profile at relapsed or refractory (RR) disease. In this study, we demonstrate the clinical impact of CE in a cohort of patients with RR AML treated between 2013 and 2023. We discovered CE is significantly more frequent in relapsed disease (58.2%, [46.6%, 69.2%]) than in refractory disease (21.1%, [14.4%, 29.2%], p < 0.001). CE negatively impacts prognosis when detected by conventional karyotyping in refractory disease (4.2 vs. 13.9 months, p < 0.011). In contrast with prior literature, CE had no impact on overall survival if detected in relapsed disease. Surprisingly, those who achieved negative measurable residual disease (MRD) were no more likely to eliminate their original clone than those who did not (p = 1). We found several cytogenetic and molecular signatures which may predispose to CE: aberrations of chromosome 17, trisomy 8, TP53, KRAS, and FLT3‐TKD. Finally, physicians were less likely to retreat those with CE with IC after receiving IC as first‐line therapy (35.0% vs. 70.9%, p = 0.004). This study illustrates the role of CE in chemotherapy‐resistant AML; we identify unique cytogenetic and molecular signatures that define a subset of patients associated with a dismal prognosis. As next‐generation sequencing panels expand and new methods to characterize cytogenetic abnormalities emerge, our findings establish a basis for future studies investigating the prognostic and therapeutic impact of CE.
Phosphorus limitation promotes soil carbon storage in a boreal forest exposed to long‐term nitrogen fertilization
Authors: Richy Etienne , Fort Tania , Odriozola Inaki , Kohout Petr , Barbi Florian , Martinovic Tijana , Tupek Boris , Adamczyk Bartosz , Lehtonen Aleksi , Mäkipää Raisa , Baldrian Petr
Published: September 2024

Forests play a crucial role in global carbon cycling by absorbing and storing significant amounts of atmospheric carbon dioxide. Although boreal forests contribute to approximately 45% of the total forest carbon sink, tree growth and soil carbon sequestration are constrained by nutrient availability. Here, we examine if long‐term nutrient input enhances tree productivity and whether this leads to carbon storage or whether stimulated microbial decomposition of organic matter limits soil carbon accumulation. Over six decades, nitrogen, phosphorus, and calcium were supplied to a Pinus sylvestris‐dominated boreal forest. We found that nitrogen fertilization alone or together with calcium and/or phosphorus increased tree biomass production by 50% and soil carbon sequestration by 65% compared to unfertilized plots. However, the nonlinear relationship observed between tree productivity and soil carbon stock across treatments suggests microbial regulation. When phosphorus was co‐applied with nitrogen, it acidified the soil, increased fungal biomass, altered microbial community composition, and enhanced biopolymer degradation capabilities. While no evidence of competition between ectomycorrhizal and saprotrophic fungi has been observed, key functional groups with the potential to reduce carbon stocks were identified. In contrast, when nitrogen was added without phosphorus, it increased soil carbon sequestration because microbial activity was likely limited by phosphorus availability. In conclusion, the addition of nitrogen to boreal forests may contribute to global warming mitigation, but this effect is context dependent.
Mediation analysis of cognitive function in the relationship between pulmonary function and depression among middle‐aged and older adults
Authors: Yang Yuying , Zhu Yue , Dai Biao , Wu Rui
Published: September 2024

Aim

This study aims to explore the association between declining lung function and depression in middle‐aged and older adults, with a special focus on the mediating role of cognitive function.

Methods

This study utilizes self‐reported and physical examination data from 5345 individuals participating in the 2015 cycle of the China Health and Retirement Longitudinal Study (CHARLS) to explore the role of cognitive function changes in mediating the effects of diminished lung function on depression among middle‐aged and older adults.

Results

Multivariate linear regression analysis revealed a positive correlation between pulmonary and cognitive functions (β = 0.003, 95% CI: 0.002∼0.003, P < 0.01) and a negative correlation between cognitive function and depression (β = −0.279, 95% CI: −0.330–0.228, P < 0.01). Cognitive function plays a mediating role in linking pulmonary function with depression, exhibiting a mediation effect of −0.0007 and a total effect of −0.0046, wherein the mediation effect contributes to 15.22% of the total effect. For females, the mediating effect of cognitive function was stronger (β = −0.0013, 95% CI: −0.0018∼–0.0008, P < 0.01) than it was for males (β = −0.0006, 95% CI: −0.0009∼–0.0003, P < 0.01).

Conclusions

The study underscores the importance of monitoring lung and cognitive functions as interconnected factors contributing to the mental health of middle‐aged and older adults. It suggests that interventions aimed at improving pulmonary health and cognitive function may help mitigate depressive symptoms among middle‐aged and older adults. Further research is warranted to validate these findings across diverse cultural and demographic settings. Geriatr Gerontol Int 2024; 24: 1210–1217.
From Hospital to Home: Applying a Co‐Design Approach to Determine the Key Components of an Intervention to Support Transition‐To‐Home After Stroke
Authors: O'Callaghan Geraldine , Fahy Martin , Hall Patricia , McCartan Deirdre , Langhorne Peter , Galvin Rose , Horgan Frances
Published: September 2024

Background

People with stroke and their families face numerous challenges as they leave hospital to return home, often experiencing multifaceted unmet needs and feelings of abandonment. The essential elements of an intervention intended to support transition‐to‐home after stroke are unclear.

Objective

The aim of the project was to engage in a co‐design process to identify the key components of a pragmatic intervention to inform a transition‐to‐home support pathway following stroke.

Materials and Methods

The study was conducted using a co‐design process engaging multiple stakeholders, including 12 people with stroke, 6 caregivers, 26 healthcare professionals and 6 individuals from stroke organisations in a series of three workshops, facilitated by the primary researcher, a wider team of researchers and an individual with lived experience of stroke. World Café methodology and Liberating Structures facilitation techniques were adapted to meet the aim of the workshops. Data collection involved observations during workshops, followed by summarising of findings and reaching group consensus agreement on outputs. Facilitated consensus on a prioritisation task resulted in the final output.

Results

The co‐design group identified 10 key intervention components of a transition‐to‐home support pathway following stroke. These components focussed on enhancing collaboration, streamlining transition processes and facilitating post‐discharge support. While a stroke coordinator was considered a top priority, increased cross‐setting information sharing and community in‐reach, where community‐based healthcare staff extended their services into hospital settings to provide continuity care, were considered most feasible to implement.

Conclusion

The co‐design approach, involving a multi‐stakeholder group and strengthened by patient and public involvement, ensured that the identified transition‐to‐home intervention components are meaningful and relevant for people with stroke and their families. Further co‐design workshops are required to refine, and feasibility test the components for generalisability within the wider Irish healthcare setting.

Patient or Public Contribution

Individuals who have experienced a stroke actively contributed to shaping the methodological design of this study and the ethics process. They engaged in the analysis of co‐design outputs and provided input for the discussion and recommendations regarding future research. An individual who had experienced a stroke formed part of the research team, co‐facilitating the co‐design workshops and co‐authoring this article.