Comprehensive Definition Research Articles

From the Frame Tale to Framing Intertextuality

The application of the term framing to Arabic texts is commonly confined to the frame tale type of which the Arabic tradition produced one of the most popular works, The Thousand and One Nights. This issue transcends the study of the Nights and the associated story-within-a-story trope, moving toward a recon­stitution of the study of the frame tale as part of literary framings more broadly conceived, which include multiple notions and applicabilities. In so doing, “Framing Narratives” aims to fill in a lacuna both in the study of frame tales in the Arabic and other Middle Eastern traditions such as Kalīla and Dimna, Barlaam and Josaphat and the Seven Sages in their different versions and the broadening of the framing category itself. This introduction presents a comprehensive and cumulative definition of framing narratives including notions of mise en abyme, mise en reflet/mise en série, paratext, and parergon, among others. The overall issue will contain definitory and structural-functionalist attempts, with additional foci on the translingual variation of frame narratives, and the intertextual variation of frames, connecting the realms of adab and poetry, philosophical and anthological genres, and scripture. Key words: Framing, frame narrative, Arabic literature, Kalīla wa-Dimna, The Thousand and One Nights, allegory of the man in the well, Gérard Genette, Werner Wolf, contextualist narratology

Corporate sustainability and performance: a bibliometric review for two decades

PurposeOver the past years, business strategies have been designed to improve ‘firms' financial and non-financial performances and achieve sustainable development, leading to corporate sustainability. This article is a bibliometric analysis of two decades of the relationship between corporate sustainability and firm performance, identifying the research focus and the gaps for future research.Design/methodology/approachThe bibliometric review of corporate sustainability and performance research is between January 2004 and June 2023. As per the Web of Science database, the theme's research commenced around 2004, growing gradually till 2023. Five hundred thirty-nine published articles by peer-reviewed ABDC-indexed A and A* journals in English have been reviewed. The bibliometrix package in R software is used with VOSviewer for the bibliometric analysis.FindingsThe study's findings indicate a lack of research on the theme from developed and underdeveloped nations. Further, the analysis reveals five clusters of research: (1) business sustainability, (2) corporate sustainability reporting, (3) corporate sustainability, strategy, and innovation, (4) stakeholder and corporate sustainability, and e) corporate sustainability assessment.Originality/valueThe future research areas proposed are on two major themes, namely, corporate sustainability and organizational competitive advantage, including sub-themes such as “Environmental, Social, and Governance (ESG) and financial performance” and “greenhouse-gas emissions” and “market orientations,” respectively. There is a need for more research in developing markets, a comprehensive definition of corporate sustainability, and further exploration of the theme linking strategy and innovation.

Visualising the Complexity of Drought: A Network Analysis Based on the Water Resilience Assessment Framework and the Actor-Relational Approach

This paper discusses the increasing severity of droughts due to climate change. It emphasises the complexity of defining drought and the diverse perspectives among stakeholders. Lots of stakeholders with unclear responsibilities are involved, which can lead to uncertainty and indecisiveness in addressing the issue. To tackle this, the present paper proposes a methodology to dissect drought systems and reveal the intricate relationships between their components. This approach combines a comprehensive definition of drought with the “Water Resilience Assessment Framework” and an “Actor-Relational Approach”, visualised through network analysis. The methodology was applied to a case study situated in the Leie Basin of Flanders, Belgium. By employing this strategy, policymakers and mediators can gain a deeper understanding of drought, identify its root causes, and prioritise necessary changes for more effective drought and water management.

Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study.

Patients with Solid Organ Transplantations (SOTx) face long-term lifestyle adaptations, psychological and social adjustments, and complex self-care regimes to maintain health post-transplant. Self-management (SM) skills represent important aspects of nursing communication with SOTx patients; however, there is potential for SM to be defined narrowly in terms of medication adherence. The study presented here collated the existing definitions in a mixed method review in order to identify SM attributes for this group (including those unique to this population). Secondary analysis of a dataset and bibliographic analysis and an expert panel were used to develop a comprehensive working definition of SOTx patients. The analysis comprised critical interpretation of the evolving definition content, concepts, and contexts of application in current usages and over time. We identified eight definitions and 63 cited definition sources from bibliographic analysis. Findings identified limitations of the existing definitions. Population-specific attributes included optimisation of transplant outcomes, active engagement in healthy behaviours, control, structure, and discipline characteristics, and moderating factors of patient motivation, self-efficacy, and cognitive function. A critical appraisal of definitions indicated inadequately defined aspects such as setting, temporal dimension, concept interaction, interventions, and measurable outcomes. The bibliographic analysis highlighted the influence of broader chronic illness constructions of SM, underpinning the generalisable SM attributes in current definitions. Further research may advance the development of a definition in exploring the relevance of SOTx-specific attributes of the definition.

Meniscal extrusion consensus statement: Acollaborative survey within the Meniscus International Network (MenIN) Study Group.

The purpose of the present study was to perform a survey administered to members of the Meniscus International Network (MenIN) Study Group, seeking to delineate the most contentious aspects of meniscal extrusion classification and provide a foundation for new, more comprehensive definitions and treatments for these pathologies. MenIN Study Group is a group of international experts treating and performing research on meniscus pathology and treatment. All MenIN Study Group members were asked to complete a survey aimed at establishing criteria for the optimal classification system for meniscal extrusion. Data obtained from the completed questionnaires were transferred into a spreadsheet and then analysed. All responses are presented as counts, percentagesor means. Forty-seven (85.5%) MenIN Study Group members completed the survey and were included in this analysis. Key aspects recommended for inclusion in a comprehensive classification system for meniscal extrusion included laterality (93.6%), anatomical location (76.6%), patient age (76.6%), body mass index (BMI) (68.1%)and aetiology (68.1%). For classifying meniscal extrusion, 53.2% considered the distance in millimetres from the tibial plateau's outer margin as the most reliable measurement technique on imaging. Preferences for imaging modalities varied, with 44.7% favouring weight-bearing magnetic resonance imaging (MRI) and 36.2% opting for weight-bearing ultrasound due to its greater availability. Respondents advocated for a classification system addressing stability or progression of meniscal extrusion (66%), reducibility (53.2%), potential progression of knee osteoarthritis (OA) (83%), influencing treatment approaches (83%), a gradation system (83%), consideration of dynamic factors (66%), association with clinical outcomes and prognosis (76.6%)and investigation around centralization procedures (57.4%). In conclusion, the findings of this survey shed light on the global perspectives regarding meniscal extrusion classification. It was generally felt that a new classification of extrusion measured on MRI scans at the mid-tibial plateau should be developed, which considers factors such as laterality, anatomical location, age, BMIand aetiology. Additionally, the results support the integration of dynamic factors and clinical outcomes in MRI-based classifications to inform treatment approaches. Level IV.

Navigating Uncertainties: A Holistic Framework for Identifying and Assessing Risks in Third-Party Logistics (3PL)

To review the extant literature on 3PL risk management (SCRM, including risk identification, assessment, treatment, and monitoring), developing a comprehensive definition and conceptual framework; to evaluate prior theory use; and to identify future research directions. Additionally, our framework emphasizes the importance of aligning performance metrics with risk objectives, facilitating ongoing monitoring and evaluation of 3PL partnerships. By establishing clear performance benchmarks and feedback mechanisms, organizations can promptly identify emerging risks and implement corrective actions as necessary. Methodology: A systematic literature review of couple of articles (published 2000-2016) based on descriptive, thematic, and content analysis. Drawing from extensive literature review and industry best practices, our framework integrates multiple dimensions of risk identification and evaluation into a cohesive methodology. We propose a structured approach that encompasses both qualitative and quantitative techniques, enabling organizations to comprehensively assess risks across various stages of the 3PL relationship lifecycle. Through the application of our holistic framework, organizations can enhance their ability to navigate uncertainties in 3PL relationships, fostering resilience and competitiveness in today's dynamic business environment. Findings: There has been a considerable focus on identifying risk types and proposing risk mitigation strategies. Research has emphasised organisational responses to 3PL risks. Research implications: A broad, contemporary understanding of 3PL risk management is provided; leading to a conceptual framework. The research agenda guides future work towards maturation of the discipline. Practical implications: Managers are encouraged to adopt a holistic approach to risk management. Guidance is provided on how to select appropriate risk treatment actions according to the probability and impact of a risk. Key components of our framework include risk categorization, stakeholder engagement, scenario analysis, and performance metrics alignment. By systematically categorizing risks according to their nature and impact, organizations can prioritize mitigation efforts and allocate resources effectively. Stakeholder engagement ensures that diverse perspectives are considered in the risk assessment process, enhancing its accuracy and relevance. Furthermore, scenario analysis allows for the exploration of potential future events and their implications on 3PL operations, enabling proactive risk management strategies. Keywords: 3PL, Risk management, Systematic literature review (SLR), theoretical approach

Measuring research quality in a more inclusive way: Evidence from the UK Research Excellence Framework

Abstract Evidence suggests that common metrics of research quality—e.g. journal publications and citations—are systematically biased against certain groups. But does relying solely on them to evaluate quality lead to lower diversity in academia? In this paper, we start to answer this question by analysing data from the UK’s nationwide research assessment exercise, the Research Excellence Framework. We find that narrowly focussed output-based measures of departmental research quality do indeed negatively correlate with the diversity of departmental staff, while measures of research impact and of the quality of the research environment correlate positively. An aggregate measure that incorporates all three components is therefore likely to better promote staff diversity compared to more narrowly defined output-focused measures. More generally, our results suggest that comprehensive definitions of research quality may be more effective at promoting diversity in academia compared to narrower measures. We further argue that funding decisions informed by broader measures result in more efficient resource allocations across the higher education sector.

Exploring Characteristics of Regenerative Business Models through a Delphi-Inspired Approach

Amidst escalating environmental and social challenges, this study explores regenerative business models’ definition and characteristics. While sustainable models have made considerable strides in research, policy, and practice, the advent of regenerative business models offers a progressive leap forward. Regenerative business models aspire to contribute to ecological restoration and societal well-being. The regenerative business model concept is, however, still in its infancy and lacks a comprehensive definition. Our study aims to expand this knowledge, using a Delphi-inspired approach that builds on the knowledge of academic and business experts. Our approach includes three rounds of surveys: an open-ended survey, a survey for rating and ranking the earlier responses of all participants, and a final survey to select key characteristics. We investigate patterns and distinctions among regenerative, regenerative business, and regenerative business models, and analyze their positioning vis-a-vis circular and net-positive models. Findings underscore that organizations adopting regenerative business models focus on planetary health and societal well-being. They generate value across multiple stakeholder levels, including nature, societies, customers, suppliers, shareholders, and employees. Despite overlapping with circular and net-positive models, regenerative business models also emphasize interdependencies between humans and nature, and provide a more holistic approach, centered on restoration rather than mere mitigation.

Neuroentrepreneurship: state of the art and future lines of work

This study aims to conduct a literature review and examine key research topics within the field of neuroentrepreneurship, categorizing works based on this classification and specifying different directions of research lines. Additionally, it seeks to compile definitions and their evolution regarding the concept of neuroentrepreneurship, contributing a new proposal. The methodology involves identifying keywords related to main themes and their direct relation to all research works encompassed in the entrepreneurship spectrum. Research articles matching the query are extracted from the Web of Science (WoS) and Scopus databases, as they provide a comprehensive citation search and access to multidisciplinary research, adhering to established inclusion-exclusion criteria. Findings allow the classification of contributions to the literature into four themes: Neuroscience and entrepreneurship, the use of neurotechnologies in entrepreneurship research, the neurological profile of the entrepreneur, and ethics in neuroentrepreneurship. Lastly, this study emphasizes its originality by presenting a set of works directly related to neuroentrepreneurship, establishing a classification based on four thematic research lines in neuroentrepreneurship. This allows extracting a limited set of definitions for the concept, classifying them based on themes incorporated in the definition. Finally, the authors provide a comprehensive definition of neuroentrepreneurship, tailored to the four major research blocks in this discipline.

The Culture of Research: A Systematic Scoping Review

Introduction: Research culture is the core of many processes in science. It is a broad concept presumably entailing practices, traditions, norms, etc. that prevail among researchers and other stakeholders in the field. Its definition, architecture, and taxonomy are essential in generating and pursuing scientific policies at universities and countries. As there is a lack of comprehensive reviews on research culture, the present publication aspires to fill the existing gap in the knowledge. This review aims to define research culture and build an architecture of research culture based on the relevant literature indexed in the Scopus database. Method: The problem, concept, and context (PCC) framework was applied to establish an effective search strategy and word the research questions corresponding to the aim. Based on Arksey and O'Malley's methodology (2005) and PRISMA checklist (2020) for systematic reviews, the authors sorted out 56 relevant publications for systematic scoping review. In addition, a bibliometric analysis was applied to examine the field. Results: Using a bibliometric analysis, the 56 publications were distributed by year, country, most prolific authors, sources, research fields, affiliation, and type of publication. With the help of VOSviewer, the authors singled out four thematic clusters (research culture; medical and biomedical research, methodology and research ethics, and clinical studies and human experiments). After synthesizing the data extracted from the documents under review, research culture was defined; components of research culture were singled out and summed up; and a framework of research culture was made up. The authors analysed the review findings in contrast with other research, offering their own comprehensive definition of research culture, its taxonomy, and an architecture of research culture. Conclusion: The current review adds to the understanding of research culture, its gist, component classification. The limitation related to the period of review (2019-2024) may be overcome by further reviews of relevant publications from a historic perspective that would broaden perceptions of the origin of modern research culture and its negative aspects.

A categorical approach for defining digital twins in the AECO industry

Operations and Maintenance (O&M) costs account for 60-80% of a facility’s lifecycle costs. Using Digital Twins (DTs) can aid in making O&M more effective and efficient, leading to time and cost savings. The concept of DT started in the Aerospace domain, and other industries eventually adopted it. DTs are a new concept to the Architecture, Engineering, Construction, and Operations (AECO) Industry, and there is a lot of confusion around this concept. The purpose of this paper is to provide a DT definition along with a classification structure to create a common ground for understanding DTs in the AECO industry, which leads to easier adoption of DTs. A systematic literature review was completed to identify the existing DT definitions and classification approaches. Then, through a content analysis, the core components of definitions were extracted. The identified components were used to develop a comprehensive and inclusive DT definition for the AECO industry, using the domain language. In a similar fashion, existing DT classification structures were studied, and their components were identified through content analysis. Using the identified components, a DT classification structure was proposed for the AECO industry using domain concepts and terms. The results were validated and refined through a series of semi-structured expert interviews and surveys. Interviewees and survey participants comprised DT experts from academia and industry with diverse backgrounds. The components of the proposed DT definition include virtual representation, data connection between physical and digital entities, analysis, actuation, and frequency of updates. The classification structure consisted of three DT categories, namely Digital Twin Prototype (DTP), Digital Shadow (DS), and Cyber-Physical System (CPS).

Hospice Knowledge, Attitudes, and Preference among Older Chinese Immigrants in the United States

Racial disparities in hospice use are a longstanding concern in the U.S. Asian Americans are among the least likely to receive hospice care and to be included in studies on this topic. This study examined the knowledge, attitudes, and preferences related to hospice care among older Chinese immigrants and associated factors. A sample of 262 Chinese immigrants age 60+ was recruited from six older adult centers in NYC. In-person interviews were conducted in Mandarin and Cantonese. Non-English-speaking older Chinese immigrants had very limited knowledge about hospice care. Only 26% of respondents had heard of hospice, and a few could correctly define any components. After receiving a comprehensive definition of hospice care, study participants expressed a positive attitude and a strong willingness to use hospice if near the end of life. Notably, some respondents still held misconceptions about hospice and were less positive in their attitude and preference for hospice care. These findings underscore the necessity for clear and accessible information about hospice among this population throughout the trajectory from good health to end of life. Further research is needed to identify the range of factors that influence the attitudes and preferences of older Chinese immigrants toward hospice care.

Anatomic Areas of Lipoframing in Breast Surgery.

Breast lipoframing is a concept in breast surgery that encompasses the often-overlooked aspects of the mammary glands, such as the surrounding structures and adipose tissue within the thorax. By acknowledging the interplay between these components and recognizing the need for their simultaneous treatment, breast lipoframing aims to optimize surgical aesthetic outcomes. This article proposes a comprehensive definition of the surrounding mammary fat tissue by delineating the specific areas of the breast involved in the lipoframing technique. It presents a retrospective analysis of 554 female patients, revealing only one case of seroma and three cases of hematoma. Furthermore, we explore the application of liposuction as a means to effectively treat these areas and achieve superior results.

CLINICAL AND PHARMACOLOGICAL ASPECTS OF APPLYING GLUCOCORTICOSTEROIDS FOR SARS-COVID-2 INFECTION: REVIEW ARTICLE

In recent years, the SARS-CoV-2 pandemic has become one of the unexpected and very serious challenges for public health around the world. Moreover, SARS-CoV-2 infection led to the development of acute respiratory distress syndrome as a result of excessive systemic inflammation, and the development of multiple organ failure, and later death. Moreover, the problem of eliminating excessive systemic inflammation, that is, reducing the production of pro-inflammatory cytokines in SARS-CoV-2, remains open. In this regard, the use of glucocorticosteroids for infection caused by SARS-CoV-2 remains quite controversial. The basis for the routine use of steroids in intensive care protocols for SARS-CoV-2 is clearly insufficient and remains the subject of further research. This review provides an analysis of literary sources, guidelines, and modern international recommendations on pathogenetic therapy of SARS-CoV-2 to prevent and eliminate hyperproduction of pro-inflammatory cytokines using glucocorticosteroid agents. The purpose of the work is to conduct an analysis of modern literary sources regarding the modern features of the clinical and pharmacological justification of the use of glucocorticosteroids in SARS-CoV-2 infection in clinical practice. The analysis of the scientific literature demonstrates that today glucocorticosteroid therapy cannot be recommended for routine use in therapeutic practice in patients with SARS-CoV-2 infection. Thus, with a mild course of SARS-CoV-2 infection, when the patient does not need oxygen support, GCS therapy is contraindicated. With a severe course of SARS-CoV-2, when the patient develops acute respiratory distress syndrome with severe respiratory failure, when there is a need for oxygen therapy, mechanical ventilation or ECMO, the use of corticosteroids is extremely necessary, and may be recommended for mandatory use. There is a pressing need for a comprehensive definition of the optimal glucocorticosteroid agent, indications, dosage, and duration of use in SARS-CoV-2 infection therapy programs. This should be done while considering biomarkers of the severity of the inflammatory process and biomarkers of the body's response to glucocorticosteroid agents.

Abstract P393: Trends in Risk Factor Control Among US Adults With Cardio-Kidney-Metabolic Multimorbidity, 1999-2020

Background: Risk factor control is foundational to preventing the onset and progression of cardiovascular, kidney, and metabolic (CKM) syndrome. Although risk factor control has been evaluated for these conditions individually, less is known about individuals with CKM syndrome. Objective: To evaluate the control of key risk factors among US adults with CKM syndrome. Methods: Nationally representative, cross-sectional data on US adults from the 1999-2020 NHANES cycles were evaluated. CKM conditions included cardiovascular disease (ASCVD or HF), at least moderate-risk chronic kidney disease, and type 2 diabetes (self-reported or HbA1c ≥6.5%). Among adults with advanced-stage CKM syndrome (≥2 conditions), the proportion with joint control of risk factors was estimated. Risk factor control was defined as: BP <140/90 mmHg, HbA1c <8%, and LDL-C <100 mg/dL. Sensitivity analyses included a stricter definition (BP <130/80, HbA1c <7%, and LDL-C <70) and an expanded set of risk factors (BMI <30 kg/m 2 and current non-smoking status). Results: Between 1999-2014, the proportion of US adults with CKM syndrome with joint control of BP, HbA1c, and LDL-C increased from 10.5% (95% CI: 7.8%, 13.2%) to 32.5% (29.6%, 35.5%), then declined to 28.8% (24.4%, 33.1%; estimated number without joint control = 14.5 million) in 2015-2020, per the main definition ( Figure ). Considering more contemporary thresholds, joint risk factor control was observed in less than 1 in 10 US adults across the study interval. Using the most comprehensive definition (BP <130/80, HbA1c <7%, LDL-C <70, BMI <30, non-current smoking) only 2.2% (1.3%, 3.1%) demonstrated optimal control in 2015-2020. Conclusions: Despite improvement between 1999-2014, comprehensive risk factor control among US adults with CKM syndrome declined in 2015-2020. More than 2 in 3 contemporary US adults with CKM syndrome are estimated to have suboptimal risk factor control, amplifying the need for integrative approaches in this high-risk population.

Design, development, and deployment of decentralized applications

Beginning with a comprehensive definition of Decentralized Applications (DApps) and their developmental trajectory, this treatise delves into their inception around 2010. It is intriguing to note that by 2020, DApps had already found preliminary applications in diverse sectors, ranging from finance to archaeology. Yet, there remains vast untapped potential awaiting exploration and refinement within the realm of DApps. The discourse then navigates the intricate web of DApps' system architecture, illuminating the cardinal aspects of their design, evolution, and eventual deployment. Herein, the essence of systematic planning during the design phase is underscored, underpinning its pivotal role in shaping the efficacy of the application. Further shedding light on DApps' expansive utility, the paper underscores their transformative influence in areas such as authentication systems and real-time operational control. However, the journey of DApps is not without its challenges. The document elucidates the complexities associated with crafting robust smart contracts, mitigating scalability concerns, and nurturing user acceptance and integration. In light of these hurdles, a clarion call is made for persistent research and avant-garde innovation, propelling DApps to their true potential in the evolving digital landscape.

Defining urban segregation: A qualitative meta-synthesis

Despite more than a century of research on urban segregation, this phenomenon is still one of the main concerns of urban planners and policymakers and a characteristic of cities that require intervention. Any policy-making in this field as an urban reality requires a clear understanding and definition of this phenomenon. But which definition? In response to this question and obtaining a basis for the definition of segregation, many efforts have been made in the past decades. However, these efforts have failed to present a framework that theoretically and practically responds to all dimensions and approaches in defining segregation. To fill this gap, the present study provides a comprehensive and integrated definition of urban segregation based on a meta-synthesis and qualitative content analysis by reviewing, categorizing, and combining the various and complex definitions in the existing literature. It presents two main categories of definitions of urban segregation: definitions based on the structural dimension and definitions based on the spatial dimension. Considering the complexity and multiple dimensions of urban segregation, a comprehensive definition of this phenomenon to present all aspects of segregation must answer six main questions: What is the nature of segregation? What people, on what basis, why, in what places and times, and how are segregated? The answers to the questions show that the presented categorization of the definitions of urban segregation covers different dimensions and aspects of this phenomenon. Therefore, combining them contributes to a comprehensive definition of it. Being more comprehensive than the previous definitions, the presented definition in this study specifies the main dimensions of urban segregation. It can provide an efficient basis for future theories, policies, and planning in urban segregation. Although the presented categories are inseparable parts of a whole, they can be examined in detail separately in future studies. Also, by connecting the definitions in the literature to intellectual paradigms and planning theories, a deeper understanding of the shaping factors and components of urban segregation can be achieved.

Psychometric Properties of the Arabic Version of the Mindfulness in Teaching Scale

Objectives: Interest in Mindfulness in several professions including teaching has increased. To develop the techniques and methods based on mindfulness, several research papers were carried on this topic in teaching according to a comprehensive definition that takes into account awareness, memory and retention to describe a variety of teaching practices, processes and features. Methods: The original version of the Mindfulness in Teaching Scale (MTS) was in English. The researchers translated it into Arabic and administered it to a sample of 554 Jordanian teachers. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) supported a two-factor structure (teacher intrapersonal mindfulness and teacher interpersonal mindfulness) as proposed by the scale’s authors. Results: The results have demonstrated that the Arabic version of the mindfulness in teaching scale consisting of 14 items and two subscales is valid and reliable for teachers in Arabic speaking countries. The means, standard deviations, skewness, and kurtosis of the MTS-A items were obtained. Mean and standard deviation values ​​ranged from 1.58 to 3.65 and 0.841 to 1.21, respectively, indicating a narrow dispersion in participant responses around the mean. Conclusions: The primary goal was to assess the MTS-A's validity and reliability among teachers in Jordan. With 9 items representing teachers' intrapersonal mindfulness and 5 items indicating teachers' interpersonal mindfulness, the 14-item two-factor CFA demonstrated that the model fit the data well. The findings show that the Arabic mindfulness in teaching scale, which consists of 14 questions and two subscales, is valid and trustworthy for use by instructors in Arabic-speaking regions.

Relative Energy Deficiency in Sport (REDs): Endocrine Manifestations, Pathophysiology and Treatments.

Research on lean, energy-deficient athletic and military cohorts has broadened the concept of the Female Athlete Triad into the Relative Energy Deficiency in Sport (REDs) syndrome. REDs represents a spectrum of abnormalities induced by low energy availability (LEA), which serves as the underlying cause of all symptoms described within the REDs concept, affecting exercising populations of either biological sex. Both short- and long-term LEA, in conjunction with other moderating factors, may produce a multitude of maladaptive changes that impair various physiological systems and adversely affect health, well-being, and sport performance. Consequently, the comprehensive definition of REDs encompasses a broad spectrum of physiological sequelae and adverse clinical outcomes related to LEA, such as neuroendocrine, bone, immune, and hematological effects, ultimately resulting in compromised health and performance. In this review, we discuss the pathophysiology of REDs and associated disorders. We briefly examine current treatment recommendations for REDs, primarily focusing on nonpharmacological, behavioral, and lifestyle modifications that target its underlying cause-energy deficit. We also discuss treatment approaches aimed at managing symptoms, such as menstrual dysfunction and bone stress injuries, and explore potential novel treatments that target the underlying physiology, emphasizing the roles of leptin and the activin-follistatin-inhibin axis, the roles of which remain to be fully elucidated, in the pathophysiology and management of REDs. In the near future, novel therapies leveraging our emerging understanding of molecules and physiological axes underlying energy availability or lack thereof may restore LEA-related abnormalities, thus preventing and/or treating REDs-related health complications, such as stress fractures, and improving performance.

Prenatal Decision-Making in Patients with Limited English Proficiency: What Factors are Involved?

A comprehensive definition of culture encompasses shared norms, beliefs, expectations, language, and customs, all of which are crucial considerations when working with patients with limited English proficiency (LEP). In this study, the authors examined how language, external influences, and patient-provider relational factors associated with decisional conflict in prenatal care patients. The authors conducted a cross-sectional study to assess decisional conflict related to postpartum contraception, elective induction, and newborn feeding methods. The survey included questions about demographics, communication methods, external influences, and provider trust, and was distributed to prenatal care patients who spoke either English or Spanish. Data analysis involved using descriptive statistics and chi-square analyses. Out of the 23 respondents, 12 were Spanish-speaking and 11 were English-speaking. Spanish-speaking participants were less likely to have health insurance compared to English-speaking participants (χ2(1, N = 23) = 3.67, p = 0.016). There was no statistically significant difference in decisional conflict between English- and Spanish-speaking participants. Religion affected 11 of 23 participants' decisions, while partner expectations influenced 10 of 23 participants. Working with an interpreter and the quality of interpretation were crucial for Spanish-speaking individuals. Most participants (59%) felt that the provider's understanding of the patient's cultural background was important for decision-making. While there was no association between language discordance and decisional conflict, several factors influencing prenatal decision-making were identified. The use and quality of interpretation significantly affected decision-making and should be prioritized for patients with LEP. Religion and partner expectations were found to be highly influential in decision-making. Respondents also emphasized the importance of the provider's understanding of the patient's cultural background.