bluuebunny/crossref_metadata_2025 huggingface dataset:
Conclusion: sustainability, smart tourism destinations and evolving visitor preferences
Authors: Akbaba Atilla
Published: October 2024

Purpose

The primary aim of this themed issue is to highlight the incorporation of sustainability principles in the progress of tourism and the monitoring of tourists' evolving preferences, all within the sustainability framework and smart tourism destinations. The strategic question underlying this theme issue is how can we interpret, relate and monitor the rapidly evolving visitor preferences within sustainability and smart tourism destinations?

Design/methodology/approach

This issue’s critical outcomes as they relate to the strategic question are reviewed, with reference to the contributions made to knowledge, policy and practice and the implications for future applied research concerning sustainability, smart tourism destinations and evolving visitor preferences.

Findings

Arising from the analysis and synthesis of recommendations, the following themes were proposed as critical concentration points for rapidly evolving visitor preferences within sustainability and smart tourism destinations: as in all areas of life, sustainability will continue to be a prominent concept in the tourism sector. Smart solutions and the use of technology have also been identified as determining factors in creating sustainable destinations. On the other hand, changing and evolving tourist preferences are emerging as a driving force for smart destinations and sustainability. Tourism destinations must take steps toward sustainability by considering the changing visitor structure, evolving demands and needs. Some articles in this special issue also analyze tourist demands and sustainability efforts of destinations in specific destinations and provide invaluable insights.

Originality/value

As it is essential for all stakeholders of the tourism industry to achieve competitiveness while securing sustainability, this particular article suggests ways for the industry as a whole, its players, destination administrations, local and national policymakers and other major stakeholders of the tourism industry to address some issues faced by the industry. Factors such as changing customer structure, use of technology and increasing environmental awareness make it necessary for destination management and all players individually to take vital measures. This paper and the collection of articles in this thematic issue offer crucial insights for academics, professionals and decision-makers in creating a complete framework to assess, connect and regularly track changing visitor preferences. The papers include recommendations for creating robust tourism locations that effectively tackle challenges, promote inclusion and prepare for future advancements. This is achieved by examining the convergence of sustainability, smart tourism and changing tourist tastes.
Asia‐Pacific consensus recommendations on the management of generalized pustular psoriasis
Authors: Choon Siew Eng , Foley Peter Anthony , Asawanonda Pravit , Fujita Hideki , Jo Seong‐Jin , Shi Yu‐ling , Theng Colin , Affandi Azura Mohd , Bang Chul Hwan , Frez Maria Lorna , Huei Huang Yu , Le Huu Doanh , Kim Tae‐Gyun , Morita Akimichi , Oon Hazel H. , Fernández‐Peñas Pablo , Rajatanavin Natta , Robinson Suganthy , Selvarajah Latha , Tsai Tsen‐Fang
Published: October 2024

Generalized pustular psoriasis (GPP) is a rare, chronic, heterogeneous, and potentially life‐threatening disease characterized by primary, sterile, and macroscopically visible pustules with or without systemic symptoms. There are ethnic differences in the genetic mutations associated with GPP that might affect the clinical manifestations and treatment responses. Currently, there is limited evidence from the patient population in the Asia‐Pacific (APAC) region, resulting in a general paucity of information on the effective management of patients with GPP in this region. This modified Delphi panel study aimed to identify current evidence and gain advanced insights to facilitate the development of a regionally tailored APAC consensus on the management of GPP. A systematic literature review (SLR) was conducted to identify published literature and develop consensus statements on (i) definition and clinical course, (ii) diagnosis of GPP, (iii) treatment outcomes, goals, and monitoring measures, and (iv) optimal management strategies and clinical practices. Statements were rated by a panel of dermatologists in two rounds, with the threshold for consensus at ≥80% agreement. Twenty experts from the APAC region reached consensus on 106 statements that were developed based on the SLR and experts' collective expertise. The experts agreed that GPP is a rare, severe, and potentially life‐threatening condition that is distinct from plaque psoriasis. This consensus emphasized the importance of a tailored treatment strategy taking into account the GPP flare severity and each patient's unique clinical circumstances. The experts reached consensus on the severity classification of GPP flares and recommended first‐line and maintenance treatment options for adult GPP, childhood GPP, and GPP in pregnancy. These consensus outcomes have been synthesized into treatment algorithms to guide dermatologists in the APAC region in their clinical decision‐making processes.
Chromosome‐level genome of diamondback terrapin provides insight into the genetic basis of salinity adaptation
Authors: JIANG Hui , WANG Zhongkai , ZHAI Xiaofei , MA Guangwei , WANG Tongliang , KONG Fei , LUO Wenkai , YU Ziwei , LI Haorong , REN Yandong , GUO Rui , JIAN Li , ZHAO Longhui , ZUO Ziye , PAN Shoupeng , QI Zan , ZHANG Yuxin , LIU Zhuoya , RAO Dingqi , LI Yongxin , WANG Jichao
Published: October 2024

Diamondback terrapins (Malaclemys terrapin centrata) exhibit strong environmental adaptability and live in both freshwater and saltwater. However, the genetic basis of this adaptability has not been the focus of research. In this study, we successfully constructed a ∼2.21‐Gb chromosome‐level genome assembly for M. t. centrata using high‐coverage and high‐depth genomic sequencing data generated on multiple platforms. The M. t. centrata genome contains 25 chromosomes and the scaffold N50 of ∼143.75 Mb, demonstrating high continuity and accuracy. In total, 53.82% of the genome assembly was composed of repetitive sequences, and 22 435 protein‐coding genes were predicted. Our phylogenetic analysis indicated that M. t. centrata was closely related to the red‐eared slider turtle (Trachemys scripta elegans), with divergence approximately ∼23.6 million years ago (Mya) during the early Neogene period of the Cenozoic era. The population size of M. t. centrata decreased significantly over the past ∼14 Mya during the Cenozoic era. Comparative genomic analysis indicated that 36 gene families related to ion transport were expanded and several genes (AQP3, solute carrier subfamily, and potassium channel genes) underwent specific amino acid site mutations in the M. t. centrata genome. Changes to these ion transport‐related genes may have contributed to the remarkable salinity adaptability of diamondback terrapin. The results of this study not only provide a high‐quality reference genome for M. t. centrata but also elucidate the possible genetic basis for salinity adaptation in this species.
Effect of orange‐fleshed sweet potato (Ipomoea batatas)–Bambara groundnut (Vigna subterranea) composite flour on quality properties of pasta
Authors: Makhuvha Makgwatla Consolerlia , Laurie Sunette , Mosala Mmathaha
Published: October 2024

Non‐wheat flours are gaining attention as substitutes for wheat flour, offering the potential to optimize local resource utilization and alleviate the demand for wheat. The study investigates the use of non‐wheat flours, particularly a blend of orange‐fleshed sweet potato (OFSP) (Ipomoea batatas) and Bambara groundnut (BG) (Vigna subterranean), as a partial replacement for wheat flour in pasta production. The aim is to improve the utilization of local resources, reduce the reliance on wheat, and enhance the nutritional quality of pasta. The production of OFSP and BG flour took place at Agricultural Research Council Roodeplaat Campus. The data were analyzed using analysis of variance, and significant means were separated using the Duncan multiple range test. The research found that pasta made from composite flour significantly influenced its composition and cooking characteristics when compared to 100% wheat pasta. The most nutritionally enriched pasta was achieved with a blend of 50% wheat, 25% OFSP, and 25% BG, featuring higher protein, ash, and fiber content. Consumers preferred pasta made from a composite flour of 70% wheat, 15% OFSP, and 15% BG. This research suggests the potential for producing pasta using OFSP and BG composite flour as a viable option.

Practical Application

The practical application of the research on orange‐fleshed sweet potatoes–Bambara groundnut‐based pasta has the potential to improve nutrition, stimulate local economies, enhance agricultural sustainability, and promote food security in regions where vitamin A deficiency is a concern and wheat importation is high.
Association between coffee consumption and metabolic syndrome: A cross‐sectional and Mendelian randomization study
Authors: Wong Tommy Hon Ting , Luo Shan , Au Yeung Shiu Lun , Louie Jimmy Chun Yu
Published: October 2024

Background

This study investigates the associations between coffee consumption and metabolic syndrome and its components, as well as the effect of milk, sugar, and artificial sweeteners on these associations.

Methods

A cross‐sectional analysis was conducted with 351805 UK Biobank participants. Coffee consumption data were collected via food frequency questionnaires and 24‐h recall. Metabolic syndrome was identified through blood biochemistry and self‐reported medication use. Odds ratios were calculated using multivariable logistic regression, and results were verified with two‐sample Mendelian randomization.

Results

Consuming up to two cups of coffee per day was inversely associated with metabolic syndrome (1 cup/day: odds ratio [OR]: 0.88, 95% confidence interval [CI]: 0.85–0.92; 2 cups/day: OR: 0.90, 95% CI: 0.86–0.93). Higher intakes showed near‐null associations. Mendelian randomization did not support a causal link between coffee intake and metabolic syndrome. Both self‐reported and genetically predicted high coffee consumption (four cups per day or more) were associated with central obesity. The inverse association between coffee consumption and metabolic syndrome was more profound among drinkers of ground coffee than those of instant coffee. Results were similar when stratified by the use of milk and sugar, yet the use of artificial sweetener with coffee was positively associated with metabolic syndrome and all component conditions.

Conclusions

Coffee consumption may increase the risk of central obesity but is unlikely to impact the risk of metabolic syndrome. The potential health effects of artificial sweeteners in coffee need further investigation.

image
Indocyanine green localization for preoperative CT‐guided localization of multiple pulmonary nodules
Authors: Zhang Shenbo , Cao Jian , Wang Kefei , Wang Zhiwei , Jin Zhengyu
Published: October 2024

Objectives

This study assesses the safety and efficacy of using indocyanine green (ICG) for preoperative CT‐guided localization of multiple pulmonary nodules.

Methods

We included patients who underwent CT‐guided preoperative ICG localization followed by video‐assisted thoracoscopic surgery (VATS). Four primary outcomes were evaluated: technical success, pneumothorax, pulmonary hemorrhage, and postoperative hospital stay (PHS). Patients were classified into single nodule and multiple nodules groups, with further subgroups based on the side of localization including unilateral and bilateral subgroups. Univariate and multivariate analyses were used to evaluate risk factors for PHS and pneumothorax.

Results

A total of 374 patients (54.8 ± 11.4 years, 99 with multiple nodules). The success rate in the multiple nodules group was 98.3%, similar to single nodules. Apart from PHS, no significant differences were observed in outcomes between patients with single and multiple nodules. Longer PHS was observed for patients with multiple nodules (3 [2–4] days vs. 3 [3–4] days, p = 0.022). Multivariable analysis indicated longer stays were associated with pulmonary hemorrhage during localization, surgical blood loss, postoperative complications, and non‐segmentectomy procedures. Advanced age emerged as the sole independent risk factor for pneumothorax. The success rate in the unilateral subgroup and the bilateral subgroup was 97.8% and 99%, respectively, with higher pneumothorax rates in the unilateral subgroup (38.3% vs. 20%).

Conclusion

CT‐guided preoperative ICG localization of multiple pulmonary nodules is safe and effective. It can be applied to both unilateral and bilateral nodules, supporting simultaneous VATS resection.
Postoperative analgesic effectiveness of ultrasound‐guided bilateral erector spinae plane block vs. rectus sheath block for midline abdominal surgery in a low‐ and middle‐income country: a randomised controlled trial
Authors: Urmale Kusse Alemu , Legesse Mebratu , Assefa Andualem , Tila Mebratu , Sintayhu Ashagrie , Mequanint Addisu , Markos Mekdes , Kussia Wendafrash , Dendir Getahun , Gebremedhin Tsegaye Demeke , Sidamo Temesgen , Obsa Mohammed Suleiman
Published: October 2024

Introduction

The use of erector spinae plane block and rectus sheath block for postoperative analgesia in midline abdominal procedures is becoming more common. However, the most effective and appropriate method remains unclear. We aimed to compare the postoperative analgesic effecacy of ultrasound‐guided bilateral erector spinae plane blocks with rectus sheath blocks for midline abdominal surgery in a low‐ and middle‐income country.

Methods

We allocated randomly 72 patients aged 18–65 y undergoing midline abdominal surgery to an erector spinae plane block (n = 36) or a rectus sheath block (n = 36) utilising a prospective, parallel study design. Patients, care providers and outcome assessors were blinded to the interventions. The primary outcome measures were total postoperative analgesia consumption, postoperative pain severity and time to first rescue analgesic administration. Secondary outcomes included the incidence of postoperative complications and adverse events.

Results

Of 78 patients assessed for eligibility, six were excluded, leaving 72 for analysis. Patients allocated to erector spinae plane block had a lower mean (SD) postoperative opioid consumption compared with those allocated to rectus sheath block (3.5 (8.7) morphine milligram equivalents vs. 8.2 (2.8) morphine milligram equivalents, respectively; p = 0.003). Time to first analgesic request was greater in patients allocated to erector spinae plane block compared with those allocated to rectus sheath block (mean (95%CI) 16 (13–17) h vs. 12 (11–13) h, respectively; p < 0.001). There were no block‐related complications in either group.

Discussion

Erector spinae plane blocks are more effective than rectus sheath blocks for the management of postoperative pain following midline abdominal surgery. Integration of erector spinae plane blocks into multimodal opioid‐sparing analgesic strategies after midline abdominal surgeries may promote enhanced patient recovery in low‐and middle‐income countries.
Cross‐Cultural Differences in the Pathways to Internet Gaming Disorder
Authors: Chew Peter K. H. , Lin Patrick K. F. , Yow Yong Jie
Published: October 2024

Background

No research to date has examined cross‐cultural differences in the pathways to internet gaming disorder (IGD). The current study aimed to address this limitation by examining the relationships between nationality (Singaporeans vs. Australians), culture orientation, gaming motivations, and IGD.

Methods

Participants were 101 Singaporeans (55.4% males) and 98 Australians (52.0% males). They completed the Culture Orientation Scale, the Motives for Online Gaming Questionnaire, and the Internet Gaming Disorder Scale‐Short‐Form.

Results

A series of mediational analyses showed that Singaporeans tend to be more collectivistic (both horizontally and vertically). In turn, this culture orientation motivates them to play games for social reasons, increasing the risk for IGD. In contrast, Australians tend to be more individualistic (vertically only). In turn, this culture orientation motivates them to play games for competitive reasons, increasing the risk for IGD.

Conclusion

Limitations include the use of samples from two countries only, precluding a generalization of the results. Future research directions include examining the role of game genres as a mediator in the nationality‐IGD relationship.
Training young co‐researchers to interview their parents: The transformative potential of intergenerational interviews
Authors: Walker Catherine , van Holstein Ellen
Published: October 2024

The turn to co‐production in geographical research is underpinned by the social justice aim to democratise academic practice, and in recent years this has extended to training young people as co‐researchers. However, discussions of intergenerational dynamics in co‐produced research are limited, and there are no accounts of family members interviewing one another. This paper responds to this oversight by presenting a reflective account of a research project centring on intergenerational family discussions and negotiations of climate change knowledge, in which young co‐researchers interviewed parents. We share key considerations for developing bespoke interview training and preparing co‐researchers to undertake interviewing, and we highlight the strengths and opportunities of intergenerational interviews in families. Our core contention is that, when planned and supported with tact and consideration, intergenerational interviews can boost young people's confidence in their skills and generate rich dialogues that may lead to decisions and outcomes that will outlive the research. However, engaging co‐researchers and their pre‐existing familial relationships in research requires careful consideration, practical training, and ongoing reflection, because these relationships are defined by intergenerational dynamics that precede and outlast the research.
Healthcare for People With Intellectual Disabilities: An Exploration of Intellectual Disability Service Providers' Experiences of Joint Working With Acute Service Providers When People With Intellectual Disabilities Access Healthcare in Acute Services
Authors: Kelleher Eileen , Caples Maria , Wills Teresa , Martin Anne‐Marie
Published: October 2024

Background

Individuals with intellectual disabilities often require various supports in their everyday lives. Many access both acute and intellectual disability services depending on their needs. Previous research has highlighted suboptimal experiences of care provided in acute services. Joint working between both services has been recognised as a measure of improving healthcare for this group. Although there is some evidence regarding this issue from the perspective of acute service providers, further research is required to understand the perspective of intellectual disability service providers.

Methods

Ten nurses working in various roles in intellectual disability services across Ireland took part in semistructured interviews. The data were analysed using thematic analysis.

Findings

Issues with inter‐service communication and insufficient policies, protocols and pathways were found to negatively impact joint working. Acute services seemed to have a limited understanding of the role and capacity of intellectual disability services. Acute services do not always identify the individual needs of the people in their care. Despite this, there were examples of joint working taking place that benefited those with intellectual disabilities.

Conclusions

Joint working needs to include improving communication between both services, co‐developing policies, protocols and pathways and appointing acute care liaison nurses.
Excitation–contraction coupling inhibitors potentiate the actions of botulinum neurotoxin type A at the neuromuscular junction
Authors: Machicoane Mickaël , Tonellato Marika , Zainotto Marica , Onillon Paul , Stazi Marco , Corso Mattia Dal , Megighian Aram , Rossetto Ornella , Le Doussal Jean‐Marc , Pirazzini Marco
Published: October 2024

Background and Purpose

Botulinum neurotoxin type A1 (BoNT/A) is one of the most potent neurotoxins known. At the same time, it is also one of the safest therapeutic agents used for the treatment of several human disorders and in aesthetic medicine. Notwithstanding great effectiveness, strategies to accelerate the onset and prolong BoNT/A action would significantly ameliorate its pharmacological effects with beneficial outcomes for clinical use.

Experimental Approach

Here, we combined BoNT/A with two fast‐acting inhibitors of excitation–contraction coupling inhibitors (ECCI), either the μ‐conotoxin CnIIIC or dantrolene, and tested the effect of their co‐injection on a model of hind‐limb paralysis in rodents using behavioural, biochemical, imaging and electrophysiological assays.

Key Results

The BoNT/A‐ECCI combinations accelerated the onset of muscle relaxation. Surprisingly, they also potentiated the peak effect and extended the duration of the three BoNT/A commercial preparations OnabotulinumtoxinA, AbobotulinumtoxinA and IncobotulinumtoxinA. ECCI co‐injection increased the number of BoNT/A molecules entering motoneuron terminals, which induced a faster and greater cleavage of SNAP‐25 during the onset and peak phases, and prolonged the attenuation of nerve‐muscle neurotransmission during the recovery phase. We estimate that ECCI co‐injection yields a threefold potentiation in BoNT/A pharmacological activity.

Conclusions and Implications

Overall, our results show that the pharmacological activity of BoNT/A can be combined and synergized with other bioactive molecules and uncover a novel strategy to enhance the neuromuscular effects of BoNT/A without altering the neurotoxin moiety or intrinsic activity, thus maintaining its exceptional safety profile.
Debate: Bridging the gap – role of nonspecialists in child and adolescent mental health care
Authors: Chachar Aisha Sanober , Mian Ayesha I.
Published: October 2024

The first point of contact for patients and families seeking professional help for health problems is often in nonspecialist community healthcare settings that vary widely across the countries in funding sources, resources and support from specialist services. They typically involve general practitioners, family physicians, general and community paediatricians, and nonphysician health workers such as nurses, social workers and public health professionals. This article discusses the role of nonspecialists in addressing the challenges of limited resources in Child and Adolescent Mental Health (CAMH) care services as healthcare systems struggle to meet the high demand. Stakeholders and decision‐makers need to reconsider traditional healthcare models and service delivery. Integrating nonspecialist community care can be a potential solution but is beset with ethical, geopolitical, practical and economic challenges. The urgency and complexity of the issue are highlighted, emphasising the need for global discussion around CAMH care.
How Do Persons With Disabilities and/or Complex Health Conditions Perceive Oral Health? A Qualitative Study
Authors: Bogner Marie‐Sophie , Scambler Sasha , Eschevins Caroline , Faulks Denise
Published: October 2024

Objectives

This qualitative study aimed to explore the experience and perception of the mouth, oral health, functioning and the social environment amongst adults with disabilities and complex health conditions.

Methods

Purposive sampling using the maximum variation strategy was performed to select participants with a wide range of experiences in terms of demographics, disability and health conditions. Consent was sought, and semi‐structured interviews were conducted, recorded and transcribed verbatim. Within the interpretivist tradition, a phenomenological approach was used to describe the lived, contextualised experience of people in relation to their mouths, as described by participants. Thematic analysis was undertaken.

Results

Eighteen participants with disabilities and complex health conditions were interviewed. Twelve individuals had an intellectual disability. Three main themes were identified: perception of the mouth and oral health; symptomatic perceptions and responses to oral health problems; and inter‐relationships between the mouth, oral health and the socio‐medical environment. The mouth had a central place in the lives of the participants, but its importance was only recognised when oral health problems interfered with daily life, function, social relationships, family life or autonomy. Certain social determinants of health were identified: social exclusion, financial insecurity, lack of autonomy, nutrition and negotiation of services. Oral problems were perceived as an additional burden to those with disabilities or complex health conditions.

Conclusion

This study provided insight into the daily lives of adults with disabilities and complex health conditions. It helps to fill the gaps in the existing literature regarding the perceptions of the mouth and oral health, connecting oral function, general health and social environment for this population.

Trial Registration

This study was registered into ClinicalTrials.gov (NCT04815434)
Featured Cover
Authors: Li Ruikun , Zhu Jie , Wang Shuo , Li Xueyuan , Li Songhang
Published: October 2024

The cover image is based on the article Effects of sterilization and disinfection methods on digitally designed surgical implant guide accuracy: An in vitro study by Ruikun Li et al., https://doi.org/10.1111/cid.13350.

image
Microglial priming by IFN‐γ involves STAT1‐mediated activation of the NLRP3 inflammasome
Authors: He Haili , Zhang Xiaomei , He Hui , Xu Gaojie , Li Liangyuan , Yang Chengyan , Liu Yu‐e , You Zili , Zhang Jinqiang
Published: October 2024

Background

Inflammatory and immune responses in the brain that contribute to various neuropsychiatric disorders may begin as microglial “priming”. Interferon (IFN)‐γ is known to cause microglial priming, but the mechanism is unclear.

Methods

We examined the effects of IFN‐γ on gene expression, microglial activation, inflammatory and immune responses and activity of the NLRP3 inflammasome in primary microglia and in the brains of mice.

Results

Our results showed that treating microglial cultures with IFN‐γ induced a hedgehog‐like morphology and upregulated markers of microglial activation (CD86, CD11b) and pro‐inflammatory molecules (IL‐1β, IL‐6, TNF‐α, iNOS), while downregulating markers of microglial homeostasis (CX3CR1, CD200R1), anti‐inflammatory molecules (MCR1, Arg‐1) and neurotrophic factors (IGF‐1, BDNF). IFN‐γ also upregulated markers of NLRP3 inflammasome activation (NLRP3, caspase‐1, gasdermin D, IL‐18). This particular transcriptional profiling makes IFN‐γ‐primed microglia with exaggerated responses upon lipopolysaccharide (LPS) stimulation. The level of NLRP3, caspase‐1, gasdermin D, IL‐1β, IL‐18, TNF‐α and iNOS in microglia cultures treated with both IFN‐γ and LPS were highest than with either one alone. Injecting IFN‐γ into the lateral ventricle of mice induced similar morphological and functional changes in hippocampal microglia as in primary microglial cultures. The effects of IFN‐γ on NLRP3 inflammasome and microglia from cultures or hippocampus were abolished when STAT1 was inhibited using fludarabin. Injecting mice with IFN‐γ alone or together with LPS induced anxiety‐ and depression‐like behaviors and impaired hippocampus‐dependent spatial memory; these effects were mitigated by fludarabin.

Conclusions

IFN‐γ primes microglia by activating STAT1, which upregulates genes that activate the NLRP3 inflammasome. Inhibiting the IFN‐γ/STAT1 axis may be a way to treat neurodegenerative diseases and psychiatric disorders that involve microglial priming.
Prevalence of dumping and hypoglycaemia symptoms after bariatric surgery: A questionnaire‐based cross‐sectional study
Authors: Jans Anders , Rask Eva , Ottosson Johan , Szabo Eva , Stenberg Erik
Published: October 2024

Dumping and post‐bariatric hypoglycaemia (PBH) are side effects that occur after bariatric surgery. The aim of this study was to estimate the prevalence of dumping and PBH symptoms before Roux‐en‐Y gastric bypass (RYGB) and sleeve gastrectomy (SG) at 6 months, 1 year, 2 years and 5 years after surgery in a Swedish population. A cross‐sectional single‐centre study was performed at Lindesberg Hospital, Region Örebro County, Sweden, between 2020 and 2023. The Swedish version of the Dumping Severity Scale (DSS‐Swe) questionnaire, which includes eight items regarding dumping symptoms and six items regarding hypoglycaemia symptoms, was used. A total of 742 DSS‐Swe questionnaires were included. The average age at surgery was 42.0 years (standard deviation [SD] = 11.9), and the average body mass index was 41.8 kg/m2 (SD = 5.9). The surgical methods consisted of RYGB (66.3%) and SG (33.7%). The proportion of RYGB patients with highly suspected dumping increased from 4.9% before surgery to 26.3% (adjusted odds ratio [OR] = 7.35, 95% confidence interval [CI] = 3.08–17.52) at the 5‐year follow‐up. PBH symptoms increased from 1.4% before surgery to 19.3% at the 5‐year follow‐up (adjusted OR = 17.88, 95% CI = 4.07–78.54). For SG patients, no significant increase in dumping or PBH symptoms was observed. In patients with persistent type 2 diabetes (T2D), there were no cases of highly suspected hypoglycaemia following RYGB or SG. Symptoms of dumping and PBH were common after RYGB, while no clear increase was observed after SG. Persistent T2D seems to be a protective factor against PBH symptoms.
Vorhersage von Psoriasis‐Arthritis bei Patienten mit Plaque‐Psoriasis durch neuartiges Nomogramm
Authors: Tan Minjia , Chen Junchen , Cheng Jiaomei , Hu Jingjin , Hu Kun , Yang Jing , Li Xingyu , Zhang Mi , Zhu Wu , Liao Liqiu , Kuang Yehong
Published: October 2024

Ziel

Die Erstellung eines Vorhersagemodells für Psoriasis‐Arthritis (PsA) anhand klinischer und sonographischer Charakteristika bei Patienten mit Plaque‐Psoriasis (PsP).

Patienten und Methoden

Demographische, klinische und sonographische Daten von Patienten mit PsP und PsA wurden zwischen Mai 2019 und Dezember 2022 erfasst.

Ergebnisse

Insgesamt umfasste die Schulungskohorte 212 Patienten mit PsP und 123 Patienten mit PsA und die Validierungskohorte 91 Patienten mit PsP und 49 Patienten mit PsA. Mittels multivariater logistischer Regression wurden Nagelpsoriasis (Odds‐Ratio [OR] 1,88, 95%‐KI: 1,07–3,29), Synovitis (OR 18,23, 95%‐KI: 4,04–82,33), Enthesitis (OR 3,71, 95%‐KI: 1,05–13,14) und Knochenerosion (OR 11,39, 95%‐KI: 3,05–42,63) als effektive Prädiktoren für PsA identifiziert. Die Fläche unter der Kurve betrug für die Schulungskohorte 0,750 (95%‐KI, 0,691–0,806) und für die Validierungskohorte 0,804 (95%‐KI, 0,723–0,886). Der Hosmer‐Lemeshow‐Test zur Anpassungsgüte zeigte sowohl für die Schulungskohorte (p  =  0,970) als auch für die Validierungskohorte (p  =  0,967) eine gute Übereinstimmung. Außerdem wiesen die Kalibrierungskurven bei beiden Kohorten auf eine gute Kalibrierung hin. Laut Entscheidungskurvenanalyse hatte das Vorhersagemodell einen guten klinischen Nutzen.

Schlussfolgerungen

Wir haben auf Grundlage von Nagelpsoriasis, Synovitis, Enthesitis und Knochenerosion ein quantitatives, intuitives und praktisches Vorhersagemodell zur Bewertung des PsA‐Risikos bei Patienten mit Plaque‐Psoriasis entwickelt.
Krankheit Vitiligo – Ein Positionspapier zur Stigmatisierung, Einschränkung der Lebensqualität und psychosozialen Komorbidität
Authors: Böhm Markus , Sommer Rachel , Gieler Uwe , Staubach Petra , Zink Alexander , Apfelbacher Christian , Peters Eva M. J.
Published: October 2024

Vitiligo ist eine häufige Erkrankung, die mit einem meist sichtbaren Pigmentverlust der Haut einhergeht. Der wichtigste Vertreter ist die nicht‐segmentale Vitiligo (NSV). Ihr liegt pathogenetisch eine autoimmunvermittelte Zerstörung der Melanozyten zugrunde. Die Erkrankung führt zu Stigmatisierung und signifikanter Einschränkung der Lebensqualität. Unter Missachtung der psychosozialen Belastung wird die Vitiligo manchmal nur als kosmetisches Problem betrachtet und laut eines globalen Surveys im Durschnitt erst nach 2,4 Jahren diagnostiziert. Es kommt zu erheblicher Krankheitslast bis hin zur Suizidalität. Stigmatisierung begünstigt die Entwicklung psychischer Komorbidität wie Angst‐ und depressive Störungen. Deren Prävalenz variiert je nach Land und Studie (0,1%–67,9%). Die Daten für Deutschland sind heterogen und basieren weitgehend auf Schätzwerten. Aufgrund der psychosozialen Einflussfaktoren, der entzündlichen Komponente und einer höheren Inzidenz somatischer Begleiterkrankungen ergibt sich die Frage, ob die NSV zu den entzündlichen Systemerkrankungen zu zählen ist. Wir empfehlen zur Optimierung der Versorgung neben der Krankheitsaktivität auch die Erhebung der Lebensqualität als Standard in die Routineversorgung einzuführen und frühzeitig auf psychische Komorbidität zu screenen, um eine fachgerechte Behandlung einzuleiten bevor Krankheitsverläufe chronifizieren und kumulative (zum Teil irreversible) Beeinträchtigungen entstehen. Ziel ist eine personalisierte und patientenorientierte integrierte Versorgung, die den Gesundheitszustand der Betroffenen nachhaltig verbessert.
RUSSELL REVIEW Soil carbon stewardship: Thinking in circles
Authors: Janzen H. Henry
Published: October 2024

The words we choose to describe our research ultimately directs its course. A dominant term in soil science now, is ‘sequestration’, referring to the removal of carbon (C) from air and its irreversible seclusion in soil, ideally as stable soil organic carbon (SOC). An emerging view, however, now sees SOC as an inherently dynamic assemblage of forms, all potentially vulnerable to decay, with no discrete, measurable fraction holding C in ‘sequestered’ form. Rather than speaking of C ‘sequestration’, then, we might refer instead to SOC ‘stewardship’. This word, now, enfolds the entire spectrum of SOC, not merely some elusive ‘persistent’ or ‘stable’ fraction, perhaps redirecting inquiry; for example, does C need to be ‘sequestered’ in stable form for SOC to serve as effective repository of excess atmospheric CO2? ‘Stewardship’ explicitly accepts the relentless turnover of SOC, emphasizing the need to manage not only fixed stocks of C, but also the cyclical flows of C through ecosystems that drive their functions. Among other benefits, ‘stewardship’ might motivate us to consider all functions of SOC (not only climate mitigation), consider the entire C cycle (not only enhancing soil C), and preserve existing troves of SOC (not only augmenting them in selected places.) Perhaps most fundamentally, by its etymology, ‘stewardship’ poses a compelling, timeless question: for whom do we steward SOC? Asking why look after SOC, not only reflects our own underlying quest for resilience, but also expands our potential audience and entices the more creative minds that must succeed us. Although ‘stewardship’ may elicit new and fruitful inquiry, we may need to look for words even more evocative, more alluring, more true to our mandate of living well within the circling C that must always sustain us.
The first AI‐based Chatbot to promote HIV self‐management: A mixed methods usability study
Authors: Ma Yuanchao , Achiche Sofiane , Tu Gavin , Vicente Serge , Lessard David , Engler Kim , Lemire Benoît ,   MARVIN chatbots Patient Expert Committee, Laymouna Moustafa , de Pokomandy Alexandra , Cox Joseph , Lebouché Bertrand
Published: October 2024

Background

We developed MARVIN, an artificial intelligence (AI)‐based chatbot that provides 24/7 expert‐validated information on self‐management‐related topics for people with HIV. This study assessed (1) the feasibility of using MARVIN, (2) its usability and acceptability, and (3) four usability subconstructs (perceived ease of use, perceived usefulness, attitude towards use, and behavioural intention to use).

Methods

In a mixed‐methods study conducted at the McGill University Health Centre, enrolled participants were asked to have 20 conversations within 3 weeks with MARVIN on predetermined topics and to complete a usability questionnaire. Feasibility, usability, acceptability, and usability subconstructs were examined against predetermined success thresholds. Qualitatively, randomly selected participants were invited to semi‐structured focus groups/interviews to discuss their experiences with MARVIN. Barriers and facilitators were identified according to the four usability subconstructs.

Results

From March 2021 to April 2022, 28 participants were surveyed after a 3‐week testing period, and nine were interviewed. Study retention was 70% (28/40). Mean usability exceeded the threshold (69.9/68), whereas mean acceptability was very close to target (23.8/24). Ratings of attitude towards MARVIN's use were positive (+14%), with the remaining subconstructs exceeding the target (5/7). Facilitators included MARVIN's reliable and useful real‐time information support, its easy accessibility, provision of convivial conversations, confidentiality, and perception as being emotionally safe. However, MARVIN's limited comprehension and the use of Facebook as an implementation platform were identified as barriers, along with the need for more conversation topics and new features (e.g., memorization).

Conclusions

The study demonstrated MARVIN's global usability. Our findings show its potential for HIV self‐management and provide direction for further development.
Unemployed and then? The role of non‐standard employment in labour market trajectories after unemployment
Authors: Lietzmann Torsten , Hohmeyer Katrin
Published: October 2024

Non‐standard employment (NSE) might offer employment opportunities for unemployed workers, who would not find a job otherwise and can improve their human capital while working in NSE instead of being unemployed. NSE thus could serve as a bridge to regular, permanent employment. However, these stepping stone effects might not occur in a segmented labour market, when the accumulated human capital is not useful for regular jobs or NSE is not a positive signal to potential employers. Using German administrative data and sequence and cluster analysis, this article examined the labour market trajectories of initially unemployed individuals between 2012 and 2015 over a 4‐year period with a focus on four common forms of NSE. The results indicate that NSE is not limited to marginal groups but 62% of the initially unemployed belong to a cluster with a substantial share of NSE. Furthermore, while most individuals stay in NSE, some regular full‐time employment occurs after NSE.
First‐principle calculations, crystal growth, and broadband near‐infrared luminescence of Nd:Y2Mg3(SiO4)3 single crystal
Authors: Li Lin , Zhang Peixiong , Li Zhen , Chen Zhenqiang
Published: October 2024

This study successfully grew Y2Mg3(SiO4)3 (YMS) single crystals doped with Nd3+ ions via laser heated pedestal growth method for the first time. Based on first‐principle calculations, the structural relaxation, energy band structure, density of states, and optical properties of YMS and Nd:YMS crystals with multiple disordered structures were calculated for the first time. The refractive index of the YMS crystal was obtained to be 1.83. The optical properties including absorption spectra, near‐infrared (NIR) luminescence spectra, and fluorescence lifetime at 1080 nm (Nd3+: 4F3/2→4I11/2) were characterized and analyzed based on the grown Nd:YMS single crystal. The crystal was found to have an ultra‐wide half‐height width (46.99 nm) of emission cross‐section, and a fluorescence lifetime of 220.38 µs, making it a luminescence material with excellent comprehensive performance.
Nanomechanical properties of RENbO4 (RE = La, Gd, Dy, Y, Yb) ceramics: A comprehensive investigation by nano indentation
Authors: Jiang Xiang , Chen Lin , Zhang Di , Yan Shixiao , Sun Xiaoliang , Wang Jiankun , Li Baihui , Xue Guiyu , Feng Jing
Published: October 2024

Excellent mechanical properties are indispensable for thermal barrier coatings (TBCs), including high hardness and low modulus, as well as excellent creep and wear resistance. This study focuses on nanomechanical properties of RENbO4 (RE = La, Gd, Dy, Y, Yb), and the effects of microstructures on their properties are analyzed. The evolutions of hardness and modulus of RENbO4 are studied based on the changes of RE3+ ionic radius, and the shorter bond lengths lead to the higher hardness and modulus due to the increasing bonding strength. The existence of ferroelastic domains causes the presence of pop out during nanoindentation, which affects the elastic and plastic work. Based on the load‐displacement curves, we further analysis the creep behavior and wear resistance of RENbO4 ceramics, and the results show that these two parameters show a negative correlation. Among the studied RENbO4 ceramics, YbNbO4 exhibits the best mechanical properties, and the used methods in current paper can be employed to screen materials with outstanding properties for various applications.
Low thermal stress and excellent gas tightness in BaO‒CaO‒Al2O3‒B2O3‒SiO2 glass‐ceramic for long‐term ITSOFC application
Authors: Ren Haishen , Ge Wenjie , Chen Le , Peng Haiyi , Meng Fancheng , Lin Huixing , Jin Ye
Published: October 2024

The increased coefficient of thermal expansion (CTE) mismatch and mechanical performance degradation of glass‐based sealant‐induced thermal stress are critical issues for long‐term application of solid oxide fuel cell (SOFC). In this work, the double effect of MgO particle on dispersion strengthening, inhibition low‐CTE phase transformation, thermal stress, and leakage rate in BaO‒CaO‒Al2O3‒B2O3‒SiO2 (BCABS) glass‐ceramic were investigated and analyzed. The low‐CTE mono‐BaAl2Si2O8 phase was suppressed by the MgO particle reacting with BCABS glass‐ceramic. Consequently, the CTE for BCABS glass‐ceramic without MgO decreases from 11.47 at 1 h to 10.18 ×10−6/°C at 1000 h and reduction rate is higher than 10%, bring about the thermal stress of sealant itself and interface had tripled (200 MPa) and leakage rate was high than 0.06 sccm/cm after 250 h. However, the CTE of 20 wt% MgO‐reinforced BCABS glass‐ceramic sealant only declined about 4.0% for 1000 h, resulting in slow increase or even decrease in the thermal stress (low than 60 MPa) and maintaining stable leakage rate below 0.04 sccm/cm for 1000 h with three thermal cycles. This study was useful for identifying optimal CTE matching and elastic modulus of glass‐based sealant for efficient and stable long‐term operation of SOFC.
X‐ray–induced multicolor long afterglow and photostimulated luminescence from Pr3+‐doped Sr3(PO4)2
Authors: Zhang Jiaxu , Liu Runyao , Fu Xiaoyan , Yi Jian , Lin Tongyan , Liu Zewen , Chen Naihui , Zhang Hongwu
Published: October 2024

In this paper, X‐ray–induced multicolor long afterglow and photostimulated luminescence from Sr3(PO4)2: Pr3+ was reported. The Rietveld refinement results have confirmed the as‐prepared sample was pure Sr3(PO4)2 phase with hexagonal crystal system. And Sr3(PO4)2: Pr3+ showed an excellent X‐ray–induced long afterglow luminescent performance. Under the excitation of X‐ray, the sample showed multicolor long afterglow luminescence from UVC to red region located at 268, 359, 466, 548, 604.3 and 685 nm, which can be ascribed to 4f5d‐3H4, 4f5d‐ 1D2, 4f5d‐3P0, 3P0→3H5 and 1D2→3H4, respectively. And the strongest afterglow emission intensity appeared at 468 nm. Furthermore, only 30 s X‐ray irradiation can induce 12 h afterglow emission, which afterglow emission intensity of 468 nm still reached 3.71 × 104 cps and was about 37.1 times stronger than the background intensity. In particular, the relation between 268 nm afterglow emission intensity and 468 nm afterglow emission intensity showed good linearity. And the UVC afterglow emission can be easily “observed” via the visible afterglow light. Furthermore, Sr3(PO4)2: Pr3+ possessed an excellent photostimulated luminescence (PSL) under the excitation of 980 nm NIR laser and the PSL intensity of the 12 circle still arrived at 1.26 × 105 cps, which was about 37.1 times stronger than the afterglow emission intensity after 5 h decay. All these results showed that the as‐prepared Sr3(PO4)2: Pr3+ phosphor was an excellent X‐ray–induced long afterglow luminescence phosphor, which possessed large potential applications in the medical field.
Whose misbehavior is inexcusable—And which one? Job‐related discrimination against ethnic minority and majority women
Authors: Ball Elena , Niedlich Claudia , Steffens Melanie C.
Published: October 2024

Based on the model of intersectional invisibility, we tested the consequences of work‐related misbehavior for women of Turkish and German descent (i.e., misbehavior involving mistakes that are stereotypically associated with masculine or feminine traits, eliciting negative evaluations). Across a series of four preregistered experiments (Ns = 746, plus two pre‐registered experiments in an Additional Supplement), we investigated evaluations of female targets in a male‐typed, highly qualified job context. We focus on exclusion and promotion decisions. A single‐paper meta‐analysis substantiates findings across samples who have different experiences regarding racism and in personnel selection. Our findings reveal a nuanced picture: Misbehavior associated with stereotypically feminine traits led to more negative consequences for Turkish women than for German women, resulting in more frequent exclusion and less frequent promotion for Turkish women. In contrast, misbehavior associated with stereotypically masculine traits led to more favorable outcomes for Turkish than German women. Thus, revealing a complex relationship between type of misbehavior and ethnicity, we identify leader prototypes as an explanatory mechanism, rather than aversive racism or shifting standards. Results suggest that Turkish women are discriminated against most for showing stereotypically feminine behavior confirming gendered racialized steretoypes, but may experience less backlash when showing counter‐stereotypical behavior than German women. We find double standards in evaluations of highly qualified women of Turkish versus German descent, with interactions with the type of misbehavior suggesting complex interplays of gender, ethnicity, and information provided about the individual in career advancement and exclusion.
“It's kinda like a sick joke”: Young people, labor market experiences, and the COVID‐19 pandemic
Authors: Shupp Parker Emily , Kloc Michael , Friedline Terri , Shanks Trina
Published: October 2024

Young people struggle to enter a new capitalist economy characterized by job instability and devalued wages and labor. The COVID‐19 pandemic exacerbated this instability, since employment sectors hit hardest by the economic recession affected jobs where young people worked. We study racially marginalized young people's labor market experiences in the United States through in‐depth interviews with seven participants conducted between 2019 and 2022, before and during the pandemic. Through coding and analysis, we develop themes of surviving, navigating the labor market, and glimpsing cracks in the capitalist wall. Interviews illustrate how racial capitalism pulls the rug out from under young people while offering illusions of stability through cobbled‐together work, benefits, and housing. Young people describe tuning themselves to become better capitalists and shifting their mindset to survive. Even so, young people recognize the pandemic created opportunities to question the status quo and reevaluate their engagements within the current capitalist economy.