bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring digital innovation in smart tourism destinations: insights from 31 premier tourist cities in digital China
Authors: Xu Jin , Shi Pei Hua , Chen Xi 
Published: January 2024

Purpose
This study aims to unveil the pivotal components and implementation pathways in the digital innovation of smart tourism destinations, while constructing a theoretical framework from a holistic perspective.

Design/methodology/approach
The research focuses on 31 significant urban smart tourism destinations in China. Secondary data was collected through manual search supplemented by big data scraping, whereas primary data was obtained from interviews with municipal tourism authorities. Grounded theory was used to theoretically construct the phenomenon of digital innovation in smart tourism destinations.

Findings
This research has formulated a data-driven knowledge framework for digital innovation in smart tourism destinations. Core components include digital organizational innovation, smart data platforms, multi-stakeholder digital collaborative ecosystem and smart tourism scenario systems. Destinations can achieve smart tourism scene innovation through closed innovation driven by smart data platforms or open innovation propelled by a multi-stakeholder digital collaborative ecosystem.

Practical implications
Based on insights from digital innovation practices, this study proposes a series of concrete recommendations aimed at assisting Destination Management Organizations in formulating and implementing more effective digital innovation strategies to enhance the sustainable digital competitiveness of destinations.

Originality/value
This study advances smart tourism destination innovation research from localized thinking to systemic thinking; extends digital innovation theory into the realm of smart tourism destination innovation; repositions the significance of knowledge in smart tourism destination innovation; and constructs a comprehensive framework for digital innovation in smart tourism destinations.
Oral and rectal colonization of methicillin‐resistant Staphylococcus aureus in long‐term care facility residents and their association with clinical status
Authors: Kusaka Satoru , Haruta Azusa , Kawada‐Matsuo Miki , Nguyen‐Tra Le Mi , Yoshikawa Mineka , Kajihara Toshiki , Yahara Koji , Hisatsune Junzo , Nomura Ryota , Tsuga Kazuhiro , Ohge Hiroki , Sugai Motoyuki , Komatsuzawa Hitoshi 
Published: January 2024

AbstractStaphylococcus aureus is a commensal bacterium in humans, but it sometimes causes opportunistic infectious diseases such as suppurative skin disease, pneumonia, and enteritis. Therefore, it is important to determine the prevalence of S. aureus and methicillin‐resistant S. aureus (MRSA) in individuals, especially older adults. In this study, we investigated the prevalence of S. aureus and MRSA in the oral cavity and feces of residents in long‐term care facilities (LTCFs). S. aureus was isolated from the oral cavity of 61/178 (34.3%) participants, including 28 MRSA‐positive participants (15.7%), and from the feces of 35/127 (27.6%) participants, including 16 MRSA‐positive participants (12.6%). S. aureus and MRSA were isolated from both sites in 19/127 individuals (15.0%) and 10/127 individuals (7.9%), respectively. Among 19 participants with S. aureus isolation from both sites, 17 participants showed the same sequence type (ST) type. Then, we analyzed the correlation of S. aureus and MRSA in the oral cavity and rectum with the participant's condition. S. aureus and MRSA positivity in the oral cavity was significantly related to tube feeding, while there was no correlation of rectal S. aureus/MRSA with any factors. Our findings regarding the oral inhabitation of MRSA and its risk factors indicate the importance of considering countermeasures against MRSA infection in LTCFs.
Racial and ethnic disparities in emergency department transfers to public hospitals
Authors: Hsuan Charleen , Vanness David J. , Zebrowski Alexis , Carr Brendan G. , Norton Edward C. , Buckler David G. , Wang Yinan , Leslie Douglas L. , Dunham Eleanor F. , Rogowski Jeannette A. 
Published: January 2024

AbstractObjectiveTo examine racial/ethnic differences in emergency department (ED) transfers to public hospitals and factors explaining these differences.Data Sources and Study SettingED and inpatient data from the Healthcare Cost and Utilization Project for Florida (2010–2019); American Hospital Association Annual Survey (2009–2018).Study DesignLogistic regression examined race/ethnicity and payer on the likelihood of transfer to a public hospital among transferred ED patients. The base model was controlled for patient and hospital characteristics and year fixed effects. Models II and III added urbanicity and hospital referral region (HRR), respectively. Model IV used hospital fixed effects, which compares patients within the same hospital. Models V and VI stratified Model IV by payer and condition, respectively. Conditions were classified as emergency care sensitive conditions (ECSCs), where transfer is protocolized, and non‐ECSCs. We reported marginal effects at the means.Data Collection/Extraction MethodsWe examined 1,265,588 adult ED patients transferred from 187 hospitals.Principal FindingsBlack patients were more likely to be transferred to public hospitals compared with White patients in all models except ECSC patients within the same initial hospital (except trauma). Black patients were 0.5–1.3 percentage points (pp) more likely to be transferred to public hospitals than White patients in the same hospital with the same payer. In the base model, Hispanic patients were more likely to be transferred to public hospitals compared with White patients, but this difference reversed after controlling for HRR. Hispanic patients were − 0.6 pp to −1.2 pp less likely to be transferred to public hospitals than White patients in the same hospital with the same payer.ConclusionsLarge population‐level differences in whether ED patients of different races/ethnicities were transferred to public hospitals were largely explained by hospital market and the initial hospital, suggesting that they may play a larger role in explaining differences in transfer to public hospitals, compared with other external factors.
Novel electrochemical strategies for the microbial conversion of CO2 into biomass and volatile fatty acids using a fluid‐like bed electrode in a three‐phase reactor
Authors: Llorente María , Tejedor‐Sanz Sara , Berná Antonio , Manchón Carlos , Esteve‐Núñez Abraham 
Published: January 2024

AbstractMicrobial electrosynthesis (MES) constitutes a bioelectrochemical process where bacteria uptake electrons extracellularly from a polarized electrode to incorporate them into their anabolic metabolism. However, the efficiency of current MES reactor designs can be lower than expected due to limitations regarding electron transfer and mass transport. One of the most promising bioreactor configurations to overcome these bottlenecks is the Microbial Electrochemical Fluidized Bed Reactor (ME‐FBR). In this study, microbial CO2 fixation is investigated for the first time in a ME‐FBR operated as a 3‐phase reactor (solid–liquid–gas). An electroconductive carbon bed, acting as a working electrode, was fluidized with gas and polarized at different potentials (−0.6, −0.8 and −1 V vs. Ag/AgCl) so it could act as an electron donor (biocathode). Under these potentials, CO2 fixation and electron transfer were evaluated. Autotrophic electroactive microorganisms from anaerobic wastewater were enriched in a ME‐FBR in the presence of 2‐bromoethanosulfonic acid (BES) to inhibit the growth of methanogens. Cyclic voltammetry analysis revealed interaction between the microorganisms and the cathode. Furthermore, volatile fatty acids like propionate, formate and acetate were detected in the culture supernatant. Acetate production had a maximum rate of ca. 1 g L−1 day−1. Planktonic cell biomass was produced under continuous culture at values as high as ca. 0.7 g L−1 dry weight. Overall, this study demonstrates the feasibility of employing a fluidized electrode with gaseous substrates and electricity as the energy source for generating biomass and carboxylic acids.
Safety of e‐cigarettes and nicotine patches as stop‐smoking aids in pregnancy: Secondary analysis of the Pregnancy Trial of E‐cigarettes and Patches (PREP) randomized controlled trial
Authors: Pesola Francesca , Smith Katie Myers , Phillips‐Waller Anna , Przulj Dunja , Griffiths Christopher , Walton Robert , McRobbie Hayden , Coleman Tim , Lewis Sarah , Whitemore Rachel , Clark Miranda , Ussher Michael , Sinclair Lesley , Seager Emily , Cooper Sue , Bauld Linda , Naughton Felix , Sasieni Peter , Manyonda Isaac , Hajek Peter 
Published: January 2024

AbstractAimsThe aim of this study was to examine the safety of e‐cigarettes (EC) and nicotine patches (NRT) when used to help pregnant smokers quit.DesignA recent trial of EC versus NRT reported safety outcomes in the randomized arms. We conducted a further analysis based on product use.SettingTwenty‐three hospitals in England and a stop‐smoking service in Scotland took part.ParticipantsThe participants comprised 1140 pregnant smokers.InterventionsWe compared women using and not using EC and NRT regularly during pregnancy.MeasurementsMeasurements included nicotine intake compared with baseline, birth weight, other pregnancy outcomes, adverse events, maternal respiratory symptoms and relapse in early abstainers.FindingsUse of EC was more common than use of NRT (47.3% vs 21.6%, P < 0.001). Women who stopped smoking (abstainers) and used EC at the end‐of‐pregnancy (EOP) reduced their salivary cotinine by 45% [49.3 ng/ml, 95% confidence interval (CI) = −79.8 to −10]. Only one abstainer used NRT at EOP. In dual users, cotinine increased by 19% (24 ng/ml, 95% CI = 3.5–68). In women reporting a reduction of at least 50% in cigarette consumption, cotinine levels increased by 10% in those using nicotine products and by 9% in those who did not. Birth weights in dual users and exclusive smokers were the same (3.1 kg). Birth weight in abstainers using either nicotine product was higher than in smokers [3.3 kg, standard deviation (SD) = 0.7] versus 3.1 kg, SD = 0.6; difference = 0.15 kg, 95% CI = 0.05–0.25) and not different from abstainers not using nicotine products (3.1 kg, SD = 0.8). Abstainers and smokers using nicotine products had no worse pregnancy outcomes or more adverse events than abstainers and smokers not using them. EC users reported more improvements than non‐users in cough [adjusted relative risk (aRR) = 0.59, 95% CI = 0.37–0.93] and phlegm (aRR = 0.53, 95% CI = 0.31–0.92), controlling for smoking status. EC or NRT use had no association with relapse.ConclusionsRegular use of e‐cigarettes or nicotine patches by pregnant smokers does not appear to be associated with any adverse outcomes.
Leptin promotes proliferation of human undifferentiated spermatogonia by activating the PI3K/AKT/mTOR pathway
Authors: Xin Song , Xiaoxuan Li , Yixuan Zhang , Zhikang Cai 
Published: January 2024

AbstractBackgroundMale infertility is a common disease affecting male reproductive health. Leptin is an important hormone that regulates various physiological processes, including reproductive function. However, few experimental studies have been carried out to elucidate the mechanism of leptin's effects on male reproductive function.ObjectiveThe purpose of this study was to investigate the effects of leptin on testicular spermatogenesis and its mechanism, so as to provide potential targets for the treatment of patients with spermatogenic dysfunction.MethodsTesticular tissues were collected from eight prostate cancer patients undergoing surgical castration. GPR125‐positive spermatogonia were isolated by two consecutive magnetic activated cell sorting (MACS), followed by incubation with conditioned medium. To identify the signaling pathway(s) involved in the effects of leptin, undifferentiated spermatogonia were treated with different concentrations of leptin and antagonists of leptin‐related pathways. The proliferative effect of leptin was evaluated by cell counting using a hemocytometer. Expressions of p‐AKT, p‐ERK, p‐STAT, and p‐S6K were determined by western blotting analysis.ResultsLeptin promoted the growth of human GPR125‐positive spermatogonia in a concentration‐dependent manner. The most significant proliferative effect was observed using 100 ng/mL leptin after 6 days of culture. Leptin significantly increased the phosphorylation of STAT3, AKT, and ERK in undifferentiated spermatogonia. Phosphatidylinositol 3‐kinase (PI3K) inhibitor LY294002 inhibited the leptin‐induced activation of AKT, ERK, and downstream S6K. Treatment with the mammalian target of rapamycin (mTOR) inhibitor rapamycin also inhibited S6K phosphorylation. Moreover, both LY294002 and rapamycin were found to inhibit the leptin‐induced proliferation of undifferentiated spermatogonia. These results suggested that the leptin‐induced proliferation of GPR125‐positive spermatogonia was dependent on the PI3K/AKT/mTOR pathway. Further exploration of proliferation and apoptotic markers suggested that leptin may alleviate cell apoptosis by regulating the expression of Bax and FasL.ConclusionsA certain concentration of leptin (25∼100 ng/mL) could promote proliferation of undifferentiated spermatogonia, which was mediated by PI3K/AKT/mTOR pathway.
Novel variations in TENT5D lead to teratozoospermia in infertile patients
Authors: Zhang Ying‐Teng , Shen Gan , Zhuo Liang‐Chai , Yang Xue , Wang Su‐Yan , Ruan Tie‐Chao , Jiang Chuan , Wang Xiang , Wang Yan , Yang Yi‐Hong , Shen Ying 
Published: January 2024

AbstractPurposeTeratozoospermia is the main pathogenic factor of male infertility. However, the genetic etiology of teratozoospermia is largely unknown. This study aims to clarify the relationship between novel variations in TENT5D and teratozoospermia in infertile patients.Materials and methodsTwo infertile patients were enrolled. Routine semen analysis of patients and normal controls was conducted with the WHO guidelines. Whole‐exome sequencing (WES) was conducted to identify pathogenic variants in the two patients. Morphology and ultrastructure analysis of spermatozoa in the two patients was determined by Papanicolaou staining, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). The functional effect of the identified variants was analyzed by immunofluorescence staining and western blotting. The expression of TENT5D in different germ cells was detected by immunofluorescence staining.ResultsTwo new hemizygous variations, c.101C > T (p.P34L) and c.125A > T (p.D42V), in TENT5D were detected in two patients with male infertility. Morphology analysis showed abnormalities in spermatozoa morphology in the two patients, including multiple heads, headless, multiple tails, coiled, and/or bent flagella. Ultrastructure analysis showed that most of the spermatozoa exhibited missing or irregularly arranged ‘9+2’ structures. Further functional experiments confirmed the abrogated TENT5D protein expression in patients. In addition, both p.P34L and p.D42V substitutions resulted in a conformational change of the TENT5D protein. We precisely analyzed the subcellular localization of TENT5D in germ cells in humans and mice. And we found that TENT5D was predominantly detected in the head and flagellum of elongating spermatids and epididymal spermatozoa.ConclusionsOur results showed further evidence of a relationship between TENT5D mutation and human male infertility, providing new genetic insight for use in the diagnosis and treatment of male infertility.
Parents' experiences of palliative care decision‐making in neonatal intensive care units: An interpretative phenomenological analysis
Authors: Saint Denny Kelly , Lamore Kristopher , Nandrino Jean‐Louis , Rethore Sabine , Prieur Charlotte , Mur Sebastien , Storme Laurent 
Published: January 2024

AbstractAimThis work explores the experiences and meaning attributed by parents who underwent the decision‐making process of withholding and/or withdrawing life‐sustaining treatment for their newborn.MethodsAudio‐recorded face‐to‐face interviews were led and analysed using interpretative phenomenological analysis. Eight families (seven mothers and five fathers) whose baby underwent withholding and/or withdrawing of life‐sustaining treatment in three neonatal intensive care units from two regions in France were included.ResultsThe findings reveal two paradoxes within the meaning‐making process of parents: role ambivalence and choice ambiguity. We contend that these paradoxes, along with the need to mitigate uncertainty, form protective psychological mechanisms that enable parents to cope with the decision, maintain their parental identity and prevent decisional regret.ConclusionRole ambivalence and choice ambiguity should be considered when shared decision‐making in the neonatal intensive care unit. Recognising and addressing these paradoxical beliefs is essential for informing parent support practices and professional recommendations, as well as add to ethical discussions pertaining to parental autonomy and physicians' rapport to uncertainty.
Muscular stress is equal when resistance exercise with blood flow restriction is matched in total work volume: A cross‐sectional, cross‐over study
Authors: Okita Koichi , Omokawa Masashi , Takada Shingo , Kadoguchi Tomoyasu , Morita Noriteru , Yokota Takashi 
Published: January 2024

AbstractAimWe compared muscular metabolic stress during exercise performed at multiple intensities, from very low to moderate, with blood flow restriction (BFR) adjusted by the same work volume.MethodsTwenty‐five healthy young adults performed unilateral plantar flexion at 1 repetition/2 s in a magnetic resonance system. The BFR exercise protocols were as follows: (A) exercise with 10% of one repetition maximum (1‐RM) for 360 s, (B) 15% 1‐RM for 240 s, (C) 20% 1‐RM for 180 s, (D) 30% 1‐RM for 120 s, and (E) 40% 1‐RM for 90 s. All protocols had the same total work volume (load × repetitions = 1800). A high‐intensity protocol at 65% 1‐RM without BFR (60 s) was also performed for comparison. We used 31P‐magnetic resonance spectroscopy to evaluate the muscular metabolic stress in the subjects' calf muscle, defined as decreases in phosphocreatine and intramuscular pH.ResultsThe phosphocreatine depletion (A: 15.6 ± 0.7, B: 14.8 ± 0.8, C: 15.2 ± 0.6, D: 14.3 ± 0.6, E: 10.9 ± 0.5 mM; no significant difference [ns]) and the intramuscular pH decrease (A: 6.82 ± 0.02, B: 6.84 ± 0.01, C: 6.83 ± 0.02, D: 6.83 ± 0.02, E: 6.77 ± 0.02; ns) at the end of each exercise were similar and greater than those produced by the 65% 1‐RM without BFR.ConclusionIf the total work volumes are equal, the metabolic stress in exercising muscle may reach similar levels at the end of exercise with BFR and could provide similar successful training effects.
Preload dependence in an animal model of mild heart failure with preserved ejection fraction (HFpEF)
Authors: Jacobsen Jens C. B. , Schubert Irene H. , Larsen Karin , Terzic Dijana , Thisted Louise , Thomsen Morten B. 
Published: January 2024

AbstractAimHeart Failure with preserved Ejection Fraction (HFpEF) is characterized by diastolic dysfunction and reduced cardiac output, but its pathophysiology remains poorly understood. Animal models of HFpEF are challenging due to difficulties in assessing the degree of heart failure in small animals. This study aimed at inducing HFpEF in a mouse model to probe preload‐dependency.MethodsIncreased body mass and arterial hypertension were induced in mice using a Western diet and NO synthase inhibition. Preload dependence was tested ex vivo.ResultsMice with obesity and hypertension exhibited reduced cardiac output, indicating a failing heart. Increased left ventricular filling pressure during diastole suggested reduced compliance. Notably, the ejection fraction was preserved, suggesting the development of HFpEF. Spontaneous physical activity at night was reduced in HFpEF mice, indicating exercise intolerance; however, the cardiac connective tissue content was comparable between HFpEF and control mice. The HFpEF mice showed increased vulnerability to reduced preload ex vivo, indicating that elevated left ventricular filling pressure compensated for the rigid left ventricle, preventing a critical decrease in cardiac output.ConclusionThis animal model successfully developed mild HFpEF with a reduced pump function that was dependent on a high preload. A model of mild HFpEF may serve as a valuable tool for studying disease progression and interventions aimed at delaying or reversing symptom advancement, considering the slow development of HFpEF in patients.
Equity ownership and identification with the founding team
Authors: Weissenböck Eva , Breugst Nicola , Patzelt Holger , Dibbern Rieke 
Published: January 2024

AbstractFounders benefit from identifying with their founding teams because identification facilitates cooperation in the team, aligns founders' actions with the norms and interests of the team, and, ultimately, enhances team performance. High identification with the team is likely to be shaped by structural characteristics of the founding team and, more specifically, founders' equity stakes—that is, founders' legal ownership of the venture. In the present study, we explore the consequences of equity ownership on a founder's subsequent identification with the team. We build on psychological ownership theory to theorize that, on the one hand, equity can trigger feelings of responsibility and care for the venture, but, on the other, it can also drive possessiveness and territoriality. These two opposing sides of psychological ownership suggest a curvilinear relationship between equity ownership and a founder's subsequent identification with the team. As equity is a team reward, we suggest that founders' perceptions of team performance accentuate the relationship. Longitudinal data including 156 data points from 82 founders support our theorizing. We discuss implications for the literatures on team identification, equity ownership, and psychological ownership.
Engineering a pH‐responsive polymeric micelle co‐loaded with paclitaxel and triptolide for breast cancer therapy
Authors: Zhang Mengmeng , Ying Na , Chen Jie , Wu Liwen , Liu Huajie , Luo Shihua , Zeng Dongdong 
Published: January 2024

AbstractBreast cancer has overtaken lung cancer as the number one cancer worldwide. Paclitaxel (PTX) is a widely used first‐line anti‐cancer drug, but it is not very effective in clinical breast cancer therapy. It has been reported that triptolide (TPL) can enhance the anticancer effect of paclitaxel, and better synergistic therapeutic effects are seen with concomitant administration of PTX and TPL. In this study, we developed pH‐responsive polymeric micelles for co‐delivery of PTX and TPL, which disassembling in acidic tumour microenvironments to target drug release and effectively kill breast cancer cells. Firstly, we synthesized amphiphilic copolymer mPEG2000‐PBAE through Michael addition reaction, confirmed by various characterizations. Polymer micelles loaded with TPL and PTX (TPL/PTX‐PMs) were prepared by the thin film dispersion method. The average particle size of TPL/PTX‐PMs was 97.29 ± 1.63 nm, with PDI of 0.237 ± 0.003 and Zeta potential of 9.57 ± 0.80 mV, LC% was 6.19 ± 0.21%, EE% was 88.67 ± 3.06%. Carrier material biocompatibility and loaded micelle cytotoxicity were assessed using the CCK‐8 method, demonstrating excellent biocompatibility. Under the same drug concentration, TPL/PTX‐PMs were the most toxic to tumour cells and had the strongest proliferation inhibitory effect. Cellular uptake assays revealed that TPL/PTX‐PMs significantly increased intracellular drug concentration and enhanced antitumor activity. Overall, pH‐responsive micellar co‐delivery of TPL and PTX is a promising approach for breast cancer therapy.