Group Level Research Articles

Asymmetry of attentive networks contributes to adult Attention-deficit/hyperactivity disorder (ADHD) pathophysiology.

Diffusion imaging studies in Attention-deficit/hyperactivity disorder (ADHD) have revealed alterations in anatomical brain connections, such as the fronto-parietal connection known as superior longitudinal fasciculus (SLF). Studies in neurotypical adults have shown that the three SLF branches (SLF I, II, III) support distinct brain functions, such as attention and inhibition; and that their pattern of lateralization is associated with attention performance. However, most studies in ADHD have investigated the SLF as a single bundle and in children; thus, the potential contribution of the lateralization of the SLF branches to adult ADHD pathophysiology remains to be elucidated. We used diffusion-weighted spherical deconvolution tractography to dissect the SLF branches in 60 adults with ADHD (including 26 responders and 34 non-responders to methylphenidate, MPH) and 20 controls. Volume and hindrance modulated orientational anisotropy (HMOA), which respectively reflect white matter macro- and microstructure, were extracted to calculate the corresponding lateralization indices. We tested whether neurotypical controls differed from adults with ADHD, and from treatment response groups in sensitivity analyses; and investigated associations with clinico-neuropsychological profiles. All the three SLF branches were lateralized in adults with ADHD, but not in controls. The lateralization of theSLFI HMOA was associated with performance at the line bisection, not that of the SLF II volume as previously reported in controls. Further, an increased left-lateralization of the SLF I HMOA was associated with higher hyperactivity levels in the ADHD group. Thus, an altered asymmetry of the SLF, perhaps especially of the dorsal branch, may contribute to adult ADHD pathophysiology.

External Debt and Economic Growth of BRICS Nations: How can BRICS Integration help them?

This study examines the relationship between external debt and economic growth in the BRICS countries. It explores how BRICS integration can aid these economies and newly joined countries in solving the debt problem. Using the latest panel data techniques and country experiences, we employed the panel mean group method (PMG) and interrupted time series analysis (ITSA) for South Africa, who joined in 2010. Results show a negative relationship between external debt and economic growth at the group level, with mixed results for individual countries. Using individual country experiences, valid implications are drawn for debt-stressed countries like Ethiopia and oil-rich nations like Saudi Arabia. Integrating new member countries in BRICS can overhaul the existing system towards broader perspectives of reforms in global financial institutions. Integration into the BRICS association can benefit these countries through reforms in global financial institutions, fairer debt restructuring, joint investment projects, macroeconomic coordination, debt management knowledge sharing, innovative financing, and collective advocacy for debt relief to enhance stability and resilience.

Gegen Qinlian Decoction Modulates Atherosclerosis and Lipid Metabolism Through Cellular Interplay and Signaling Pathways.

The objective of this study is to investigate Gegen Qinlian decoction (GQD) effects on lipid metabolism and explore its mechanism for preventing and treating atherosclerosis. An atherosclerotic rat model was established, and after an 8-week high-fat diet, atherosclerosis and non-alcoholic fatty liver disease were assessed. Subsequently, GQD was administered at low and high doses. Histopathological aortic wall changes, hepatic lipid deposition, and blood lipid changes were evaluated. ELISA indicated the influence of TNF-α and IL-13, and Western blotting revealed MerTK, ABCA1, and LXR-α expression. A foam macrophage model was established, and Cell activity was detected by the MTT method. ELISA indicated the influence of PPAR-γ. The expression of ABCA1, ABCA7, ABCG1, GAS6, MerTK, SCARB1, LXR- α and LXR-β mRNA were detected by qPCR. and Western blotting revealed MerTK and LXR-α expression. The impact of drug-containing serum of GQD on efferocytosis-related factors was studied. GQD improved atherosclerosis and non-alcoholic fatty liver disease and reduced serum low-density lipoprotein levels in the high-dose group. The high- and low-dose groups showed upregulated ABCA1, MerTK, and LXR-α expression in blood vessels and the liver, respectively. GQD decreased serum TNF-α and increased IL-13 levels. PPAR-γ expression was elevated in the high-, and low-dose groups. In the high-and low-dose groups, ABCA7, GAS6, SCARB1, and LXR-α, ABCA1 and MerTK, and ABCG1 gene expression were upregulated, respectively. Both low- and high-dose serum-containing drugs promoted LXR-β gene expression, and LXR-α protein expression was improved in the high-dose group. GQD improves rat atherosclerosis and hepatic lipid metabolism by regulating PPAR-γ, LXR-α, LXR-β, ABCA1, ABCA7, and ABCG1 expression and augmenting cellular intercalation through the GAS6/TAM pathway.

Oxidative stress in the alveolar lavage fluid of children with Mycoplasma pneumoniae pneumonia.

To investigate the correlation between oxidative stress in the bronchoalveolar lavage fluid (BALF) of children with Mycoplasma pneumoniae pneumonia (MPP) and the clinical characteristics of severe MPP (SMPP) and refractory MPP (RMPP). Clinical and BALF-related data were collected from 83 patients with MPP, of which 29 had SMPP and 54 had general MPP (GMPP); 37 patients were in the RMPP group and 46 in the non-RMPP group. The levels of malondialdehyde (MDA) and advanced oxidation protein products (AOPP) as well as the activity levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) in BALF were detected. Logistic regression analyses were performed on MDA, AOPP, SOD, GSH-PX, gender, heat peak, neutrophil percentage, C-reactive protein, lactate dehydrogenase, d-dimer, lung consolidation, sputum embolus, and pleural effusion. The levels of MDA and AOPP in the BALF of the MPP group were significantly higher than those in the control group (p < .05), whereas SOD and GSH-PX levels were lower than those in the control group (p < .05). The BALF AOPP levels in the RMPP group were higher than those in the non-RMPP group, and the SOD and GSH-PX levels in the BALF were lower than those in the non-RMPP group; the difference was statistically significant (p < .05). The levels of MDA and AOPP in the BALF of children in the SMPP group were higher than those in the GMPP group, and the levels of SOD and GSH-PX were lower than those in the GMPP group, with statistically significant differences (p < .05). The C-index of the logistic regression model was 0.960 (95% confidence interval 0.958-0.963), which indicates that the model has good predictive ability. Advanced oxidation protein products may be a marker for predicting the conditions of SMPP and RMPP, and the prediction model can assess the risk of progression in children to RMPP, which is conducive to clinical diagnosis and treatment.

Biochemical analysis of soft tissue infectious fluids and its diagnostic value in necrotizing soft tissue infections: a 5-year cohort study

BackgroundNecrotizing soft tissue infections (NSTI) are rapidly progressing and life-threatening conditions that require prompt diagnosis. However, differentiating NSTI from other non-necrotizing skin and soft tissue infections (SSTIs) remains challenging. We aimed to evaluate the diagnostic value of the biochemical analysis of soft tissue infectious fluid in distinguishing NSTIs from non-necrotizing SSTIs.MethodsThis cohort study prospectively enrolled adult patients between May 2023 and April 2024, and retrospectively included patients from April 2019 to April 2023. Patients with a clinical suspicion of NSTI in the limbs who underwent successful ultrasound-guided aspiration to obtain soft tissue infectious fluid for biochemical analysis were evaluated and classified into the NSTI and non-necrotizing SSTI groups based on their final discharge diagnosis. Common extravascular body fluid (EBF) criteria were applied.ResultsOf the 72 patients who met the inclusion criteria, 10 patients with abscesses identified via ultrasound-guided aspiration were excluded. Based on discharge diagnoses, 39 and 23 patients were classified into the NSTI and non-necrotizing SSTI groups, respectively. Biochemical analysis revealed significantly higher albumin, lactate, lactate dehydrogenase (LDH), and total protein levels in the NSTI group than in the non-necrotizing SSTI group, and the NSTI group had significantly lower glucose levels and pH in soft tissue fluids.In the biochemical analysis, LDH demonstrated outstanding discrimination (area under the curve (AUC) = 0.955; p < 0.001) among the biochemical markers. Albumin (AUC = 0.884; p < 0.001), lactate (AUC = 0.891; p < 0.001), and total protein (AUC = 0.883; p < 0.001) levels also showed excellent discrimination. Glucose level (AUC = 0.774; p < 0.001) and pH (AUC = 0.780; p < 0.001) showed acceptable discrimination. When the EBF criteria were evaluated, the total scores of Light’s criteria (AUC = 0.925; p < 0.001), fluid-to-serum LDH ratio (AUC = 0.929; p < 0.001), and fluid-to-serum total protein ratio (AUC = 0.927; p < 0.001) demonstrated outstanding discrimination.ConclusionBiochemical analysis and EBF criteria demonstrated diagnostic performances ranging from acceptable to outstanding for NSTI when analyzing soft tissue infectious fluid. These findings provide valuable diagnostic insights into the recognition of NSTI. Further research is required to validate these findings.

Trends in socioeconomic disparities in urban heat exposure and adaptation options in mid-size U.S. cities

There is ample evidence that Environmental Justice communities experience high levels of extreme heat. However, it is unknown how disparities in urban heat exposure and adaptation options change over time. This study investigates socioeconomic disparities over time in urban heat exposure and adaptation options in eight mid-sized Northeastern cities. We ask: How were socioeconomic factors associated with heat exposure and adaptation options over time? We analyzed disparities at the census block group level and census block level, respectively. At the census block group level, we ran spatial regression models between socioeconomic variables, including race, income, gender, and age, and heat exposure and adaptation variables, including land surface temperature, normalized different vegetation index (NDVI), tree cover, and air conditioning ownership rate. We found that: Low median household income is always associated with high LST and low NDVI from 1990 to 2020; Low percentage of females is always associated with high LST and low NDVI from 1990 to 2020. High percentage of POC is associated with high LST in 2010 and 2020, but not in 1990 and 2000; Low median household income and low percentage of elderly are associated with lower tree cover; High percentage of POC, low percentage of elderly, and low median household income are associated with lower AC rates. In analysis at the census block level by city, we found that disparities in urban heat exposure between predominantly POC and predominantly white communities increased in most cities during 1990-2020. Predominantly POC communities consistently have lower vegetation cover over time in most cities. Disparities in vegetation cover per unit area increased in most cities, whereas disparities in vegetation cover per capita decreased in most cities. Our findings of the trends in disparities in heat exposure and adaptation are useful for forecasting disparities in the future. These findings also suggest that interventions should prioritize cities with increasing disparities in heat exposure and adaptation.

Evaluating peripheral blood lymphocyte subset composition and lipopolysaccharide-induced cytokine secretory activity in mononuclear leukocyte cultures from patients with febrile and meningeal forms of tick-borne encephalitis

Introduction.Multiple studies on immune response in patients with various clinical forms of tick-borne encephalitis (TBE) have shown conflicting results. The study aim was to estimate the changes in peripheral blood lymphocyte subset counts and activity of spontaneous and lipopolysaccharide (LPS)-stimulated cytokine production in the mononuclear leukocyte cultures in patients with febrile and meningeal acute TBE.Materials and methods.Groups 1 and 2 included 16 and 12 patients with febrile and meningeal acute TBE, respectively. The control group included 13 healthy donors. Hemogram and T-lymphocyte, T-helper cell, T-cytotoxic and NK cell counts were analyzed by flow cytometry at week 1 of the disease as well as the spontaneous and LPS-stimulated secretion levels of TNFα, IL-1β, IL-6, IL-10, IL-8, and MCP-1 were assessed by ELISA in the supernatants of mononuclear cell cultures twice: during hospitalization and two weeks later. Statistical analysis was performed by the Mann–Whitney U-test, and Wilcoxon test.Results.Group 2 demonstrated significant decrease in spontaneous and/or LPS-stimulated levels of proinflammatory cytokines IL-1β, IL-6, MCP-1, and TNFα, but showed higher IL-8 level as compared with Group 1. In addition, spontaneous and/or LPS-induced levels of IL-6 and TNFαin Group 2 did not significantly differ from the controls, which presumably also indicated the suppression of their production. In contrast, spontaneous and/or LPS-induced levels of IL-1β, IL-6, MCP-1, and TNFαin Group 1 were higher than in the controls. The spontaneous IL-10 level in the patients from both groups were higher than in the controls. Peripheral blood lymphocyte and T-cytotoxic T-lymphocyte counts in both groups of TBE patients were lower than in the controls. There was significant increase in neutrophil counts, decrease in NK cell count in Group 2 as compared to the patients with a milder febrile form.Conclusion.Meningeal acute TBE patients was presumably associated with inadequate immune response with NK cell deficiency, T-cell dysfunction, increased neutrophil count in the peripheral blood and impaired pro-inflammatory cytokine production related to innate immune response.

BOOK REVIEW: CORPUS LINGUISTICS AND SECOND LANGUAGE ACQUISITION: PERSPECTIVES, ISSUES, FINDINGS

This article discusses the application of corpus linguistic methods in second language acquisition (SLA) research. It highlights the significance of utilizing native and learner corpora, along with automated tools for corpus annotation and analysis, to explore various aspects of SLA. The article is based on a book titled "Corpus Linguistics and Second Language Acquisition: Perspectives, Issues, Findings," which covers five chapters. These chapters delve into topics such as variations in L2 usage at a group level, factors influencing L2 processing and production, group-level longitudinal trajectories of L2 development, and inter- and intra-learner variability in L2 development. The book aims to provide valuable insights and methodologies for researchers interested in employing corpus linguistic methods to enhance their SLA research.

Anti-inflammatory effects of tiotropium in copd: a randomized double-blind trial

IntroductionChronic Obstructive Pulmonary Disease (COPD) is a major global health issue characterized by respiratory symptoms and exacerbations, significantly impacting mortality and quality of life. Muscarinic antagonists are known to prevent exacerbations, possibly by mitigating airway inflammation. This study evaluated the anti-inflammatory effects of tiotropium in patients with COPD by examining inflammatory protein profiles in sputum and blood, and genome-wide expression in sputum.MethodsWe conducted the prospective, double-blind, randomized-controlled ANTIOFLAM trial. Patients with COPD GOLD II and worse, aged≥40 years and with≥10 smoking pack years were included. After a 4-week wash-out period of inhaled corticosteroids (ICS) and anticholinergics, participants were randomized to 6 weeks of treatment with placebo or tiotropium (soft mist inhaler, 5 µg daily). Our primary endpoint was a decrease of sputum interleukin-6 and interleukin-8 levels in the tiotropium group when compared to the placebo group.ResultsWe evaluated samples of 33 participants (n=17 placebo and n=16 tiotropium). Changes in sputum proteins interleukin-6 and interleukin-8 were significantly higher after treatment with tiotropium when compared to placebo (p&lt;0.05). Differential expression analysis did not reveal gene expression differences including interleukin-6 and −8.ConclusionWe did not find tiotropium to have anti-inflammatory effects in sputum or blood of patients with COPD. In contrast, we found 6 weeks of treatment with tiotropium to increase the concentration of almost all tested sputum inflammatory proteins when compared to placebo, while RNA expression levels did not change.

Towards Standardized Assessment of Outcomes in Back Pain—Validation of Linking Studies Between Disease-Specific and Generic Patient-Reported Outcome Measures

Background: Comparing outcomes across different health measurement tools is essential where various patient-reported outcome measures (PROMs) are used. In spinal surgery, where recent studies show that over 30 different PROMs are applied, this need becomes even more pressing. Although several statistical transformations between the Oswestry Disability Index (ODI) and the PROMIS Profile 29 have been proposed, validation studies on conversion equations and cross-walk tables remain limited. In this study, we examined the agreement between observed ODI scores and those predicted from the PROMIS Profile 29 in a large sample of patients with low back pain, collected from routine clinical care. Methods: We compared the performance of regression and linking models at both the individual and group levels. Using Bland–Altman plots, we assessed the mean difference, 95% limits of agreement, root mean squared error (RMSE), and standardized mean differences (Cohen’s d) between predicted and observed ODI scores. Results: While group-level agreement was satisfactory, with negligible effect sizes, individual prediction accuracy was relatively poor. Additionally, regression models showed inconsistent performance across the ODI score range, though incorporating more domains marginally improved predictions. Conclusions: The equipercentile linking approach demonstrated stable agreement across all ODI scores, making it the preferred method. Future regression models should account for nonlinear relationships between PROMs to enhance prediction accuracy.

Correlation study between lipid profile parameters and liver function enzymes in Babylon province

Objective: The present study was an observational case control design. The data of study were collected in the period from first of January 2024 to March 2024. The study was conducted from clinical Laboratory private in Hilla City, Babylon province, Iraq. Material and methods: A total number of subjects involved in this study was 150 patients, from both sex (male and female) with age range (5-85). Blood samples were taken from each one to determination lipid profile tests (total cholesterol, total triglyceride, High and Low-density lipoprotein cholesterol and liver function tests (ALT, AST, ALP, TSB) and investigation the correlation between them. Results: The results showed that, these were significant correlation between these tests according to male groups, the strength and direction of the correlation between TC and TG levels. The value being significant suggests that there was a moderate strong relationship between these variables (0.491). A strong positive correlation between TC and LDL levels (0.799), HDL and ALP levels (0.290), ALT and AST levels (0.777). In addition, a positive association between AST and ALP levels (0.125), TC and LDL levels (0.799). On the other hand, a weak negative association TC and AST levels (0.045), TC and TSB levels (-0.185), TG and HDL levels (-0.04). TG and AST levels (-0.065), TG and TSB levels (-0.184), HDL and ALT levels (0.123), HDL and AST levels (-0.133), ALT and TSB levels (-0.08) and between ALP and TSB levels (-0.08). However, a moderate negative association between TG and LDL levels (-0.32) and a very weak negative association between HDL and TSB (-0.016). Conclusion: In male group, a strong positive correlation between TC and LDL levels, HDL and ALP levels, ALT and AST levels. A positive association between AST and ALP levels, TC and LDL levels, these were significant correlation between these tests according to female groups, the strength and direction of the correlation between TC and TG levels, a moderate strong relationship between these variables, TC and LDL levels, ALT and AST levels, ALT and ALP levels, ALT and TSB levels, AST and ALP levels, AST and TSB levels and ALP and TSB levels. And moderately strong negative correlation between HDL and ALT levels. So, a relatively weak positive correlation between LDL and AST levels in female group. Moderately positive correlation between LDL and ALP levels and between LDL and TSB levels.

MTORC1 and mTORC2 Levels in Patients With Psoriasis

Introduction: In recent years, the role of the mammalian target of rapamycin (mTOR) pathway, which is one of the intracellular signaling pathways and known as the main control pathway of metabolism, in the pathogenesis of psoriasis has been emphasized. Objectives: We sought to investigate the importance of the mTOR pathway in the pathogenesis of psoriasis. Methods: Forty patients with psoriasis and 40 healthy volunteers were included in this case-control study. Serum fasting mTORC1 and mTORC2 levels of the study groups were examined by enzyme-linked immunosorbent assay. Results: Serum mTORC1 and mTORC2 levels were significantly lower in patients with psoriasis than controls (p= 0.001). A positive correlation was found between serum mTORC1 and serum mTORC2 levels in patients with psoriasis (p=0,001, r=0,826). Conclusion: The lower serum levels of mTORC1 and mTORC2 complexes which are active signalling molecules in the cell, were found to be lower in patient with psoriasis, suggesting that it may be an indicator of increased intracellular activation of these molecules. Our opinion that agents that can effectively inhibit both mTOR complexes may be more effective in the treatment of psoriasis.

Effects of resistance and strength training on serum phosphorus levels in male footballers: implications for physical educators and sports trainers

Background and Study Aim. Sports performance and overall health of athletes are highly dependent on various physiological markers. Among these, blood biochemistry is of great importance and should be carefully considered in athletes' training regimens. However, the effect of strength and resistance training on serum phosphorus levels still requires further clarification and more effective solutions. The aim of this study was to determine the effect of strength and resistance training on serum phosphorus levels in elite male soccer players. Material and Methods. A sample of 90 volunteers was recruited from football athletes in the Peshawar division. Thirty participants were selected from each of the under-16, under-19, and under-23 age groups. They were divided into three groups: the Resistance Training Group (RTG), the Strength Training Group (STG), and the Control Group (CG). Each group consisted of 30 participants, with 10 from each age category. Phosphorus levels and anthropometric measurements (height, weight, BMI, waist circumference, hip circumference, and waist-to-hip ratio (WHR)) were assessed before and after a 12-week strength and resistance training intervention. Analysis of Variance (ANOVA) and paired sample t-tests were used to evaluate changes over time. Results. Significant improvements were observed in serum phosphorus levels in the Resistance Training Group (4.77±0.258 vs. 3.66±0.207, P&lt;0.001) and in the Strength Training Group (4.31±0.304 vs. 3.66±0.209, P&lt;0.001). A 12-week regimen of strength and resistance training significantly improved serum phosphorus levels among the participants. Analysis of variance indicated that both strength and resistance training significantly affected serum phosphorus levels after 12 weeks of intervention. Tukey’s HSD test revealed that the effects of resistance training were more pronounced than those of strength training. Conclusions. This study highlights the importance of incorporating both strength and resistance training in athletic programs. These training approaches are crucial for optimizing physical health and performance. The findings underscore the need for educators and trainers to adapt and refine their methods to maximize the benefits of these interventions. By doing so, they can enhance the effectiveness of training regimens and contribute to the overall well-being of athletes.

Efficacy and safety of Danlou tablets in the treatment of stable angina pectoris with intermingled phlegm and blood stasis syndrome in coronary heart disease: a multicenter randomized controlled study

ObjectivesIn this study, we assessed the clinical efficacy and safety of Danlou tablets in the treatment of stable angina pectoris (SAP) with intermingled phlegm and blood stasis (IPBS), to provide high-quality evidence-based medical evidence for the prevention and treatment of coronary heart disease.MethodsIn this multicenter randomized controlled study, 304 patients diagnosed with stable angina pectoris with IPBS enrolled from 12 national traditional Chinese medicine (TCM) clinical research centers in China were randomly assigned to the treatment group and the control group at a ratio of 1:1. Each group was divided into four subgroups based on the results of TCM syndrome differentiation: IPBS, IPBS combined with qi deficiency, IPBS combined with qi stagnation, and IPBS combined with toxin accumulation. The control group was treated with routine Western medicine. In addition to routine Western medicine treatment, the treatment group (the IPBS group) was treated with Danlou tablets or Danlou tablets supplemented by interventional therapies based on the results of traditional Chinese medicine differentiation. The frequency of angina attacks per week was the main efficacy evaluation indicator and the secondary efficacy evaluation indicators included angina symptom score, Seattle Angina Questionnaire, an electrocardiogram (ECG) efficacy evaluation, a cardiac Doppler two-dimensional ultrasound, an electrocardiogram treadmill exercise test, blood lipids, blood glucose, a coagulation function test, hemorheology indicators, homocysteine, C-reactive protein (CRP) or high sensitivity-CRP, TCM syndromes (syndrome score, tongue, pulse), and long-term prognosis (endpoint outcome, cardiovascular events).ResultsThere were 300 cases in the full analysis set (FAS), 266 in the per-protocol set (PPS), and 300 in the safety set. Regarding the main efficacy indicator, after treatment, the reduction in the frequency of weekly angina attacks in the treatment group was significantly greater than that in the control group (P &amp;lt; 0.05). The results of the FAS and PPS were consistent. Regarding the secondary efficacy evaluation indicators, the angina symptom, TCM syndrome, ECG evaluation, Seattle Angina Pectoris Questionnaire, and 36-item Health Status Survey Summary Form scores of the treatment group were significantly higher than the control group (P &amp;lt; 0.05) and the homocysteine levels of the treatment group were significantly reduced (P &amp;lt; 0.05). The results of the FAS and PPS were consistent. In the PPS, the triglyceride levels in the treatment group were significantly lower than those in the control group after treatment (P &amp;lt; 0.05). The activated partial thromboplastin time in the treatment group decreased significantly (P &amp;lt; 0.05). There was no statistically significant difference in the safety indicators and incidence of adverse reactions between the two groups.ConclusionTreatment with Danlou tablets and the modified combination therapy based on Western medicine treatment could improve angina pectoris symptoms of patients with SAP and IPBS syndrome and its concurrent syndromes, and improve patients’ quality of life. Furthermore, the treatment is safe, has a long-term prognosis, and is worth further promotion and application in clinical practice.Clinical Trial Registrationhttps://www.chictr.org.cn/showprojEN.html?proj=235570, ChiCTR registry, ChiCTR1900023708.

Leveraging the cultural intelligence of sport employees in the globalized sports industry

PurposeIn the contemporary globalized sports industry, it is crucial for sport employees to cultivate an essential capability – cultural intelligence (CQ) – to excel in culturally diverse sport environments. The purpose of this study is to propose a comprehensive conceptual framework of sport employees' CQ for enhancing management practices in sport organizations.Design/methodology/approachBy conducting a thorough literature review of relevant business and sport management literature, this research offers a synopsis of CQ and advocates for the advancement of a developed conceptual framework for sport employees' CQ (CQ-SE).FindingsThe conceptual framework of CQ-SE is proposed to facilitate employees’ effective integration into diverse environments within sport organizations. This framework identifies predictors that enhance sport employees’ CQ, moderating factors to provide deeper insights into these relationships and outcomes at individual, group and organizational levels. We additionally elaborate on the anticipated benefits for stakeholders, given the services provided by sport practitioners.Originality/valueThis study is one of the initial endeavors to conceptualize the concept of CQ for sport employees. This study contributes to the literature on sport organizational culture and human resource management by emphasizing the pivotal role of sport employees’ CQ in promoting greater inclusivity in sport organizations. We encourage sport management researchers to explore the application of CQ in sport contexts and empirically test the relationships proposed in this framework.

The Role of Social Media in Promoting Inclusive Communication between the Non-Disabled and People with Disabilities through Accessibility Features

The study sought to establish whether social media can promote inclusive communication between people with disabilities and those without through accessible features in Saudi Arabia. Two areas of interest in the study were inclusivity and accessibility of social media features. People with disabilities must be included in the online space and have access to features that enable them to communicate easily. Social media communication can be sending a friend request, chatting, or responding to people's posts. The study engaged a self-report of 154 participants of varied levels of education and age groups, including gender, different provinces around the country, and the social media platforms they preferred. The descriptive and inferential analyses show that social media platforms can promote inclusive communication if accessible features are available. Accessible features include alt text, a simple user interface, hashtags, emoticons, and captions.

Evaluation of Neutrophil Gelatinase-Associated Lipocalin Levels in Children With Febrile Seizures: A Case-Control Study.

Febrile seizure (FS) is a common pediatric neurological disorder, which may be associated with hypoxia and kidney injury. We aimed to investigate serum levels of neutrophil gelatinase-associated lipocalin (NGAL) in children with FS. This case-control study included 50 children with FS, 50 febrile controls (FCs), and 50 healthy controls (HCs). We measured serum NGAL levels using a human enzyme-linked immunosorbent assay. Serum NGAL/creatinine values showed significant differences within and between study groups with the highest levels for the FS group (1382 ± 215), the middle for FCs (1133 ± 129), and the lowest for HCs (857 ± 97). None of the study participants had abnormal serum creatinine levels, and their values were comparable among the 3 study groups. In conclusion, children with FS may have increased serum NGAL levels despite normal serum creatinine, indicating that FS could contribute to subclinical renal injury without significant loss of excretory kidney function.

Effects of magnesium and potassium supplementation on insomnia and sleep hormones in patients with diabetes mellitus

ObjectivesDiabetes mellitus is a metabolic condition with hyperglycemia. Literature has shown a correlation between poor sleep quality and duration with an increased incidence of insomnia in diabetic individuals. The goal of this study was to determine the magnesium and potassium supplementation effect among diabetic individuals with insomnia.MethodsA randomized controlled trial (single blind) was conducted on 320 patients with diabetes; after 2 months of follow-up, 290 patients completed the trial. The Insomnia Severity Index (ISI) was used to assess the severity and duration of insomnia, before and after the trial. Tablets containing supplements were prepared: placebo (T1), magnesium (Mg, T2), potassium (K, T3), and a combination of Mg and K (T4). Melatonin and cortisol (sleep hormones) were measured from blood (serum) using an enzyme-linked immunosorbent assay (ELISA), before and after the trial.ResultsThe study included 93 (32.1%) male and 197 (67.9%) female participants. According to the analysis, there was a significant association between the treatment groups and ISI after the trial (post-trial), p = 0.0001. Analysis showed that there was significant association between pre- and post-serum cortisol levels in treatment groups 2, 3, and 4 (T2, T3, and T4) as p-values are 0.001, 0.001, and 0.001 respectively. Similar findings were observed for serum melatonin.ConclusionsThe study revealed that magnesium, potassium, and magnesium and potassium combined had a significant effect on serum cortisol and melatonin levels (sleep hormones). In addition, supplementation significantly decreased the severity of insomnia among patients with diabetes by improving sleep duration.

Syndemic vulnerability in Dutch urban cities: investigating health disparities and intersectionality

Abstract Background Syndemics, the clustering of health and social issues, disproportionately affect marginalized communities. While prior research indicates sex-specific variations in syndemic vulnerability, current research often overlooks other sociodemographic characteristics and their interaction. An intersectionality-informed syndemic approach could offer more insights into the mechanisms in syndemic suffering, providing a deeper understanding and identifying groups most affected by structural inequalities. Methods Our study focused on adult residents in Leiden and The Hague, the Netherlands, registered at different general practices. Using existing routine health data linked with Central Bureau for Statistics information, we included adults who were registered with a general practitioner in 2018 and 2019, had a minimum of two registered health conditions documented by their general practitioner, lived in Leiden or The Hague, and were at least 18 years old in 2018. Results A total of 43340 adults were included for analyses. Distinct health condition clusters were observed within sex and age groups. Women experiences a broader range of health issues, often characterized by mental and psychosomatic symptoms like mood/anxiety disorders and abdominal complaints. Conversely, men exhibited a higher prevalence of specific physical conditions, including hypertension, diabetes, and cardiovascular diseases. Conclusions The findings align with previous research, suggesting the importance of further exploration into the role of intersectionality in syndemics. Currently, we are investigating the foundations of these disparities, including interaction analyses and Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA). Using MAIHDA, we will examine the relationship between intersectionality and syndemic vulnerability, quantifying intersecting factors (sex, ethnicity, SES) and exploring their impact at individual and group levels. Key messages • Understanding intersectionality in health disparities is crucial for addressing syndemic vulnerabilities. • Tailored interventions informed by intersectionality may promote equitable health outcomes.

Associations of Cardiac myosin binding protein C to Troponin I in patients with chronic heart failure during exercise. A substudy of the SMARTEX-HF trial

Abstract Aim Cardiac myosin binding protein C (cMyC) has shown promise being more sensitive than cardiac troponins, rising faster after myocardial infarction[i]. Its association to hs-cTnI in heart failure patients during physical activity is not known. The aim of this study was to assess the association between a novel biomarker: cMyC and the clinically used high sensitivity cardiac Troponin I (hs-cTnI) during a 12-week exercise training program in patients with chronic symptomatic heart failure with reduced ejection fraction (HFrEF). The changes of biomarkers in plasma levels in an intervention group, performing structured exercise programs, were compared to those in a control group, instructed to perform regular recommended exercise (RRE) according to current guidelines. Methods and results This was a post hoc analysis of the SMARTEX-HF trial in 215 patients with symptomatic heart failure (HF) with Left Ventricular Ejection Fraction (LVEF) &amp;lt;35% and NYHA II-III. The patients were randomly assigned to High Intensity Interval Training (HIIT, n=77), Moderate Continuous Training (MCT, n=65) or RRE, (n=73) for 12 weeks. Measurements and clinical data were acquired before and after the 12-week intervention. In 191 patients, plasma was available for hs-cTnI testing and in 189 patients plasma was available for cMyC testing. Due to the lack of a normal distribution, the values were log transformed. There was a significant association of change in log hs-cTnI and change in log cMyC (Pearson correlation R=0.52 (95% CI 0.37- 0.66) p&amp;lt;0.001) (Figure 1). For any 10% increase in cMyC level, the ratio of the hs-cTnI level increased with approximately 5% (Figure 2). There was no association between the levels of cMyC at baseline and change in hs-cTnI at 12 weeks. Conclusion Changes in levels of the novel biomarker cMyC was significantly associated with hs-cTnI plasma levels in patients with symptomatic chronic HFrEF during a structured 12 week exercise training program. Being more sensitive, it may indicate a role as a future marker of subclinical myocardial damage.Models with adjustmentsMarginal effect at the mean