bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

AbstractBackgroundThe 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.MethodsFocus 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.FindingsFour 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.ConclusionsThese 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

ABSTRACTPlant‐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

ABSTRACTAimTo 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 MethodsData 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).ResultsNinety‐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.ConclusionFrom 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

AbstractAlthough 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

AbstractDiabetic 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

AbstractAimTo assess the variation in patterns of use of insulin and other antidiabetic medicines across China, both geographically and over time.Materials and MethodsNationally, 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.ResultsNationally, 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.ConclusionsFrom 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

ABSTRACTBackgroundIntensive 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.MethodsCompetitive 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).ResultsOverall, 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.ConclusionAn 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

ABSTRACTThis 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

ABSTRACTClonal 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

AbstractForests 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

AimThis 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.MethodsThis 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.ResultsMultivariate 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).ConclusionsThe 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

ABSTRACTBackgroundPeople 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.ObjectiveThe 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 MethodsThe 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.ResultsThe 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.ConclusionThe 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 ContributionIndividuals 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.