Meaningful Definition Research Articles

Optimised Skeletal Muscle Mass as a Key Strategy for Obesity Management

The ‘Body Mass Index’ (BMI) is an anachronistic and outdated ratio that is used as an internationally accepted diagnostic criterion for obesity, and to prioritise, stratify, and outcome-assess its management options. On an individual level, the BMI has the potential to mislead, including inaccuracies in cardiovascular risk assessment. Furthermore, the BMI places excessive emphasis on a reduction in overall body weight (rather than optimised body composition) and contributes towards a misunderstanding of the quiddity of obesity and a dispassionate societal perspective and response to the global obesity problem. The overall objective of this review is to provide an overview of obesity that transitions away from the BMI and towards a novel vista: viewing obesity from the perspective of the skeletal muscle (SM). We resurrect the SM as a tissue hidden in plain sight and provide an overview of the key role that the SM plays in influencing metabolic health and efficiency. We discuss the complex interlinks between the SM and the adipose tissue (AT) through key myokines and adipokines, and argue that rather than two separate tissues, the SM and AT should be considered as a single entity: the ‘Adipo–Muscle Axis’. We discuss the vicious circle of sarcopenic obesity, in which aging- and obesity-related decline in SM mass contributes to a worsened metabolic status and insulin resistance, which in turn further compounds SM mass and function. We provide an overview of the approaches that can mitigate against the decline in SM mass in the context of negative energy balance, including the optimisation of dietary protein intake and resistance physical exercises, and of novel molecules in development that target the SM, which will play an important role in the future management of obesity. Finally, we argue that the Adipo–Muscle Ratio (AMR) would provide a more clinically meaningful descriptor and definition of obesity than the BMI and would help to shift our focus regarding its effective management away from merely inducing weight loss and towards optimising the AMR with proper attention to the maintenance and augmentation of SM mass and function.

Should the Definition of Low Birth Weight Be Same in Every Ethnicity Considering the DOHaD Concept?

Low birth weight (LBW) is a significant concern not only because of its association with perinatal outcomes, but also because of its long-term impact on future health. Despite the physical differences among individuals of different ethnicities, the definition of LBW remains the same for all ethnicities. This study aimed to explore and discuss this issue. We compiled national data from several countries and found that maternal height was negatively correlated with LBW incidence. We discovered the INTERGROWTH-21st chart may not be suitable for the Japanese population, as the Japanese birth weight chart differs from the INTERGROWTH-21st chart. Researchers have reported different LBW cutoff values used to assess adverse perinatal outcomes for different countries. However, there is currently no definition of LBW independent of the mother's country of origin that can be used for predicting the risk of adverse health outcomes. Therefore, the current era of personalized healthcare may be the perfect time to establish a standard definition of LBW which is independent of the mother's country of origin. Considering the future of healthcare, it seems an apt time to discuss the development of a more meaningful definition of LBW that can be applied across ethnicities. Further research is needed to investigate the cutoff values of LBW in every ethnicity.

Exploring the Potential of Electronic Patient-Generated Health Data for Evaluating Treatment Response to Intramuscular Steroids in Rheumatoid Arthritis: Case Series.

Mobile health devices are increasingly available, presenting exciting opportunities to remotely collect high-frequency, electronic patient-generated health data (ePGHD). This novel data type may provide detailed insights into disease activity outside usual clinical settings. Assessing treatment responses, which can be hampered by the infrequency of appointments and recall bias, is a promising, novel application of ePGHD. Drugs with short treatment effects, such as intramuscular steroid injections, illustrate the challenge, as patients are unlikely to accurately recall treatment responses at follow-ups, which often occur several months later. Retrospective assessment means that responses may be over- or underestimated. High-frequency ePGHD, such as daily, app-collected, patient-reported symptoms between clinic appointments, may bridge this gap. However, the potential of ePGHD remains untapped due to the absence of established definitions for treatment response using ePGHD or established methodological approaches for analyzing this type of data. This study aims to explore the feasibility of evaluating treatment responses to intramuscular steroid therapy in a case series of patients with rheumatoid arthritis tracking daily symptoms using a smartphone app. We report a case series of patients who collected ePGHD through the REmote Monitoring Of Rheumatoid Arthritis (REMORA) smartphone app for daily remote symptom tracking. Symptoms were tracked on a 0-10 scale. We described the patients' longitudinal pain scores before and after intramuscular steroid injections. The baseline pain score was calculated as the mean pain score in the 10 days prior to the injection. This was compared to the pain scores in the days following the injection. "Response" was defined as any improvement from the baseline score on the first day following the injection. The response end time was defined as the first date when the pain score exceeded the pre-steroid baseline. We included 6 patients who, between them, received 9 steroid injections. Average pre-injection pain scores ranged from 3.3 to 9.3. Using our definitions, 7 injections demonstrated a response. Among the responders, the duration of response ranged from 1 to 54 days (median 9, IQR 7-41), average pain score improvement ranged from 0.1 to 5.3 (median 3.3, IQR 2.2-4.0), and maximum pain score improvement ranged from 0.1 to 7.0 (median 4.3, IQR 1.7 to 6.0). This case series demonstrates the feasibility of using ePGHD to evaluate treatment response and is an important exploratory step toward developing more robust methodological approaches for analysis of this novel data type. Issues highlighted by our analysis include the importance of accounting for one-off data points, varying response start times, and confounders such as other medications. Future analysis of ePGHD across a larger population is required to address issues highlighted by our analysis and to develop meaningful consensus definitions for treatment response in time-series data.

Treatment Classification by Intent in Oncology-The Need for Meaningful Definitions: Curative, Palliative and Potentially Life-Prolonging.

Realistic cancer treatment goals should be used by health care professionals and communicated to patients, families, and the public. The current nomenclature on this subject is outdated and has not been changed since the advent of modern oncology in the middle of the 20th century. Based on the literature we propose a three-tier system composed of curative, palliative, and potentially life-prolonging (PLP) therapies, instead of the current two-tier system of only curative and palliative treatment. The new system introduces the notion of prolonged survival. Furthermore, the negative connotation linked to palliative care is also eliminated in this setting. The current terminology used to describe cancer treatment goals has not been updated since the mid-20th century and it is time for a more modern approach. We propose a three-tier system: (1) curative treatment, (2) palliative care, and (3) potentially life-prolonging therapy.

‘Sattelzeit’: the invention of ‘premodern history’ in the 1970s

ABSTRACT In her historicisation of the concept of the ‘Sattelzeit,’ Julia Angster argues that the term does not represent a meaningful definition of a specific historical epoch. Instead, it serves as source material for analysing the notions of West German historians during the 1970s. Although their conception of the ‘Sattelzeit’ built on the work of R. Koselleck, it simplifies his concept by transforming an analytical tool of conceptual history into a starting point for social history. It enabled the conception of the Western world, understood as the epitome of ‘modernity’, as a counterpart to a non-modern other. This, in turn, was influenced by modernisation theories developed by US sociology in the 1950s, ultimately aimed at guiding US policies in the ‘development’ of the ‘Third World’. Modernity thus became a political goal and a result of economic development, to be perceived in the European past as well as in the present of the ‘developing world’. In the 1970s, this understanding of ‘modernity’ was crucial for West German historiography and politics, both trying to inscribe themselves into the modern world of the West.

An exploration of clinically meaningful definitions of cough bouts.

The measurement of cough frequency is widely used in clinical trials, typically expressed as the number of explosive cough sounds per hour. However, this measure does not capture the clustering of coughs into bouts. Coughing bouts contribute to perceived cough severity and the physical complications of coughing, but an agreed standard definition of cough bouts is lacking. The objectives of the present study were to explore the impact of different definitions of cough bouts on the parameters generated, their relationships with reported cough severity and influence of age and gender in refractory chronic cough (RCC). We analysed 24-h acoustic recordings and concurrent cough severity visual analogue scales from 91 RCC patients (62% female, median (interquartile range) age 60.0 (54-67.0) years). A custom-built algorithm calculated cough bouts, defined by the intervals between explosive cough sounds. Bouts defined by inter-cough intervals from ≤0.5 to ≤10 s (0.5 s increments) were explored, and parameters including number of bouts, median/maximum bout length and total bout duration calculated. Using inter-cough intervals of >3 s to define cough bouts made little difference to cough bout parameters. Correlations between cough severity and bout parameters were weak but most likely to be significant when single coughs were removed. Cough-free time/total time spent coughing tended to have more influence on cough severity than the average cough bout length, irrespective of the interval used. These analyses favour definitions of cough bouts utilising inter-cough intervals of ≤3 s and the exclusion of single coughs from cough bout analysis.

Wet markets in Southeast Asia and access to healthy diets

Hunger and malnutrition in all forms continues to rise in Africa and Asia. Urban and rural communities’ diets in Southeast Asia (SEA) are increasingly unhealthy, with consumption influenced by affordability and convenience. The cost of a healthy diet is a major barrier to accessing healthy foods in SEA. Wet markets are key places in food environments where people buy and sell a variety of foods. They are especially important for food and nutrition insecure communities. This mini narrative review explores the role that wet markets, in SEA food environments, play in providing local communities with access to healthy foods. Fourteen peer-review papers, published in English between 2017 and 2022, were identified during screening and analysed according to six food environment domains. Findings highlight that convenient access to wet markets facilitates access to fruits and vegetables in peri urban and urban areas. Fresh foods, most notably fruits, were viewed as being more expensive than processed foods which in turn influenced purchasing behavior. Divergent findings were presented in the identified papers regarding affordability of food in wet markets. Concerns about food quality and the use of chemicals and pesticides were raised. This review was constrained by several factors including the lack of consistent and meaningful definitions and typologies of the varied forms of wet markets. Looking ahead, better defined interpretations of wet markets can enhance the development and refinement of appropriate policies and actions and comparison of wet markets, in respect of access to diverse, healthy foods, vendor practices and consumer food choices.

Saltation Diffusion Penetration: A New Measure of Specific Politico-Economic and Military Relations

At every stage of human existence, the security environment has been marked by various challenges and processes that have passed through the course of its history. The development of societies, changes in socio-economic conditions, technological progress, political and ideological trends also determined the change in the security environment. The unprecedented military, political, economic and ideological confrontation of the Cold War period, as well as the current extremely complex situation in the world, are causing new dynamics in the security environment. New challenges have emerged for world order and security – terrorism and extremism, military and non-military conflicts, economic and political destabilization, ethnic and religious tensions, cyber wars and many more. etc., risks and threats that have a strong negative impact on the social sustainability of our planet. The lack of clear rules for political and economic behavior and the growth of confrontation in international relations have led to a total disorientation of the global modern social system. Dominant in this direction are not only current wars and permanent threats from local and global conflict situations, but also unconventional technologies, methods and means of influence in the internal political life of states. Scientific and expert literature temporarily imposed a new terminological apparatus, with which to name the various processes, phenomena and operations with a markedly political and military character. Despite the existence of this terminological diversity, however, in the last few years there has been a need to fill the "gap" in understanding their nature and metrics. The need for a new meaningful definition of the specific political-economic, technological and social decisions and consequences appeared mostly in social practice. In this regard, in this report we will consider a new measure of specific politico-economic and military relations, which we have called “Striking Diffuse Penetration” (SDP) or Public Diffuse Entropy (PDE). Regardless of the fact that these two definitions, we propose a third linguistic construction that unites the first two and name the following expression form Saltation Diffusion Penetration.

THE SPECIFICS OF USING THE PROFESSIONAL LANGUAGE OF MANAGEMENT

The article examines the problems of the formation and development of the professional language of management. The position on the need for research and practical implementation of system categories, concepts, and mechanisms of the professional management language is presented. It is proposed that the features of the professional language of management be determined. Features and strategic directions for the development of this process are determined. The critical parameters of the formation and development of the terminological series of the professional language of management are analyzed. Particular attention is paid to considering the semantic dynamics of the formation process and the practical use of specific terms and phrases that characterize the professional management system. The importance of innovative dynamics in the system of personnel policy and knowledge of the terminology of management processes is shown. The objective necessity of fundamental and innovative training of managers is determined as a basis for their orientation towards the systematic development of the managerial profession. Approaches to the implementation of meaningful definitions of the management process are considered. The need to transform the professional qualities of management personnel with an emphasis on the peculiarities of the terminological series of the professional language of management is proven. Attention is focused on the need to develop socio-cultural indicators of management professionalization. The basic principles of using the professional management language are determined, and the need for their practical implementation is proved. The position on the role of the managerial elite in developing an innovative society is presented. Attention is focused on developing the process of professionalization of organizational activity in Ukraine and defining the basic principles of using the professional language of management.

High-risk multiple myeloma: Redefining genetic, clinical, and functional high-risk disease in the era of molecular medicine and immunotherapy.

Multiple myeloma (MM) exhibits significant heterogeneity in its presentation, genetics, and treatment response. Despite therapeutic advances, some patients continue to relapse early (ER, <18-months) and rapidly cycle through therapies. Myriad prognostic factors have been identified and incorporated into risk stratification models; however, these produce discordant, often three-tiered outputs that fail to identify many patients destined for ER. Treatment strategies are increasingly focused on disease biology and trials enriched for high-risk (HR)MM, but consensus on the minimum required testing and a succinct, specific, and clinically meaningful definition for HRMM remains elusive. We review the risk-factors, definitions, and future directions for HRMM.

Definition of Polypharmacy in Heart Failure: A Scoping Review of the Literature.

Patients with heart failure (HF) have a high prevalence of polypharmacy, which can lead to drug interactions, cognitive impairment, and medication non-compliance. However, the definition of polypharmacy in these patients is still inconsistent. The aim of this scoping review was to find the most common definition of polypharmacy in HF patients. We conducted a scoping review searching Medline, Embase, CINAHL, and Cochrane using terms including polypharmacy, HF and deprescribing, which resulted in 7,949 articles. Articles without a definition of polypharmacy in HF patients and articles which included patients < 18 years of age were excluded; only 59 articles were included. Of the 59 articles, 49% (n = 29) were retrospective, 20% (n = 12) were prospective, 10% (n = 6) were cross-sectional, and 27% (n = 16) were review articles. Twenty percent (n = 12) of the articles focused on HF with reduced ejection fraction, 10% (n = 6) focused on HF with preserved ejection fraction and 69% (n = 41) articles either focused on both diagnoses or did not clarify the specific type of HF. The most common cutoff for polypharmacy in HF was five medications (59%, n = 35). There was no consensus regarding the inclusion or exclusion of over-the-counter medications, supplements, or vitamins. Some newer studies used a cutoff of 10 medications (14%, n = 8), and this may be a more practical and meaningful definition for HF patients.

Strategic management of intellectual property for technology as an object of civil law relations

Strategic management of intellectual property for technology as an object of civil law relations

Full employment and working future

AbstractWorking Nation is not the radical break with the existing policy framework implied by Albanese’s pre-election rhetoric. However, restoring a meaningful definition of full employment as an objective of government policy is a step in the right direction.

Augmented reality in higher school as a tool for implementation of STEM education

Augmented reality in higher school as a tool for implementation of STEM education

Augmented reality in higher school as a tool for implementation of STEM education

The article provides a meaningful definition of the concepts of STEM technology, STEM education, STEM approach, and STEM training; the meaning and main ways of using elements of augmented and virtual reality for higher education as a means of implementing STEM education are revealed. The purpose of the article is to show the importance and necessity of using elements of augmented reality in higher education as a means of implementing STEM education. As a result, an experimental study was conducted to clarify the state of development and the use of modern innovative technologies in education, clarifying the question – of to what extent modern technologies can effectively organize distance learning, and STEM education in higher education when using elements of augmented reality, which are provided to messengers preference of educators, which platforms are used by teachers in working with students of higher education during quarantine, etc. The conclusions summarize the most effective modern technologies for preparing and conducting practical online classes in higher education as a means of implementing STEM education and highlight the most important condition for creating a STEM environment in higher education.

Prevalence, mortality, and aetiology of paediatric shock in a tertiary hospital in Malawi: A cohort study.

Shock is considered one of the most important mechanisms of critical illness in children. However, data on paediatric shock in sub-Saharan Africa is limited, which constrains development of effective treatment strategies. We aimed to describe the prevalence, mortality, and aetiology of paediatric shock in a tertiary hospital in Malawi. Children aged two months to 16 years presenting with shock (FEAST criteria; respiratory distress and/or impaired consciousness, and at least one sign of impaired circulation; capillary refill>3 seconds, cold extremities, weak pulse, or severe tachycardia) to the emergency department were included and followed-up prospectively using routinely collected data between February 2019 and January 2020. Prevalence, mortality and aetiology of shock were reported for both the FEAST criteria and World Health Organization (WHO) definition. The association between aetiology and mortality was assessed with univariable analysis. Of all screened admissions (N = 12,840), 679 (5.3%) children presented with shock using FEAST criteria and the mortality was 79/663 (11.9%). WHO-defined shock applied to 16/12,840 (0.1%) and the mortality was 9/15 (60.0%). Main diagnoses were viral/reactive airway diseases (40.4%), severe pneumonia (14.3%), gastroenteritis (11.3%) and presumed sepsis (5.7%). Children diagnosed with presumed sepsis and gastroenteritis had the highest odds of dying (OR 11.3; 95%-CI:4.9-25.8 and OR 4.4; 95%-CI:2.4-8.2). Considering the high mortality, prevalence of paediatric shock (FEAST and WHO definitions) in Malawi is high. Sepsis and gastroenteritis are diagnoses associated with poor outcome in these children. Consensus on a clinical meaningful definition for paediatric shock is essential to boost future studies.

Equivalence testing for multiple groups

SummaryTesting for equivalence, rather than testing for a difference, is an important component of some scientific studies. While the focus of the existing literature is on comparing two groups for equivalence, real‐world applications arise regularly that require testing across more than two groups. This paper reviews the existing approaches for testing across multiple groups and proposes a novel framework for multigroup equivalence testing under a Bayesian paradigm. This approach allows for a more scientifically meaningful definition of the equivalence margin and a more powerful test than the few existing alternatives. This approach also allows a new definition of equivalence based on future differences.

Measuring structural nonstationarity: The use of imaging information to quantify homogeneity and inhomogeneity.

Heterogeneity is the concept we encounter in numerous research areas and everyday life. While "not mixing apples and oranges" is easy to grasp, a more quantitative approach to such segregation is not always readily available. Consider the problem from a different angle: To what extent does one have to make apples more orange and oranges more "apple-shaped" to put them into the same basket (according to their appearance alone)? This question highlights the central problem of the blurred interface between heterogeneous and homogeneous, which also depends on the metrics used for its identification. This work uncovers the physics of structural stationarity quantification, based on correlation functions (CFs) and clustering based on CFs different between image subregions. By applying the methodology to a wide variety of synthetic and real images of binary porous media, we confirmed computationally that only periodically unit-celled structures and images produced by stationary processes with resolutions close to infinity are strictly stationary. Natural structures without recurring unit cells are only weakly stationary. We established a physically meaningful definition for these stationarity types and their distinction from nonstationarity. In addition, the importance of information content of the chosen metrics is highlighted and discussed. We believe the methodology as proposed in this contribution will find its way into numerous research areas dealing with materials, structures, and measurements and modeling based on structural imaging information.

What explains the well-being benefits of physical activity? A mixed-methods analysis of the roles of participation frequency and social identification

ObjectivePhysical activity in a social setting is said to be associated with well-being because it provides opportunities for participants to form social relationships. However, there are inconsistent findings regarding the well-being benefits of participating in physical activity with others. To address this inconclusive evidence, we draw on the social identity approach to health and well-being to examine whether (a) the frequency of physical activity participation in a social setting and (b) the degree of social identification associated with it, have different relationships with participants’ well-being. MethodsWe implemented a two-phase, mixed-methods design with members of women's only fitness clubs in Japan. In Study 1, we collected survey responses about social identification, life satisfaction, and eudaimonic well-being from 1118 members. The survey data were combined with respondents' objective participation data from a membership database. In Study 2, we interviewed a sample of club members to understand how the nature of social relationships differed depending on the degree of their social identification. ResultsStudy 1 found that social identification with a fitness club, but not the frequency of attending the club for physical activity, was positively associated with members’ well-being. Study 2 revealed that members with high social identification experienced more affective relationships with other members than those with medium or low identification. ConclusionsOur research provides quantitative and qualitative evidence supporting the association between social identification and the well-being benefits of physical activity in a social setting. It confirms the predictions of the social identity approach to health and well-being, demonstrating that people enjoy well-being benefits from physical activity participation when it is internalized as a meaningful definition of self.

Quantifying impact-relevant heatwave durations

Heatwaves are weather hazards that can influence societal and natural systems. Recently, heatwaves have increased in frequency, duration, and intensity, and this trend is projected to continue as a consequence of climate change. The study of heatwaves is hampered by the lack of a common definition, which limits comparability between studies. This applies in particular to the considered time scale for utilised metrics. Here, we study which durations of heatwaves are most impact-relevant for various types of impacts. For this purpose, we analyse societal metrics related to health (heat-related hospitalisations, mortality) and public attention (Google trends, news articles) in Germany. Country-averaged temperatures are calculated for the period of 2010–2019 and the warmest periods of all time scales between 1 and 90 days are selected. Then, we assess and compare the societal response during those periods to identify the heatwave durations with the most pronounced impacts. Note that these durations are based on average temperatures across the given time frame while individual days may be less warm. The results differ slightly between the considered societal metrics but indicate overall that heatwaves induce the strongest societal response at durations between 2 weeks and 2 months for Germany. Finally, we show that heatwave duration affects the societal response independent of, and additionally to, heatwave temperatures. This finding highlights the relevance of making informed choices on the considered time scale in heatwave analyses. The approach we introduce here can be extended to other societal indices, countries, and hazard types to reveal more meaningful definitions of climate extremes to guide future research on these events.