Direct Lithium Extraction from α-Spodumene through Solid-State Reactions for Sustainable Li2CO3 Production.

With increasing battery demand comes a need for diversified Li sources beyond brines. Among all Li-bearing minerals, spodumene is most often used for its high Li content and natural abundance. However, the traditional approach to process spodumene is costly and energy-intensive, requiring the mineral be transformed from its natural α to ß phase at >1000 °C. Acid leaching is then applied, followed by neutralization to precipitate Li2CO3. In this work, we report an alternative method to extract Li directly from α-spodumene, which is performed at lower temperatures and avoids the use of acids. It is shown that Li2CO3 is formed with >90% yield at 750 °C by reacting α-spodumene with Na2CO3 and Al2O3. The addition of Al2O3 is critical to reduce the amount of Li2SiO3 that forms when only Na2CO3 is used, instead providing increased thermodynamic driving force to form NaAlSiO4 and Li2CO3 as the sole products. We find that this reaction is most effective at 4 h, after which volatility limits the yield. Following its extraction, Li2CO3 can be isolated by washing the sample using deionized water. This energy-saving and acid-free route to obtain Li2CO3 directly from spodumene can help meet the growing demand for Li.

"In Their Own Words": Families' Experiences With Tooth Autotransplantation for the Replacement of Maxillary Incisors in Children.

OBJECTIVES: To examine families' experiences, including motivation and barriers to undergoing tooth autotransplantation (AT), and their perceptions of associated esthetic and functional outcomes. METHODS: Semi-structured, in-depth-interviews (IDIs) were conducted in person with families who had children that underwent the AT procedure. Interviews were audio recorded and transcribed. Transcripts were coded and thematically analyzed both deductively and inductively. A facilitators and barriers matrix and journey maps were created to draw inferences on patterns arising from main themes. RESULTS: Twenty families selecting AT as a solution for a missing maxillary incisor were recruited and interviewed. Overall, all families interviewed had a positive experience with the AT procedure. Motivating factors for undergoing the AT procedure included wanting an earlier intervention for the missing incisor, wishing to mitigate negative psychosocial effects, and the anticipated positive outcomes that would last into adulthood. Barriers to uptake of the AT procedure included the lack of dental practitioner awareness of AT as a potential solution and a large number of appointments and travel. Families were also initially concerned over potential complications that could arise from their child undergoing this procedure. The cost of the procedure was both a barrier and a facilitator for treatment. CONCLUSIONS: The study results demonstrate that the overall AT is favorably considered by the families of growing children for the replacement of maxillary incisors and highlight factors that may act as motivators or barriers to its uptake.

Second molar eruption disturbances in borderline extraction orthodontic patients.

INTRODUCTION: Nonextraction treatment is associated with a greater prevalence of third molar impactions, whereas data on second molars are lacking. This study investigated whether there is a difference in the prevalence of second molar eruption disturbances when crowding is treated with or without extractions. METHODS: Patients were grouped by maxillary and mandibular crowding, including mild crowding (<5 mm) without extractions, borderline crowding (5-9 mm) without extractions, and borderline crowding with extractions. The 535 evaluated arches were from 346 patients aged 10-15 years with unerupted second molars at treatment start. The frequency and severity of second molar eruption disturbances were scored in final records using a severity classification based on a modified Archer system, a hybrid Archer Pell-Gregory system, and a partial impaction scale. Pretreatment panoramic radiographs were scored for impaction-risk indicators. Fisher exact test was used. RESULTS: In the maxilla, 20.0% of nonextraction patients with borderline crowding had second molar eruption disturbances compared to 5.2% of extraction patients with borderline crowding (P = 0.010). In the mandible, 27.6% of nonextraction borderline crowding patients had second molar eruption disturbances compared to 7.1% of extraction patients with borderline crowding (P = 0.006). There was no difference in the frequency of eruption disturbances between mild crowding without extractions and borderline crowding without extractions. The prevalence of impactions was higher in the maxilla when molars were apically positioned and in the mandible when molars were mesially angulated or had insufficient space pretreatment. CONCLUSIONS: In patients with borderline crowding, extraction treatment reduces the risk of second molar eruption disturbances; however, nonextraction treatment does not increase the risk when compared with patients with mild crowding. When considering extractions for crowding, providers should evaluate second molar impaction-risk indicators on pretreatment radiographs.

Optimizing donor tooth selection for autotransplantation in the anterior maxilla via CBCT-based root width and crown-root angle measurements.

BACKGROUND/AIM: The clinical management of growing patients with missing teeth in the anterior maxilla can be challenging due to limited treatment options and high esthetic demands. Tooth autotransplantation (AT) is a viable option for these cases. The selection of donor teeth has been reported to be driven by root development, existing malocclusion, and esthetics. The aim of this study was to add to the evidence base of tooth selection criteria for AT by examining candidate donor teeth root width and crown-root angles, two factors arguably important for surgical planning and esthetics. MATERIAL AND METHODS: Cementoenamel junction (CEJ) tooth width and crown-root angle measurements were made using cone-beam computed tomography (CBCT) images of 30 children and adolescents of European descent (mean age = 13 years, range = 10-17 years; 63% male) from a private orthodontic practice. Measurements of maxillary central and lateral incisors (index teeth) were compared with measurements of maxillary second premolars, mandibular central incisors, and mandibular first and second premolars (candidate donor teeth). Analyses relied on descriptive statistics of mean within-subject differences between index and donor teeth and the proportion of individuals without clinically important differences (i.e., >1.5 mm width deficit and > 15 degrees crown-root angle difference). RESULTS: Mandibular first premolars were the most compatible teeth for the replacement of maxillary central incisors based on both width (≥97% of individuals) and angle measurements (≥87% of individuals), followed closely by mandibular second premolars. Mandibular central incisors were the most compatible for the replacement of maxillary laterals, among all individuals based on width and ≥ 90% based on angle, whereas mandibular first premolars were somewhat less compatible. CONCLUSIONS: The study offers evidence of within-person, CBCT-based root width dimension and crown-root angle compatibilities. This information can be considered in addition to existing tooth selection criteria for AT including Angle's classification, midline deviation, crowding severity, root development, and esthetics.

Pharmacokinetics of diphenhydramine following single-dose intravenous and oral administration in non-fasted adult horses.

Diphenhydramine is an H1 receptor antagonist used to control urticaria and other allergic signs caused by type I hypersensitivity reactions in horses (Equus caballus). Limited studies have been conducted on pharmacokinetics of this drug in horses, with no studies involving oral formulations. Our study investigated pharmacokinetics of an oral diphenhydramine formulation compared to intravenous administration in non-fasted adult horses. Six healthy horses underwent a single administration of three different doses of diphenhydramine (1 mg/kg intravenously, 1 mg/kg intragastrically, and 5 mg/kg intragastrically) with a two-week washout period between doses. Bioavailability of intragastric diphenhydramine was less than one percent and six percent for 1 mg/kg and 5 mg/kg intragastric doses, respectively. This poor bioavailability is similar to what is reported in dogs. Two of six horses experienced transient side effects after intravenous diphenhydramine administration, emphasizing the need for determining therapeutic plasma levels in efforts to determine the lowest effective dose minimizing risk of adverse effects. The main conclusion of our study was that oral diphenhydramine at doses up to 5 mg/kg are unlikely to achieve therapeutic plasma levels in adult horses.

Plasma pharmacokinetics, pulmonary disposition, and safety of subcutaneous gamithromycin in alpacas.

The study objective was to determine the disposition of gamithromycin in plasma, peripheral blood polymorphonuclear cells (PMNs), pulmonary epithelial lining fluid (PELF), and bronchoalveolar lavage (BAL) cells in alpacas. A single subcutaneous injection of gamithromycin (6.6 mg/kg) was administered to six healthy adult alpacas. At various time points after administration, gamithromycin concentrations were analyzed via LC-MS/MS in plasma, PMNs, PELF, and BAL cells until Day 14 post-injection. Plasma gamithromycin concentrations were measured in all six alpacas; the remaining three body compartments were analyzed in four alpacas. Gamithromycin rapidly concentrated in blood PMNs, BAL cells, and PELF. Shorter Tmax , and lower Cmax, and AUC were observed in plasma than in the other three compartments. Cmax was highest in BAL cells (26001.80 ± 12400.00 ng/ml) and PMNs (2573.00 ± 963.30 ng/ml) compared to PELF (660.80 ± 413.70 ng/ml) and plasma (452.30 ± 196.20 ng/ml). Mean terminal half-lives were 72.60 ± 14.10 h in plasma, 56.60 ± 10.60 h in PELF, 62.80 ± 85.30 h in PMNs, and 93.60 ± 124.80 h in BAL cells. No injection site reactions occurred. One alpaca developed colic but no other adverse reactions were noted. Overall, gamithromycin was highly concentrated in white blood cells and pulmonary fluids/cells. Clinical utilization of gamithromycin in alpacas should be done with caution until further investigation of potential for colic.

Uranium isotope fractionation by abiotic reductive precipitation.

Significant uranium (U) isotope fractionation has been observed during abiotic reduction of aqueous U, counter to the expectation that uranium isotopes are only fractionated by bioassociated enzymatic reduction. In our experiments, aqueous U is removed from solution by reductive precipitation onto the surfaces of synthetic iron monosulfide. The magnitude of uranium isotopic fractionation increases with decreasing aqueous U removal rate and with increasing amounts of neutrally charged aqueous Ca-U-CO3 species. Our discovery means that abiotic U isotope fractionation likely occurs in any reducing environment with aqueous Ca ≥ 1 mM, and that the magnitude of isotopic fractionation changes in response to changes in aqueous major ion concentrations that affect U speciation. Our results have implications for the study of anoxia in the ancient oceans and other environments.

Phosphorus Speciation in Atmospherically Deposited Particulate Matter and Implications for Terrestrial Ecosystem Productivity.

Chemical forms of phosphorus (P) in airborne particulate matter (PM) are poorly known and do not correlate with solubility or extraction measurements commonly used to infer speciation. We used P X-ray absorption near-edge structure (XANES) and 31P nuclear magnetic resonance (NMR) spectroscopies to determine P species in PM collected at four mountain sites (Colorado and California). Organic P species dominated samples from high elevations, with organic P estimated at 65-100% of total P in bulk samples by XANES and 79-88% in extracted fractions (62-84% of total P) by NMR regardless of particle size (≥10 or 1-10 µm). Phosphorus monoester and diester organic species were dominant and present in about equal proportions, with low fractions of inorganic P species. By comparison, PM from low elevation contained mixtures of organic and inorganic P, with organic P estimated at 30-60% of total P. Intercontinental PM transport determined from radiogenic lead (Pb) isotopes varied from 0 to 59% (mean 37%) Asian-sourced Pb at high elevation, whereas stronger regional PM inputs were found at low elevation. Airborne flux of bioavailable P to high-elevation ecosystems may be twice as high as estimated by global models, which will disproportionately affect net primary productivity.

Count Your Calories and Share Them: Health Benefits of Sharing mHealth Information on Social Networking Sites.

This study investigates the relationship between sharing tracked mobile health (mHealth) information online, supportive communication, feedback, and health behavior. Based on the Integrated Theory of mHealth, our model asserts that sharing tracked health information on social networking sites benefits users' perceptions of their health because of the supportive communication they gain from members of their online social networks and that the amount of feedback people receive moderates these associations. Users of mHealth apps (N = 511) completed an online survey, and results revealed that both sharing tracked health information and receiving feedback from an online social network were positively associated with supportive communication. Network support both corresponded with improved health behavior and mediated the association between sharing health information and users' health behavior. As users received greater amounts of feedback from their online social networks, however, the association between sharing tracked health information and health behavior decreased. Theoretical implications for sharing tracked health information and practical implications for using mHealth apps are discussed.

Identity Conflict and Sexual Risk for Black and Latino YMSM.

Young (aged 18-30) Black and Latino men who have sex with men are at a higher risk of contracting HIV than their White counterparts. In order to better understand the unique nature of sexual risk-taking, we examined the extent to which ethnic group, ethnic identity, and sexual pride predicted condomless anal sex with casual partners among 161 young men who have sex with men (YMSM) who identify as Black or Latino. Negative binomial regressions were conducted using a cross-sectional design. Sexual pride was a negative predictor of condomless anal sex across all participants, but this effect was moderated by ethnic exploration and ethnic group; the relationship between sexual pride and condomless anal sex was strengthened by greater ethnic exploration among Latino YMSM, and weakened by greater ethnic exploration among Black YMSM. Implications for intersectional identity, identity conflict, and HIV prevention among young gay men of color are discussed.

Water Table Dynamics and Biogeochemical Cycling in a Shallow, Variably-Saturated Floodplain.

Three-dimensional variably saturated flow and multicomponent biogeochemical reactive transport modeling, based on published and newly generated data, is used to better understand the interplay of hydrology, geochemistry, and biology controlling the cycling of carbon, nitrogen, oxygen, iron, sulfur, and uranium in a shallow floodplain. In this system, aerobic respiration generally maintains anoxic groundwater below an oxic vadose zone until seasonal snowmelt-driven water table peaking transports dissolved oxygen (DO) and nitrate from the vadose zone into the alluvial aquifer. The response to this perturbation is localized due to distinct physico-biogeochemical environments and relatively long time scales for transport through the floodplain aquifer and vadose zone. Naturally reduced zones (NRZs) containing sediments higher in organic matter, iron sulfides, and non-crystalline U(IV) rapidly consume DO and nitrate to maintain anoxic conditions, yielding Fe(II) from FeS oxidative dissolution, nitrite from denitrification, and U(VI) from nitrite-promoted U(IV) oxidation. Redox cycling is a key factor for sustaining the observed aquifer behaviors despite continuous oxygen influx and the annual hydrologically induced oxidation event. Depth-dependent activity of fermenters, aerobes, nitrate reducers, sulfate reducers, and chemolithoautotrophs (e.g., oxidizing Fe(II), S compounds, and ammonium) is linked to the presence of DO, which has higher concentrations near the water table.

Prioritizing Seafloor Mapping for Washington's Pacific Coast.

Remote sensing systems are critical tools used for characterizing the geological and ecological composition of the seafloor. However, creating comprehensive and detailed maps of ocean and coastal environments has been hindered by the high cost of operating ship- and aircraft-based sensors. While a number of groups (e.g., academic research, government resource management, and private sector) are engaged in or would benefit from the collection of additional seafloor mapping data, disparate priorities, dauntingly large data gaps, and insufficient funding have confounded strategic planning efforts. In this study, we addressed these challenges by implementing a quantitative, spatial process to facilitate prioritizing seafloor mapping needs in Washington State. The Washington State Prioritization Tool (WASP), a custom web-based mapping tool, was developed to solicit and analyze mapping priorities from each participating group. The process resulted in the identification of several discrete, high priority mapping hotspots. As a result, several of the areas have been or will be subsequently mapped. Furthermore, information captured during the process about the intended application of the mapping data was paramount for identifying the optimum remote sensing sensors and acquisition parameters to use during subsequent mapping surveys.

Se Isotopes as Groundwater Redox Indicators: Detecting Natural Attenuation of Se at an in Situ Recovery U Mine.

One of the major ecological concerns associated with the in situ recovery (ISR) of uranium (U) is the environmental release of soluble, toxic selenium (Se) oxyanions generated by mining. Post-mining natural attenuation by the residual reductants in the ore body and reduced down-gradient sediments should mitigate the risk of Se contamination in groundwater. In this work, we investigate the Se concentrations and Se isotope systematics of groundwater and of U ore bearing sediments from an ISR site at Rosita, TX, USA. Our results show that selenate (Se(VI)) is the dominant Se species in Rosita groundwater, and while several up-gradient wells have elevated Se(VI), the majority of the ore zone and down-gradient wells have little or no Se oxyanions. In addition, the δ82SeVI of Rosita groundwater is generally elevated relative to the U ore up to +6.14‰, with the most enriched values observed in the ore-zone wells. Increasing δ82Se with decreasing Se(VI) conforms to a Rayleigh type distillation model with an ε of -2.25‰ ± 0.61‰, suggesting natural Se(VI) reduction occurring along the hydraulic gradient at the Rosita ISR site. Furthermore, our results show that Se isotopes are excellent sensors for detecting and monitoring post-mining natural attenuation of Se oxyanions at ISR sites.

Isotopic Evidence for Reductive Immobilization of Uranium Across a Roll-Front Mineral Deposit.

We use uranium (U) isotope ratios to detect and quantify the extent of natural U reduction in groundwater across a roll front redox gradient. Our study was conducted at the Smith Ranch-Highland in situ recovery (ISR) U mine in eastern Wyoming, USA, where economic U deposits occur in the Paleocene Fort Union formation. To evaluate the fate of aqueous U in and adjacent to the ore body, we investigated the chemical composition and isotope ratios of groundwater samples from the roll-front type ore body and surrounding monitoring wells of a previously mined area. The (238)U/(235)U of groundwater varies by approximately 3‰ and is correlated with U concentrations. Fluid samples down-gradient of the ore zone are the most depleted in (238)U and have the lowest U concentrations. Activity ratios of (234)U/(238)U are ∼5.5 up-gradient of the ore zone, ∼1.0 in the ore zone, and between 2.3 and 3.7 in the down-gradient monitoring wells. High-precision measurements of (234)U/(238)U and (238)U/(235)U allow for development of a conceptual model that evaluates both the migration of U from the ore body and the extent of natural attenuation due to reduction. We find that the premining migration of U down-gradient of the delineated ore body is minimal along eight transects due to reduction in or adjacent to the ore body, whereas two other transects show little or no sign of reduction in the down-gradient region. These results suggest that characterization of U isotopic ratios at the mine planning stage, in conjunction with routine geochemical analyses, can be used to identify where more or less postmining remediation will be necessary.

Fecal Recovery of Ingested Cellular DNA: Implications for Noninvasive Detection of Upper Gastrointestinal Neoplasms.

BACKGROUND: Stool DNA testing represents a potential noninvasive approach to detect upper gastrointestinal (UGI) neoplasms. However, little is known about fecal recovery efficiency of DNA exfoliated from UGI tumors. AIMS: The purpose of this study was to establish a human ingestion model that quantitatively approximates daily cellular shedding from UGI neoplasms and to estimate fecal DNA marker recovery rates. METHODS: Healthy volunteers (n = 10) ingested two scheduled doses of raw salmon, 0.3 and 30 g, simulating the mass exfoliated daily from 1 to 4.5 cm lesions. To approach a steady-state, each dose was ingested over three consecutive days in randomized order. Following defecation of an indicator dye ingested with test meals, stools were collected over 48 h. Ingested salmon DNA was captured from stools using probes targeting pathognomonic Salmonidae sequences (SlmII). Captured DNA was quantified using PCR primers to generate 178, 138, 88 and 55 bp amplicons. RESULTS: SlmII sequences were recovered from all stools following salmon ingestion; recovery was proportional to amount ingested (p = 0.004). Fecal recovery of ingested salmon varied inversely with amplicon size targeted; mean recovery rates of SlmII were 0.49, 0.91, 3.63, and 7.31 copies per 100,000 copies ingested for 178, 134, 88, and 55 bp amplicons, respectively (p < 0.0001). Longer oro-anal transit was associated with reduced recovery. CONCLUSIONS: While recovery efficiencies are low, ingested cellular DNA simulating daily amounts shed from UGI tumors can readily be detected in stool. Assay of shorter-fragment analyte increases recovery. This ingestion model has potential value in studying the effects of perturbations relevant to the fecal recovery of DNA exfoliated from UGI tumors.

Isotopic and Geochemical Tracers for U(VI) Reduction and U Mobility at an in Situ Recovery U Mine.

In situ recovery (ISR) uranium (U) mining mobilizes U in its oxidized hexavalent form (U(VI)) by oxidative dissolution of U from the roll-front U deposits. Postmining natural attenuation of residual U(VI) at ISR mines is a potential remediation strategy. Detection and monitoring of naturally occurring reducing subsurface environments are important for successful implementation of this remediation scheme. We used the isotopic tracers (238)U/(235)U (δ(238)U), (234)U/(238)U activity ratio, and (34)S/(32)S (δ(34)S), and geochemical measurements of U ore and groundwater collected from 32 wells located within, upgradient, and downgradient of a roll-front U deposit to detect U(VI) reduction and U mobility at an ISR mining site at Rosita, TX, USA. The δ(238)U in Rosita groundwater varies from +0.61‰ to -2.49‰, with a trend toward lower δ(238)U in downgradient wells. The concurrent decrease in U(VI) concentration and δ(238)U with an ε of 0.48‰ ± 0.08‰ is indicative of naturally occurring reducing environments conducive to U(VI) reduction. Additionally, characteristic (234)U/(238)U activity ratio and δ(34)S values may also be used to trace the mobility of the ore zone groundwater after mining has ended. These results support the use of U isotope-based detection of natural attenuation of U(VI) at Rosita and other similar ISR mining sites.

Polo-like kinase 2 is a mediator of hedgehog survival signaling in cholangiocarcinoma.

UNLABELLED: Cholangiocarcinoma (CCA) cells paradoxically express the death ligand tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) and thus rely on potent survival signals to circumvent cell death by TRAIL. Hedgehog (Hh) signaling is an important survival pathway in CCA. Herein, we further examine the mechanisms whereby Hh signaling mediates apoptosis resistance in CCA, revealing a pivotal role for the cell division regulating serine/threonine kinase polo-like kinase 2 (PLK2). We employed 50 human CCA samples (25 intrahepatic and 25 extrahepatic CCA) as well as human KMCH-1, Mz-CHA-1, and HUCCT-1 CCA cells for these studies. In vivo experiments were conducted using a syngeneic rat orthotopic CCA model. In human samples, polo-like kinase (PLK)1/2/3-immunoreactive cancer cells were present in the preponderance of intra- and extrahepatic CCA specimens. Inhibition of Hh signaling by cyclopamine reduced PLK2, but not PLK1 or PLK3, messenger RNA and protein expression in vehicle-treated and sonic Hh-treated CCA cells, confirming our previous microarray study. PLK2 regulation by Hh signaling appears to be direct, because the Hh transcription factors, glioma-associated oncogene 1 and 2, bind to the PLK2 promotor. Moreover, inhibition of PLK2 by the PLK inhibitor, BI 6727 (volasertib), or PLK2 knockdown was proapoptotic in CCA cells. BI 6727 administration or PLK2 knockdown decreased cellular protein levels of antiapoptotic myeloid cell leukemia 1 (Mcl-1), an effect reversed by the proteasome inhibitor, MG-132. Finally, BI 6727 administration reduced Mcl-1 protein expression in CCA cells, resulting in CCA cell apoptosis and tumor suppression in vivo. CONCLUSION: PLK2 appears to be an important mediator of Hh survival signaling. These results suggest PLK inhibitors to be of therapeutic value for treatment of human CCA.

A Chinese imprint in insoluble pollutants recently deposited in central Greenland as indicated by lead isotopes.

A unique ∼ 10 year record of the lead isotopic composition of airborne insoluble particulate matter deposited in central Greenland was extracted from recent snow layers at NorthGRIP (75.1°N, 042.3°W; elevation 2,959 m), spanning the years 1989-2001. Comparison with lead isotopic signatures of both natural and anthropogenic northern hemisphere (NH) aerosol sources shows that human activities must have accounted for most of the insoluble lead deposited on Greenland during the late 1990 s, exceeding by far the natural contribution from large Asian mineral dust inputs. Lead isotopes imply predominance with time of European/Canadian sources over U.S.-derived lead, with an admixed signature typical of Chinese anthropogenic lead sources. The relative contribution of the latter shows a marked seasonal increase during spring. Our record also suggests that China's weight in the overall supply of insoluble pollutants deposited on Greenland was growing over the past decade of the 20th century.

Predicting continuance-findings from a longitudinal study of older adults using an eHealth newsletter.

While eHealth technologies are promisingly efficient and widespread, theoretical frameworks capable of predicting long-term use, termed continuance, are lacking. Attempts to extend prominent information technology (IT) theories to the area of eHealth have been limited by small sample sizes, cross-sectional designs, self-reported as opposed to actual use measures, and a focus on technology adoption rather than continuance. To address these gaps in the literature, this analysis includes empirical evidence of actual use of an eHealth technology over the course of one year. This large (n = 4,570) longitudinal study focuses on older adults, a population with many health needs and among whom eHealth use may be particularly important. With three measurement points over the course of a year, this study examined the effects of utilitarian and hedonic beliefs on the continued use of an eHealth newsletter using constructs from IT adoption and continuance theories. Additional analyses compared the relative strength of intentions compared to earlier use in predicting later use. Usage intention was strongly predicted by both hedonic beliefs and utilitarian beliefs. In addition, utilitarian beliefs had both direct effects on intention and indirect effects, mediated by hedonic beliefs. While intention predicted subsequent use, earlier use was a significantly stronger predictor of use than intention. These findings make a theoretical contribution to an emerging literature by shedding light on the complex interplay of reasoned action and automaticity in the context of eHealth continuance.