Exploring the Travel Behavior and Experiences of Norwegian Surfers: Cold- Versus Warm-Water Surfing

More affordable travel opportunities have facilitated a swift rise in surf tourism, which is a growing multibillion dollar global business niche within the broader sport tourism industry. It is argued that a growing number of surfers who are searching for the perfect wave without the crowds found in well-established surfing destinations are shifting to cold-water surfing. Previous research on surf tourism has largely focused on warm- and temperate-water surfing and related travel. However, an exploration of and an attempt to comprehend cold-water surf tourism and how it compares to similar activities in warm water has been overlooked. This study focuses on understanding the travel behavior and related experiences of Norwegian surf tourists domestically and internationally, to cold- and warm-water destinations. Data were collected using a phenomenological approach and semistructured in-depth interviews with 18 experienced Norwegian surfers. Results show that these surfers are highly mobile, visiting warm-water surf destinations such as Morocco, Bali, Australia, and Hawaii and also cold-water surf destinations such as Norway, Iceland, Scotland, and Canada. They travel to surf at least once a year, staying between 10 days and 3 months, preferably in cheap accommodation. The longer the travel distance, the longer the stay. Their experiences of “localism,” where local surfers behave aggressively toward visiting surfers, were more common in crowded warm-water destinations. In addition to the enjoyment of surfing, these Norwegian surf tourists valued opportunities to create new social relationships, experience new and different cultures, and expand their “world-view” via their surf travel. They appreciated unique natural environments and experienced a deep connection to nature. This research presents the first empirical data on the travel behavior and related experiences of surf tourists from a nontraditional surfing nation in ScandinaviaacceptedVersio

On-Treatment Platelet Reactivity is a Predictor of Adverse Events in Peripheral Artery Disease Patients Undergoing Percutaneous Angioplasty

Objectives: Few data are available on the association between a different entity of platelet inhibition on antiplatelet treatment and clinical outcomes in patients with peripheral artery disease (PAD). The aim of this study was to evaluate the degree of on-treatment platelet reactivity, and its association with ischaemic and haemorrhagic adverse events at follow up in PAD patients undergoing percutaneous transluminal angioplasty (PTA). Methods: In this observational, prospective, single centre study, 177 consecutive patients with PAD undergoing PTA were enrolled, and treated with dual antiplatelet therapy with aspirin and a P2Y12 inhibitor. Platelet function was assessed on blood samples obtained within 24 h from PTA by light transmission aggregometry (LTA) using arachidonic acid (AA) and adenosine diphosphate (ADP) as agonists of platelet aggregation. High on-treatment platelet reactivity (HPR) was defined by LTA ≥ 20% if induced by AA, and LTA ≥ 70% if induced by ADP. Follow up was performed to record outcomes (death, major amputation, target vessel re-intervention, acute myocardial infarction and/or myocardial revascularisation, stroke/TIA, and bleeding). Results: HPR by AA and HPR by ADP were found in 45% and 32% of patients, respectively. During follow up (median duration 23 months) 23 deaths (13%) were recorded; 27 patients (17.5%) underwent target limb revascularisation (TLR), two (1.3%) amputation, and six (3.9%) myocardial revascularisation. Twenty-four patients (15.6%) experienced minor bleeding. On multivariable analysis, HPR by AA and HPR by ADP were independent predictors of death [HR 3.8 (1.2–11.7), p =.023 and HR 4.8 (1.6–14.5), p =.006, respectively]. The median value of LTA by ADP was significantly lower in patients with bleeding complications than in those without [26.5% (22–39.2) vs. 62% (44.5–74), p <.001). LTA by ADP ≤ 41% was independently associated with bleeding HR 14.6 (2.6–24.0), p =.001] on multivariable analysis. Conclusions: In this study a high prevalence of on-clopidogrel and aspirin high platelet reactivity was found, which was significantly associated with the risk of death. Conversely, a low on-clopidogrel platelet reactivity was associated with a higher risk of bleeding. These results document that the entity of platelet inhibition is associated with both thrombotic and bleeding complications in PAD patients

Prilling of API/fatty acid suspensions : processability and characterisation

Current study evaluated the processability and characteristics of prills made of an active pharmaceutical ingredient/fatty acid (API/FA) suspension instead of previously studied API/FA solutions to enlarge the application field of prilling. Metformin hydrochloride (MET) and paracetamol (PAR) were used as model APIs while both the effect of drug load (10–40%) and FA chain length (C14–C22) were evaluated. API/FA suspensions were processable on lab-scale prilling equipment without thermal degradation, nozzle obstruction or sedimentation in function of processing time. The collected prills were spherical (AR ≥ 0.898) with a smooth surface (sphericity ≥ 0.914) and a particle size of ±2.3 mm and 2.4 mm for MET and PAR prills, respectively, independent of drug load and/or FA chain length. In vitro drug release evaluation revealed a faster drug release at higher drug load, higher API water solubility and shorter FA chain length. Solid state characterisation via XRD and Raman spectroscopy showed that API and FA crystallinity was maintained after thermal processing via prilling and during storage. Evaluation of the similarity factor indicated a stable drug release (f2 > 50) from MET and PAR prills after 6 months storage at 25 °C or 40 °C

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Structure and dynamics in PEO nanocomposites

In this work, the effect of confinement on the local, the segmental and the ionic processes of poly(ethylene oxide)/montmorillonite (PEO/MMT) intercalates is investigated. X-ray diffraction and DSC data show that the intercalated PEO chains remain amorphous and it is only the excess PEO chains outside the galleries that crystallize. This is also evident in the behavior of the elastic intensity of quasi-elastic neutron scattering (QENS) experiments on the same hybrids. Dielectric relaxation spectroscopy reveals that confinement results in an acceleration of the PEO segmental dynamics that display an Arrhenius temperature dependence with low activation energy, whereas the local beta-process remains unaffected