Contemporary Studies Research Articles

Interdisciplinarity in the Use of Playful Technologies in Early Childhood Education: Impacts on Teaching and Learning

Objective: This study aims to investigate the impact of the use of technological resources in early childhood education, highlighting how the introduction of technologies, such as television, digital games, and educational software, can improve learning and interaction in the classroom. Theoretical Framework: The study is based on the theories of Vygotsky (1988) and the contemporary studies of Jankowski and Wrobel (2021), which emphasize the importance of interactivity and the conscious use of technology in the teaching-learning process for children. Method: The research was carried out at the Instituto do Saber Mundo Azul, in Montes Claros - MG, with five teachers who, for a week, used different technological resources in their pedagogical practices. Data collection was done through questionnaires applied to the teachers. Results and Discussion: The results indicated that the use of technology increased students' interest in the activities, however, the retention of the content was limited by the excitement generated by the playful resources. The discussion addresses the importance of planning the use of these tools to maximize their educational impact. Research Implications: This study contributes to the understanding of how technological resources can be effectively incorporated into early childhood education, providing insights into ongoing teacher training and the integration of technologies into the curriculum. Originality/Value: The research offers an analysis of the challenges and benefits of implementing technologies in early childhood education, highlighting the need for appropriate pedagogical strategies for the use of these tools.

Enchanted realism: Representations of self-fulfilment among Italian youth after the pandemic

Our aim in this article is to analyse youth aspirations for self-fulfilment through work in the interplay between individualization and self-entrepreneurship. Theoretically, we discuss the main approaches of individualization and self-government in contemporary youth studies. Empirically, we focus on urban youth in the post-pandemic context, in the Italian city of Milan, paying specific attention to the transformation of their aspirations and social relations after the experience of the lockdown. We highlight the rise of a new form of self-narration that we define ‘enchanted realism’. Such self-narration tries not to completely give up hopes of self-fulfilment in the face of the challenges of the neoliberalist socio-economic environment, but at the same time, it resizes the myth of the entrepreneurial self by unveiled doubts and fears of inadequacy, paving the way to less self-referential attitudes.

Human dignity and the pursuit of knowledge in Islamic thought: Insights from the Quran

This research examines the interplay between human dignity and the pursuit of knowledge within Islamic thought, using insights from the Quran. It explores how Islamic epistemology emphasizes the harmonious integration of divine revelation and human reason, underscoring the importance of knowledge as a key factor in both intellectual and spiritual development. By analyzing the contributions of classical Islamic scholars, such as Al-Farabi, Ibn Sina, and Al-Ghazali, alongside Western epistemological traditions, the study highlights complementary and contrasting approaches to understanding knowledge and its role in shaping ethics and governance. Furthermore, the research draws on contemporary case studies, such as the Marrakesh Declaration and Masdar City, to illustrate how Quranic principles of cooperation, justice, and environmental stewardship can inform modern societal frameworks. Ultimately, the study argues for the continued relevance of Islamic thought in addressing contemporary global challenges, emphasizing that the pursuit of knowledge not only advances scientific discovery but also promotes human dignity, justice, and societal well-being.

ICT Growth and the Fintech Boom: A Mismatched Capability Perspective from Nigeria

This article draws on both, dynamic capability theory and reviews of contemporary market research studies to assess the sustainability of Nigeria’s burgeoning fintech sector. It highlights the need for targeted education and training schemes to address a skills-driven, dynamic capability mismatch between larger and micro-enterprise employers in Nigeria’s organizational landscape. The talent pool of qualified candidates is limited, competition is intense, and the fintech boom has led to substantial emigration of the young and digitally skilled. Although unevenly distributed government efforts are evident, micro-employers have yet to benefit from these interventions.

Association Between Atrial Fibrillation and Long-term Mortality in Acute MI Patients

Background: AF is a common complication of an acute MI (AMI) and goes along with adverse events. Nevertheless, the therapeutical guidelines and pharmacological possibilities have improved over the past years. Therefore, this contemporary study aimed to clarify the effect of AF on long-term mortality in patients with incident AMI. Methods: This study included 2,313 patients aged 25–84 years with initial AMI that occurred from 2009 until 2017, documented within the population-based Augsburg Myocardial Infarction Registry. Patients were monitored from hospital admission, with a median follow-up duration of 4.5 years (interquartile range 4.4 years). Survival analysis and multivariable Cox regression analysis were conducted to explore the relationship between AF and long-term all-cause and cardiovascular disease mortality. Results: Altogether, 156 individuals had AF on their admission ECG, while the remaining 2,157 presented with sinus rhythm (SR). Patients with AF were significantly older, more frequently had arterial hypertension, non-ST-segment elevation MI, worse kidney function, smaller AMIs, and were more often former and non-smokers. An increased long-term all-cause mortality was observed among the AF group. (AF patients 39.1%, SR group 16.7%), Upon multivariable adjustment, a HR of 1.40 (95% CI [1.05–1.87]; p=0.023) was calculated when comparing the AF with SR patients. Conclusion: An independently increased risk of long-term mortality for patients with AF compared with patients with SR in case of incident AMI was identified. Therefore, AF should be considered as a serious risk factor in AMI patients, and must be treated aggressively to reduce mortality risk.

Chinatown, part five? ‘Capitalism with Asian values’ in Vancouver commentary on Elvin Wyly's ‘Regarding the Pain of (Indigenous) Others’

In this commentary on Elvin Wyly’s ‘Regarding the Pain of (Indigenous) Others’, I comment on the absent ontology of Asian subjectivities in urban studies of neoliberal global cities. Wyly’s account of neoliberal Vancouver hellscapes frames racial formations and narratives of dispossession as formed by capital. Asian subjectivities, I argue in this commentary, are also flattened by narratives of capital into purely economic subjects, but what Wyly’s reading of Vancouver opens up, I also hope to show, is the possibility of tracing the complex life stories of Asian capitalist characters in Vancouver’s neoliberal hellscape. In this way, Wyly avoids the trap of the previous urban studies entries in the post-Chinatown ilk, where global cities are depicted as being shaped by capital with the complexity of Roman Polanski’s Chinatown, but ironically have neither ‘Asian’ nor ‘Chinese’ characters in them that are subjectively complex. Paying attention to complex Asian subjectivities in neoliberal cities allows for further questioning of the relationship between race and capital in contemporary urban studies.

Evidence for preventing EVRB in cirrhotic patients: A systematic review.

Systematic strategies for preventing and treating esophagogastric variceal rebleeding (EVRB) are currently inadequate. This systematic review aimed to update this critical gap by searching contemporary studies from major guideline websites, databases, and professional associations focused on EVRB prevention in cirrhosis patients. Key findings highlight evaluation methods, risk management, preventive measures, health education, and follow-up strategies. Notably, a hepatic venous pressure gradient exceeding 18 mmHg is identified as a reliable predictor of gastroesophageal varices (GOV) rebleeding. Effective management of primary diseases is crucial, with methods including antiviral and anti-fibrotic therapies, alcohol avoidance, vaccination, and careful medication management. The combination of nonselective β-blockers (NSBBs) and endoscopic variceal ligation (EVL) is established as the gold standard for secondary EVRB prevention. For patients experiencing recurrent bleeding despite NSBBs and EVL, transjugular intrahepatic portosystemic shunt (TIPS) therapy is recommended. Surgical options, such as surgical shunt and devascularization, are advised for those unsuitable for endoscopic therapy or TIPS, particularly in Child-Pugh A and B patients unresponsive to treatment. Additionally, traditional Chinese medicine options, such as Fufang Biejia Ruangan Tablets, Fuzheng Huayu Capsules, and Anluo Huaxian Pills, have shown promise in improving hepatic fibrosis and GOV in cirrhotic patients. This review offers a comprehensive overview of current prevention and treatment strategies for EVRB, providing valuable insights for clinicians and healthcare professionals.

Merleau-Ponty nos arquivos Husserl: uma entrevista com Emmanuel de Saint Aubert

Silvana de Souza Ramos and Iracy Ferreira dos Santos Junior’s interview with Emmanuel de Saint Aubert explores the history and role of the Husserl Archives (Paris) in fostering multidisciplinary research in phenomenology. Saint Aubert clarifies Merleau-Ponty’s engagement with Husserl’s manuscripts, describing the situated and complex reading he undertook not only of these manuscripts but also of Husserl’s work as a whole. This aspect is particularly significant for contemporary French philosophical studies, as Merleau-Ponty played a pivotal role in introducing Husserl’s ideas into French thought. This clarification allows us to show the originality of Merleau-Ponty’s philosophy, as it reveals that he was not merely an exegete of Husserl, but a restless and multifaceted thinker, deeply involved in the intellectual and political debates of his time. If he cannot be reduced to a mere reader of Husserl, neither can his later ontology be simply attributed to Heidegger’s influence. Once engaged in a meticulous study of the unfinished manuscripts that Merleau-Ponty left behind due to his premature death, which were drafts for a new book, Saint Aubert conducted a thorough investigation of Merleau-Ponty’s use of key terms in his ontology – chair, Leib, empiétement, chiasmi – showing that these terms do not literally translate or express concepts derived from Husserl or Heidegger. On the contrary, these terms acquire a multifaceted range of meanings in Merleau-Ponty’s writings, nourished by his philosophical readings and meditations, by his scientific and literary refinement, as well as his ethical and political concerns. Saint Aubert’s research, dedicated to the interpretation of Merleau-Ponty’s so-called “unpublished” works, resulted in the publication of five books by Vrin, all guided by a transversal genetic reading of Merleau-Ponty’s work. Additionally, with the help of other researchers, Saint Aubert carefully edited and published several volumes of Merleau-Ponty’s manuscripts. This material, made available in an organized and contextualized manner, is of incomparable richness, allowing for a more precise understanding of Merleau-Ponty’s role in contemporary thought, while also illuminating the meaning of his ontological project.

Systematic Review of Nevus Counting and Reporting Methodologies in Contemporary Studies of the General Population

Introduction: Having many melanocytic nevi on the skin is a risk factor for melanoma. However, the reproducibility of nevus counts in previous studies is limited due to high inter- and intraobserver variation. Despite the introduction of a protocol for counting and reporting of nevi in 1990 by the International Agency for Research on Cancer (IARC), significant variations in nevus counting methods persist across studies. Objectives: We sought to review the variations in nevus counting and reporting methods, adherence and deviations from the IARC protocol, and the reproducibility of nevus counting studies. Methods: A systematic search of Embase, PubMed and Web of Science was conducted. The review was limited to nevus (>2 mm) counting studies of general population adults conducted between 2000 and 2022, and studies using skilled examiners. Results: Out of the 8 studies which were eligible for inclusion, none followed the IARC protocol. Three studies used a predefined criterion to count nevi. Five studies provided training for their observers. Three studies assessed the inter- or intraobserver variation using the correlation coefficient (>0.75), and 3 studies attempted to verify the validity and the reproducibility of the counts. There was little to no agreement in nevus counting and reporting procedures in the reviewed studies, and most studies did not report their procedures adequately. Conclusion: This review highlights the need for an easily accessible and feasible protocol for identification, counting and reporting of nevi, which also considers nevus counting from total-body imaging and automated nevus counts since these technologies are expected to become widely available for future studies.

Architectural Modernisation in Panevėžys During the 1930s: Exploring the Works of Civil Engineer Antanas Gargasas

Summary In contemporary studies of Lithuanian interwar architecture, so far the greatest attention is paid to the analysis of the architectural development and modernization processes that took place in the city of Kaunas, the temporary capital of the country at the time. The work of architectural specialists who worked there is also analysed more. However, at the same time, little is known about the development of architecture created in the smaller cities of Lithuania at that time and its modernization. Thus, this article aims to more thoroughly reveal and analyse the processes of modernization of Panevėžys city architecture that took place in the 1930s, choosing the designs of Antanas Gargasas, who worked there as a municipal engineer in 1931–1940, as the research object. This is done in the article by analysing and presenting the majority of his designed public buildings and the most significant and typical residential buildings. The article, which was written based on archival material, the press of the research period and the contemporary studies of the interwar architecture, contains an assumption that the buildings designed by Antanas Gargasas had a significant influence on the processes of modernization of the Panevėžys architecture at that time and the spread of new stylistic trends in it. The article is supplemented by the drawings and photos of the buildings designed by the engineer.

Gender identity disorder and its relations to avoidance symptoms among homosexuals

Gender identity refers to the way humans view themselves and perceive themselves to be attractive both sexually and romantically. It is an individual's appreciation and satisfaction of being heterosexual, bisexual, homosexual, or cisgender. It refers to an individual's sexual understanding of himself and is part of one's identity, which is different from the sexual understanding of oneself. Gender identity disorder means a robust desire of pertinence towards the opposite sex and robustly insistence on this otherness. Avoidance is classified within the framework of cluster 3 of personality disorders, which is identified by The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Hence, one can argue those who have this kind of personality disorder may appear in them withdrawal behavior; and they view themselves as restless, and they feel that they are rejected and despised by others. The researcher argues that homosexuals in Kurdish society are not accepted, and a large majority of people see them as sick, and others as victim due to their vulnerability to social and psychological problems. This study aims at finding relations between gender identity disorder and symptoms of avoidance in homosexual persons. The descriptive and relational methodology is used to intentionally select 108 subjects, 84 males and 24 females. Based on literatures and contemporary studies in the field, the researcher prepares the items of the gender identity disorder, yet for symptoms of avoidance, the researcher relies on and takes its terminologies from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The terminologies in both variables are presented to groups of experts in education, psychology, and psychiatrics, and for extracting stability from both the measures, (split-half) and (alpha Cronbach’s) is used. After applying the last measures on individuals from the sample of the study, statistics of the data is analyzed using Statistical Package for the Social Sciences (SPSS). The study concludes that there is a robust, positive and significant correlation between gender identity disorder and avoidance symptoms among homosexuals. Based on the results recommendations are also given.

Cognitive patterns according to mini-mental state examination domains in patients with AF and association with all-cause mortality: a cluster analysis from a contemporary prospective study

Abstract Background Atrial fibrillation (AF) is associated with cognitive impairment even in the absence of previous stroke. However, data on specific patterns of cognitive impairment and their association with outcomes are limited. Purpose We aimed to identify different phenotypic groups of AF patients stratified according to specific cognitive domains using cluster analysis and evaluate the association between identified clusters and adverse outcomes. Methods We used data from a prospective observational study on AF patients excluding those with previous clinically overt stroke. We performed a hierarchical cluster analysis based on Ward’s Method using data from the Mini-Mental State Examination (MMSE) administered during the enrollment. The MMSE includes 6 distinct cognitive domains. We normalized each domain’s score from 0 to 100 to preserve the ranking and the interpretability of the test. Patients’ clusters were identified by examining the distance between cluster coefficients and by visual inspection of the dendrogram. All-cause mortality was the primary endpoint. Results A total of 872 stroke-free AF patients were included. Three clusters based on MMSE domains were identified: Cluster 1 (n=494, 56.7%); Cluster 2 (n=243, 27.9%) and Cluster 3 (n=135, 15.5%). The clusters greatly differed according to the cognitive domains affected and baseline characteristics (Table). The use of oral anticoagulants did not differ among clusters and it was substantially high (88.6%). Cluster 2 had a higher prevalence of cognitive impairment (37.9% vs 35.6% for Cluster 3 and 1.0% for Cluster 1, p<0.001) with a lower mean MMSE score compared to other clusters. The analysis of MMSE domains showed substantial deficits in the orientation, attention/calculation, and recall domains with peculiar differences among the clusters. Cluster 2 showed the most significant impairment in the copying domain (100%) while Cluster 3 had a higher impairment in attention/calculation and recall domains. After a median follow-up of 629 days, all-cause mortality was 15.9% with a significantly higher prevalence in Cluster 2 (26.9% vs 10.0% and 15.5% for Cluster 1 and Cluster 3 respectively, p<0.001). At the adjusted Cox regression analysis, Cluster 2 was independently associated with a higher risk of all-cause mortality compared with Cluster 1 (HR 1.83, 95% CI 1.18-2.82) while Cluster 3 was not independently associated with the outcome (Figure). Conclusions In a prospective observational cohort of stroke-free AF patients, we identified three clusters showing different patterns of cognitive impairment, affecting specific MMSE domains and resulting in a different risk of mortality. Our findings highlight the clinical implications of cognitive impairment and stress the need for a more holistic approach to AF patients including a comprehensive cognitive assessment, as well as the need for studies on interventions able to positively affect cognitive impairment.Figure

Lipoprotein(a) cardiovascular disease risk not captured by low density lipoprotein cholesterol and apolipoprotein B

Abstract Background Elevated lipoprotein(a) affects 1 in 5 individuals and is considered a causal risk factor for atherosclerotic cardiovascular disease (ASCVD) and aortic valve stenosis (AVS). However, lipoprotein(a) measurements are not widely implemented in clinical practice. Low-density lipoprotein (LDL) cholesterol and apolipoprotein B (ApoB) measurements include contributions from lipoprotein(a), yet whether these measurements can replace measurements of lipoprotein(a) in assessing cardiovascular disease risk from this causal risk factor is unknown. Purpose We tested the hypotheses that lipoprotein(a) risk of ASCVD and AVS is captured by LDL cholesterol or ApoB. Methods We included 70,189 individuals from a prospective contemporary cohort study of the general population. Mediated risk by LDL cholesterol and ApoB in the association between lipoprotein(a) and risk of ASCVD and AVS was examined using four-way decomposition analyses stratified by statin treatment at baseline. Results During a median follow-up of 10.8 years, 7,127 developed ASCVD and 1,516 AVS. Per 50 mg/dL higher lipoprotein(a), multivariable adjusted hazard ratios were 1.22 (95% CI: 1.18-1.26) for ASCVD and 1.36 (1.28-1.46) for AVS. In individuals without statin use, LDL cholesterol mediated 19% (15%-24%) of the risk of ASCVD from lipoprotein(a) and 7.7% (1.5%-14%) of the risk of AVS from lipoprotein(a) (Figure 1). Corresponding values for ApoB were 14.0% (11%-18%) and 6.6% (2.8%-10%). In statin users (n=9,570), LDL cholesterol did not mediate risk of ASCVD from lipoprotein(a) but mediated 8.0% (0.8%-15%) of the risk of AVS from lipoprotein(a). Correspondingly, ApoB mediated 9.8% (2.2%-17%) of the risk of ASCVD and 4.2% (0.4%-8.0%) of the risk of AVS from lipoprotein(a). Conclusion Lipoprotein(a) risk of ASCVD and AVS is not adequately captured by LDL cholesterol and ApoB. Therefore, lipoprotein(a) measurement is needed in all individuals to capture the cardiovascular disease risk from this causal risk factor.

Association between completeness of revascularization and cardiovascular outcomes in patients with diabetes and non-ST elevation myocardial infarction: a population-based registry analysis

Abstract Introduction Approximately one-third of the patients presenting with non-ST elevation myocardial infarction (NSTEMI) have diabetes. From these, two-thirds have multivessel coronary disease. The impact of completeness of revascularization in this population remains unclear. Purpose To evaluate the contemporary patterns of coronary revascularization among patients with diabetes and NSTEMI, and the clinical outcomes stratified by anatomic completeness of revascularization. Methods All patients with diabetes and multivessel disease admitted for NSTEMI between April 2009 and March 2020 in Ontario, Canada were included. Patients with previous coronary artery bypass graft surgery (CABG) at any time, percutaneous coronary intervention (PCI) in the previous 90 days, or shock were excluded. Patients were classified in four groups, from the most to the least complete revascularization strategy: CABG, complete revascularization with PCI, incomplete revascularization with PCI, or no revascularization. Outcomes included all-cause death and the composite of all-cause death, myocardial infarction, and stroke. Multivariable Cox regression was used to account for confounding (demographics, comorbidities, left ventricular function, coronary anatomy, laboratory tests, and diabetes treatment). Results We included 14,511 patients (mean age: 68.7±11.5y; 69.6% males). A total of 4,525 (31.2%) patients were treated with CABG, 3,008 (20.7%) with complete PCI, 3,624 (25.0%) with incomplete PCI and 3,354 (23.1%) were not revascularized. Patients with more complex coronary disease were more frequently treated with CABG, while PCI was more common in those with less complex disease (p<0.001; Fig 1). The mean number of grafts in the CABG group was 3.4±1.0. The mean number of stents in the complete and incomplete PCI groups was 2.4±1.3 and 1.7±0.9, respectively. Adjusted 5-y risks of all-cause death following CABG, complete PCI, incomplete PCI and no revascularization were, respectively, 25.9%, 29.8%, 32.2%, and 39.4%. Over a median follow-up of 5.8ys, CABG was associated with reduced all-cause death compared with complete PCI (HR 0.82; 95%CI 0.75 - 0.90), incomplete PCI (HR 0.73; 95%CI 0.67 - 0.80), or no revascularization (HR 0.54; 95%CI 0.50 - 0.58); p<0.001 for all (Fig 2). Adjusted 5-y risks of the composite endpoint following CABG, complete PCI, incomplete PCI and no revascularization were, respectively, 34.0%, 41.5%, 44.6%, and 52.9%. CABG was associated with reduced rates of the composite endpoint compared with complete PCI (HR 0.75; 95%CI 0.69 - 0.81), incomplete PCI (HR 0.67; 95%CI 0.62 - 0.72), or no revascularization (HR 0.50; 95%CI 0.47 - 0.54); p<0.001 for all. Conclusion In this contemporary real-world cohort study, almost a quarter of the patients with diabetes and NSTEMI did not receive any revascularization procedure. Cardiovascular outcomes were incrementally improved with CABG or complete revascularization with PCI, compared to no revascularization.Figure 1Figure 2

Clinical presentation, risk factors and six-month outcomes in Ugandan women with peripartum cardiomyopathy: prospective case-control study

Abstract Background Peripartum Cardiomyopathy (PPCM) frequently affects women of African descent. There is scarcity of data pertaining to the clinical presentation and outcomes of PPCM patients in Uganda, particularly when employing modern diagnostic tools and adhering to guideline-directed medical therapy (GDMT). Purpose We aimed to delineate the clinical characteristics, echocardiographic findings, and 6-month outcomes among women in Uganda diagnosed with PPCM. Methods Prospective case-control design conducted from June 2022 to August 2023. We enrolled 80 PPCM cases and 80 matched controls. Inclusion criteria comprised: (i) peripartum state, (ii) signs and symptoms of HF, (iii) left ventricular (LV) ejection fraction ≤ 45%, and (iv) exclusion of alternative causes of HF. Controls were healthy women matched for age and parity. Over a 6-month period, enrolled PPCM cases were diligently monitored while on GDMT. All participants underwent a physical examination, 12-lead electrocardiography, and a detailed echocardiography incorporating global longitudinal strain measurements at both baseline and the 6-month follow-up. Results At baseline, amongst the cases, the mean age was 33.6 ± 6.6 years, mean parity was 3±2.1 pregnancies. HF onset occurred within 9.5±6.5 weeks post-delivery. A total of 20 (25.0%) cases presented in NYHA Class 4 with dyspnea as the predominant symptom in 79.95% of cases. Atrial fibrillation (AF) was observed in 2(2.5%) patients. In comparison with healthy controls, high gravidity (0.2±1.0; p<0.001) was identified as the only predictor of PPCM in this study. (Table 1) At 6-months follow up, the mean LV ejection fraction (LVEF) showed improvement from 35.7±-11.0% to 45.9 ± 15.7% (p<0.001) accompanied by a reduction in left ventricular diameter (LVD) from 6.1±0.7 cm to 5.5±1cm(p<0.001). At the 6-month follow-up, recovery (LVEF ≥ 50%) occurred in 37 cases (55%), and 52 (65%)patients were asymptomatic (NYHA Class 1) at the 6-month follow-up. Six-month mortality data were available for 5(6.3%) women, and one patient successfully underwent the insertion of an Implantable Cardioverter-defibrillator for recurrent Ventricular Tachycardia. Regarding GDMT, 55 participants received Bromocriptine as part of their medication. Twenty(25%) patients received anticoagulation for AF(n=2) or intracardiac thrombus (n=6, 1.67%) (Figure 1) resulting in 2(2.5%) strokes within the 6-month follow-up. Conclusion The current study demonstrated a comparable mortality rate on GDMT, aligning with contemporary global studies at 7.5%. The observed high thrombus burden in patients may indicate suboptimal adherence to anticoagulation therapy. While the incidence of PPCM remains undefined in Uganda, the primary predisposing factor identified was high gravidity. A noteworthy proportion of patients exhibited incomplete LV recovery, suggesting the need for larger studies to comprehensively define the maternal and fetal outcomes in Uganda.Figure 1Table 1

A regional multicentre prospective survey addressing sport-related myocardial infarction: clinical characteristics of 155 patients and one year follow-up

Abstract Background Exercise is a keystone of cardiovascular prevention; however, it is also a powerful trigger of acute cardiovascular events including sudden cardiac arrest and acute myocardial infarction. Contemporary studies addressing these sport-related myocardial infarction (SR-MI) are scarce. Aim To describe clinical characteristics and follow-up of SR-MI. Methods We conducted a regional multicentric prospective survey addressing patients admitted for a SR-MI in 2 intensive coronary units. SR-MI was defined as MI onset occurring during sport or within the 1st hour of recovery. A one-year follow-up was performed by phone call. Results From April 1st 2018 to February 23th 2023, 155 SRMI were included, of whom 13 (8.4%) were female, median age was 61-y. (IQR 54-66). Cycling was the most frequent sport (32.5%) followed by fitness and hiking (12.6% each) then jogging (11.3%) (Figure). Most were ST elevation MI (68.8%). The main risk factors were dyslipidaemia (33.8%), hypertension (27.3%) and tobacco smoking (24.5%). No cardiovascular risk factor other than age was identified in 38 patients (25.7%). Prodromal symptoms were reported by 66 subjects (42.6%). SR-MI occurred mostly during exercise (60.6%). Out of hospital cardiac arrest (OHCA) occurred in 20 (12.6%) patients, more commonly among patients with prior coronary artery disease (CAD) (p = 0.02) and tobacco smoking (p=0.047). A significant single vessel disease was observed in 67 patients (43.2%); revascularization was performed by stenting in 134 patients (86.5%) and surgery in 11 (7.1%). In-hospital death occurred in 4 patients and was associated to OHCA (p=0.007). Among the survivors at time of discharge (151 patients), 141 were eligible to follow-up, none one lost: one patient died suddenly at home, one suffered from a recurrent MI, one experienced a cardioversion from his implantable cardioverter defibrillator (ICD) and an ICD was implanted in 4 others. A cardiovascular rehabilitation was performed in 101 patients (65.2%); from the 30 smokers at the time of SRMI, 26 declared smoking cessation. Conclusions Among patients admitted for a SR-MI, most were male. Prodromal symptoms were common but neglected. OHCA occurred in 1 patient out of 8 and was associated with history of CAD, tobacco smoking and in-hospital death. Such findings highlight the need for mass education to prevention including recognition of prodromal symptoms and management of cardiac arrest. In this exercising population, rehabilitation rate was high and quitting tobacco was commonly achieved.Table

Risk factors of obstructive sleep apnea syndrome in the developmental age

Background: Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent respiratory sleep disorder in children, associated with severe health consequences, including hypertension, cardiac dysfunction, and neurocognitive impairment. Despite extensive research on OSAS in adults, the risk factors for pediatric OSAS remain underexplored. Objective: This literature review aims to identify and present the key risk factors associated with pediatric OSAS based on contemporary studies. Methods: A systematic search of the PubMed and Scopus databases was conducted for literature published between 2016 and 2024. Search terms included “obstructive sleep apnea,” “children,” and “risk factors.” A total of 93 relevant studies were reviewed after excluding non-pediatric and irrelevant papers from an initial pool of 283. Results: The most commonly identified risk factors for pediatric OSAS include adenoid and tonsillar hypertrophy, obesity, craniofacial abnormalities, and asthma. Additional risk factors such as allergic rhinitis, recurrent upper respiratory infections, nasal stenosis, congenital diseases, low vitamin D levels, and preterm birth were also noted. Conclusion: Pediatric OSAS is influenced by multiple factors, including anatomical, physiological, and genetic components. Further research is required to explore emerging risk factors, such as role of vitamin D deficiency and microbiota, and to clarify the impact of variables like ethnicity and breastfeeding.

Risk-enhancing factors and social determinants of health in risk assessment for atherosclerotic cardiovascular disease.

The Pooled Cohort Equations (PCEs) do not accurately estimate atherosclerotic cardiovascular disease (ASCVD) risk in certain populations. The 2018 AHA/ACC cholesterol guideline identified risk-enhancing factors as a supplement to PCEs-based risk assessment. However, the role of each risk-enhancing factor in ASCVD risk assessment has not been well quantified. Further, social determinants of health (SDOH) are not included in the PCEs nor considered as risk-enhancing factors in the US cholesterol guideline. We sought to evaluate ASCVD risk associated with each risk-enhancing factor and commonly collected SDOH including education, income, and employment status, and to assess if adding risk-enhancing factors and SDOH to the PCEs improve ASCVD risk prediction. We included individuals aged 40 to 75 years, without ASCVD or diabetes at baseline, and with low-density lipoprotein cholesterol 70-189 mg/dL from two contemporary prospective cohort studies (MESA and REGARDS) and from Kaiser Permanente Southern California (KPSC). The primary endpoint was incident ASCVD defined as nonfatal myocardial infarction, fatal coronary heart disease, or fatal or nonfatal stroke over a 10-year period (median follow-up 10 years). We used Cox proportional hazards models to estimate associations between risk-enhancing factors and SDOH with ASCVD. We also assessed changes in model performance after adding risk-enhancing factors and SDOH to the PCEs. We included 13,863 adults (mean age 60.7 years) from the prospective cohorts and 307,931 adults (mean age 54.8 years) from KPSC. Risk-enhancing factors including hypercholesterolemia, hypertriglyceridemia, metabolic syndrome, and chronic kidney disease were associated with a higher ASCVD risk, independent of 10-year risk estimated by the PCEs. Low education, low income, and unemployment were also associated with higher ASCVD risk. While adding individual risk-enhancing factors or SDOH to the PCEs had limited impact on model performance, adding multiple risk-enhancing factors and SDOH simultaneously led to modest improvements in discrimination (C-index increased by up to 0.07), calibration (integrated Brier score reduced by up to 2.3%), and net reclassification improvement up to 41.4%. These findings suggest including SDOH and risk-enhancing factors may improve ASCVD risk assessment.

Challenges and Strategies in the Industrial Application of Dendrobium officinale

Dendrobium officinale Kimura & Migo (D. officinale) is a well-recognized traditional Chinese medicinal herb that is both medicinal and edible. Contemporary pharmacological studies have revealed that D. officinale contains abundant bioactive compounds, including polysaccharides, flavonoids, alkaloids, and dendrobine, exhibiting diverse pharmacological properties such as antioxidant, anti-inflammatory, and immunomodulatory effects. However, the industrial application of D. officinale faces many problems, such as the scarcity of wild resources, low natural reproduction rate, and slow growth rate as well as the lack of relevant industrial standards. Nevertheless, substantial advancements, including the exploitation of artificial propagation techniques and breeding of new varieties, have been achieved in recent years. These developments have effectively addressed the challenges associated with its low natural reproduction rate and the scarcity of wild resources. This review summarizes the progress in the industrial development, seedling cultivation, and pharmacological exploration of D. officinale in recent years. Furthermore, it analyzes current research inadequacies and offers strategic solutions to enhance its application in healthcare and medicine.

The Role of Managerial Competencies in Higher Education: Navigating Current Transformational Trends

Objective: This study investigates the managerial competencies required in the field of higher education in response to contemporary transformational trends. The main goal is to explore how these competencies are shaped by the ongoing digital transformation, strategic management approaches, and the shift towards entrepreneurial university models. Theoretical Framework: The research draws on key concepts related to digital leadership, human capital development, and Agile management. Theories of educational management and models of intellectual capital are employed to frame the investigation and provide a comprehensive understanding of the changing dynamics in higher education. Method: A qualitative and mixed-methods approach was utilized, incorporating data from reports, surveys, and contemporary studies on digital competencies, hybrid learning, and leadership in educational institutions. The study includes both theoretical analysis and empirical data collection through case studies and expert assessments. Results and Discussion: The findings reveal that digitalization and the transition to blended learning environments are driving the need for new managerial skills. These skills include digital leadership, strategic decision-making, and the ability to balance traditional and online educational models. The discussion highlights the importance of flexible management approaches, such as Agile, in addressing these emerging challenges. Research Implications: The study provides practical and theoretical insights into how higher education institutions can adapt their leadership strategies to meet the demands of digitalization. These findings have implications for educational policy, institutional governance, and the development of leadership training programs. Originality/Value: This research contributes to the growing body of literature on higher education management by offering a fresh perspective on the evolving competencies required in today’s digital age. The value lies in its focus on the intersection of digital transformation and managerial competencies, offering practical solutions for enhancing leadership in higher education.