Search Results (102)

Objectives: Diabetes Mellitus involves demanding challenges that interfere with family functioning and routines. In turn, family and social context impacts individual glycemic control. This study aims to identify this recursive interplay, the mutual influences of family systems and diabetes management. Design: Data was collected through a cross-sectional design comparing patients, aged 22–55, with and without metabolic control. Methods: Participants filled out a set of self-report measures of sociodemographic, clinical and family systems assessment. Patients (91) were also invited to describe their perception about disease management interference regarding family functioning. We first examined the extent to which family variables grouped dataset to determine if there were similarities and dissimilarities that fit with our initial diabetic groups’ classification. Results: Cluster analysis results identify a two-cluster solution validating initial classification of two groups of patients: 49 with metabolic control (MC) and 42 without metabolic control (NoMC). Independent sample tests suggested statistically significant differences between groups in family subscales- family difficulties and family communication (p < 0.05). Binary logistic regression shed light on predictors of explained variance to no metabolic control, in four models: Sociodemographic, Clinical data, SCORE-15/Congruence Scale and Eating Behavior. Furthermore, groups differ on family support, level and sources of family conflict caused by diabetes management issues. Considering only patients who co-habit with a partner for more than one year (N = 44), NoMC patients score lower on marital functioning in all categories (p < 0.05). Discussion: Family-Chronic illness interaction plays a significant role in a patient’s adherence to treatment. This study highlights the Standards of Medical Care for Diabetes, considering caregivers and family members on diabetes care. Full article

Background: A growing body of evidence suggests that diet can modify Parkinson’s disease (PD) outcomes, although there is disagreement about what should be included and excluded in such a diet. Existing evidence suggests that adherence to the MIND and Mediterranean (MEDI) diets are associated with reduced PD symptoms, but only a few variables from the adherence scales are responsible for the statistically observed improvement. Objectives: The goal was to use patient-reported outcomes in a large cohort to identify the foods and dietary patterns (PRO diet) most strongly associated with the fewest PD symptoms over time, and to develop a composite adherence scale to enable comparisons between MEDI, MIND, and PRO. Methods: Data were obtained from the prospective longitudinal natural history study and from Modifiable Variables in Parkinsonism (MVP)—a study designed to identify behaviors associated with patient-reported outcomes (PRO-PD). Upon the completion of the binary and food frequency data collection, using various predictive models and considering congruence with historical data, the PRO diet was created via an iterative process. Our goal was to create a new scale and compare its performance to the existing MIND and MEDI scores. The comparison was made at baseline, using the regression models for PRO-PD and the different scales as the predictors. The models were compared via the Akaike Information Criterion (AIC). To examine whether baseline adherence levels predicted subsequent symptom trajectories, the baseline PRO diet adherence and subsequent slope of progression were evaluated. Results: Data from 2290 individuals with PD were available for this analysis. The Mediterranean and MIND diets showed almost identical effects. For both the diets, the effect they had on non-motor symptoms was about twice the effect on motor symptoms. The slopes for the total PRO-PD for MEDI, MIND, and PRO-21 were −64.20467, −64.04220, and −28.61995, respectively. The AIC value differences were substantial (>2), indicating meaningful improvements in the model fit for total PRO-PD, as follows: MEDI: 28,897.24, MIND: 28,793.08, and PRO-21: 27,500.71. The subset of individuals who were most adherent to the PRO-21 diet at baseline had the slowest subsequent progression, as measured by a 43% reduced PRO-PD slope, compared to the less adherent groups. Conclusions: The PRO-21 outperformed the MIND and MEDI diets in the model fit, overcoming the ceiling effects and showing orders of magnitude and superior explanatory power for variance in PD outcomes, despite the smaller per-unit effect sizes. However, its rigorous demands may introduce barriers related to cost, feasibility, and sustainability, underscoring the need for future intervention trials to assess real-world feasibility, adherence, side effects, and clinical impact. Full article

This paper seeks to test the explanatory potential of different sociological perspectives in relation to the development of new sport models that reflect the growth of leisure sport participation in urban outdoor places and the decline in traditional practices in associations and clubs. In this regard, this study employs an analytical framework to examine global trends, with a particular focus on the specific context of the municipality of Zaragoza (Spain). With a multi-method approach, a 10-year-period dataset (2009–2019) incorporating sport participation surveys, observational data, and a focus group study is analysed. Three theories are tested: Maffesoli’s neo-tribes; neo-Bourdieuian ideas about urban subcultures; and Elias’s theory of civilizing processes. The results show a congruence between the three theories regarding identity negotiation, commodification, and community sense. However, disparities were found between the three theories, with one or more of them exhibiting an absence of class consciousness that supports subcultural interpretation and distinct notions of change versus continuity of the analyzed phenomena. This paper concludes that recent sports participation trends are best explained with reference to the quest of excitement and using healthism as a dominant ideology or social imperative. Full article

This paper proposes a sustainable innovation management model (hereinafter MGI) aimed at enhancing sustainability and leveraging open innovation opportunities within the Citrus agro-industrial chain in the Quindío Department, Colombia. The methodology combines surveys, consensus percentages, relevance and congruence indices, and a review of the literature from the last ten years, particularly in the Google Scholar and Scopus databases. A total of 97 documents directly related to innovation management in the citrus sector were reviewed, along with 58 indirect references. Through three questionnaires, 120 variables were identified, categorized into input (53), transformation (36), and output (31) stages. The findings, supported by sector analysis and foresight studies conducted for six regional agro-industrial chains, led to the development of three potential MGI models, one of which was selected for further application. The study highlights several challenges within the citrus value chain, including weak leadership, limited market competitiveness, outdated organizational structures, slow adoption of advanced technologies, and inadequate investment. The proposed MGI, with a focus on sustainable innovation, offers a generic interactive model that presents a dynamic and adaptable solution to drive competitiveness and value creation in the citrus sector. The chain studied requires not only the participation of different interest groups, but also the application of artificial intelligence to close the gaps and allow for sustainable innovation to be generated of sustainable innovation. Full article

Background/Objectives: Frailty screening is crucial for identifying vulnerable older adults who may benefit from interventions. However, the implementation of screening in primary care and integration into personalised care pathways remains limited. This study examined the feasibility of a two-step frailty screening approach combining PRISMA-7 and the Clinical Frailty Scale (CFS). The study assessed PRISMA-7 cut-offs’ impact on frailty classification, CFS agreement, and activation of integrated domiciliary care. Methods: This cross-sectional study was conducted in Northern Italy. General practitioners screened patients aged ≥75 years using the PRISMA-7 tool; if the result was positive (score ≥ 3), the Clinical Frailty Scale (CFS) was subsequently applied. Descriptive statistics, group comparisons, correlation analyses, and logistic regression models were employed to evaluate the predictors of frailty and activation of integrated domiciliary care. Comparisons were made for PRISMA-7 cut-off values ≥3 and ≥4. Results: Among the 18,658 patients evaluated using PRISMA-7, 46.0% were identified as frail with a threshold of ≥3 and 28.8% with ≥4. In a subset of 7970 patients assessed using both PRISMA-7 and the Clinical Frailty Scale (CFS), CFS confirmed frailty (score ≥ 5) in 48.3% of the patients at a PRISMA-7 cut-off of three and 68.2% at a cut-off of four. The female sex predicted frailty by CFS, whereas the male sex was correlated with frailty at the PRISMA-7 cut-off of three. Rural location was correlated with frailty by PRISMA-7 but showed an inverse relationship with frailty by CFS. Integrated domiciliary care began in 14.2% of the patients meeting the clinical criteria, with a higher frequency in rural areas. Concordance between PRISMA-7 and CFS increased with patient age, and at a cut-off of four. Conclusions: Two-step frailty screening using PRISMA-7 and CFS is viable for primary care. Using a PRISMA-7 cut-off score of ≥4 may reduce frailty overestimation, enhance congruence with clinical assessments, and reduce sex-related bias. These findings support incorporating structured screening into personalised care planning and refining frailty tools to improve equity and effectiveness. Full article

Introduction: Elbow primary stability is guaranteed by the anatomical congruency between the humeral trochlea and the greater sigmoid notch (GSN). Elbow dislocation typically occurs in a semi-extended position, but computed tomography (CT) scans are typically acquired at 90° of elbow flexion, which may misleadingly suggest that the apex of the coronoid aligns with the trochlear center of rotation. This study aims to evaluate the anatomical features of the coronoid and GSN in a dislocated versus non-dislocated group, demonstrating that a more prominent coronoid process is more commonly observed in elbows without dislocation compared to those with dislocation. Materials and Methods: A total of 50 CT scans, equally divided between dislocated elbows and non-dislocated elbows, were analyzed, and the critical coronoid angle (CCA) was measured on a specific slice of the CT scan (level of evidence III). The CCA was calculated from two lines that arise in the center of the GSN, with the first one crossing the coronoid tip and the second parallel to the posterior olecranon cortex. Results: A significant difference in the CCA (p < 0.001) between the two groups was highlighted. In particular, it was found that 14/25 patients from the dislocated elbow group had a CCA below or equal to 27°, and all the non-dislocated subjects had a CCA ≥ 27°. These preliminary results suggest that a CCA ≤ 27° could be a threshold for requiring further imaging of soft tissues or closer follow-up. This may result from either a hypoplastic coronoid process or a decreased concavity of the GSN. Based on the CCA values, a logistic regression model (DAM model) was proposed to associate a coefficient of protection to the CCA, the angle of flexion during dislocation (FdD), and a parameter X, which is a factor that encompasses the contribution of soft tissues. Conclusions: A low CCA is statistically more frequent in dislocated elbows versus non-dislocated ones, creating a specific anatomical condition. The CCA should be carefully evaluated by elbow surgeons to guide patient-specific treatment. The DAM model can permit the stratification of patients eligible for further diagnostic analysis. Full article

Background and Objectives: Total knee arthroplasty (TKA) is one of the most common medical procedures worldwide. However, 10 to 20% of patients are still dissatisfied despite implants and surgical technique advancements. Recently, several medial-stabilized TKAs have been developed in attempts to replicate the native kinematics of the knee. The aim of this scoping review on medial-stabilized TKA inserts—medial congruent (MC) and medial pivot (MP)—is to focus on their clinical outcomes and the role of the posterior cruciate ligament (PCL), aiming to systematically map the existing research and highlight current knowledge gaps. Materials and Methods: A search of the PubMed, Embase and Cochrane databases was performed to identify relevant studies on the kinematics and outcomes of medial pivot (MP) or medial congruent (MC) inserts. The following Mesh terms were used in combination with the Boolean operators “AND” and “OR”: “total knee arthroplasty”, “total knee replacement”, “medial pivot”, “medial congruence”, “outcomes” and “kinematic”. Original studies reporting on clinical outcomes assessed with validated patient-reported scales, surgical techniques and reoperation rates for any reason with a minimum follow-up of 18 months were included. Results: A total of 39 articles met the inclusion criteria, accounting for 6143 total knee replacements. The overall reoperation-free survivorship rate was 98.4% (6047 out of 6143 knees) at a weighted average follow-up of 6.3 years (range 1.5–15.2 years, SD 0.7). Both MP and MC inserts demonstrated good outcomes, with no differences between groups. Few studies evaluated the role of the PCL in MP and MC inserts, with no differences in terms of clinical outcomes between retaining and sacrificing the PCL. Conclusions: MS-TKA demonstrated good outcomes in the literature independently of the specific design (medial pivot or medial congruent). Different possible biases may be present when evaluating the outcomes of these inserts, including different types of alignment and soft tissue balancing philosophies. Full article

The promotion of critical thinking has become a key objective for educational institutions worldwide. In this context, it is essential to continue researching and promoting pedagogical strategies that favor its development. This study aims to explore academics’ perceptions of the characteristics of their academic units that could facilitate the development of critical thinking, as well as students’ perceptions of their own critical thinking skills, their levels of satisfaction, and the learning outcomes achieved. To achieve this objective, questionnaires were administered to 31 academics and 150 students at a Chilean university. The results revealed that, although academics assigned high scores to the three dimensions evaluated (gender diversity, academic preparation, and value congruence), when analyzing the data disaggregated by gender and school, significant differences in their perceptions emerged. On the other hand, in the case of students, the items related to facilities and equipment (satisfaction dimension) obtained the lowest scores. Likewise, no direct and uniform relationship was identified between the characteristics of academics and the development of critical thinking when grouping the data by school. Finally, a strong and significant correlation was observed between satisfaction, learning outcomes, and students’ perceived critical thinking skills. Several recommendations are presented to address the identified issues. Full article

The living gymnosperms include about 1200 species in five major groups: cycads, ginkgo, gnetophytes, Pinaceae (conifers I), and cupressophytes (conifers II). Molecular phylogenetic studies have yet to reach a unanimously agreed-upon relationship among them. Moreover, cytonuclear phylogenetic incongruence has been repeatedly observed in gymnosperms. We collated a comprehensive dataset from available genomes of 17 gymnosperms across the five major groups and added our own high-quality assembly of a species from Podocarpaceae (the second largest conifer family) to increase sampling width. We used these data to infer reconciled nuclear species phylogenies using two separate methods to ensure the robustness of our conclusions. We also reconstructed organelle phylogenomic trees from 42 mitochondrial and 82 plastid genes from 38 and 289 gymnosperm species across the five major groups, respectively. Our nuclear phylogeny consistently recovers the Ginkgo–cycads clade as the first lineage split from other gymnosperm clades and the Pinaceae as sister to gnetophytes (the Gnepines hypothesis). In contrast, the mitochondrial tree places cycads as the earliest lineage in gymnosperms and gnetophytes as sister to cupressophytes (the Gnecup hypothesis) while the plastomic tree supports the Ginkgo–cycads clade and gnetophytes as the sister to cupressophytes. We also examined the effect of mitochondrial RNA editing sites on the gymnosperm phylogeny by manipulating the nucleotide and amino acid sequences at these sites. Only complete removal of editing sites has an effect on phylogenetic inference, leading to a closer congruence between mitogenomic and nuclear phylogenies. This suggests that RNA editing sites carry a phylogenetic signal with distinct evolutionary traits. Full article

Background/Objectives: Improving food safety practices among young adults is critical to public health, but effective communication strategies are under-researched. This study investigated the effectiveness of a 12-day message-based intervention to promote safe food handling practices using a randomised controlled trial. Methods: A total of 588 participants (aged 18 to 35 years) were randomly assigned to one of four experimental conditions or to a control group. Participants in the intervention groups received daily messages via a mobile app, while the control group received no messages. The intervention combined belief-based content to raise awareness with skill-based content to teach practical food handling, framed by either positive or negative emotional appeals. The experimental conditions differed in message congruence, with belief-based and skill-based content framed either consistently (both positive or both negative) or inconsistently (one positive, one negative). To assess the impact of the intervention, self-reported adherence to food safety practices, food safety awareness, and self-efficacy were measured at baseline and post-intervention. Results: The results showed that the intervention significantly improved food safety practices, especially when the messages were congruent in valence. Pre-intervention self-efficacy moderated the effects, with higher self-efficacy increasing receptivity to certain messages, while lower self-efficacy benefited from a different framing. Self-efficacy, but not awareness, mediated behaviour change, highlighting its key role in the success of the intervention. Conclusions: These results emphasise the importance of message valence congruence and individual self-efficacy levels in designing effective food safety interventions. Future research should investigate long-term intervention effects, adaptive mHealth strategies, and tailored communication approaches to maximise engagement and sustained behaviour change. Full article

Background: Patellofemoral instability is a pathological condition that is characterized by altered joint congruence, which manifests as episodes of subluxation or dislocation of the patella. The aim of this study was to systematically review the literature on this condition by comparing the results of various studies evaluating the effectiveness of surgical versus conservative treatment approaches for patellar instability, particularly in patients experiencing a first episode of patellar dislocation. Methods: The research was conducted using three different databases: PubMed, Cochrane Library, and PEDro. Both randomized controlled trials (RCTs) and non-randomized studies of interventions (NRSIs) with full text availability were included. All articles were in English, and no temporal limits were imposed during the search. Results: In total, 10 articles met the inclusion criteria and were included in the systematic review. The standard for statistical significance was p < 0.05. The statistical analysis of re-dislocation rates indicated a statistically significant difference between the conservative and surgical groups (p = 0.023). The statistical analysis also showed that the mean Kujala score was significantly lower in the non-operative group (80.94) than the surgical group (89.83) (p = 0.017). These results indicate that surgical treatment is significantly more effective in reducing re-dislocation rates than conservative treatment and has better Kujala scores than conservative treatment. Conclusions: A reduction in the re-dislocation rate and improved scores on subjective tests related to pain and quality of life were observed with surgical treatment. Nevertheless, a higher level of evidence is needed to more clearly and accurately determine the most effective treatment approach. Full article

Microplastics, remnants of macroplastics that have broken down to fragments smaller than 5 mm, and nanoplastics, broken down even further to sizes < 1 μm, are pervasive in aquatic ecosystems. These plastic particles are consumed by microscopic organisms, leading to bioaccumulation up trophic levels. The accumulation of plastic in the organismal gut can result in various repercussions, including cellular contamination and genomic modifications such as DNA methylation. While methylation has been studied in teleost fishes, the impact of nanoplastic exposure on this process in any species remains largely unexplored. This study delves into this largely uncharted territory, investigating the accumulation of methylation due to nanoplastic exposure within the genome of cultured bluegill BF-2 cells (Lepomis macrochirus) using methylation-sensitive AFLPs. The methylation state was analyzed through capillary gel analysis and electropherograms. Differential methylation occurred between several control and experimental groups due to nanoplastic exposure; however, these differences were not dose- or time-dependent. These results could suggest that higher dosages and exposure times to nanoplastics do not result in increased methylation levels in congruence with the dosage and exposure time; rather, only the presence of nanoplastics is enough to cause DNA methylation changes. Full article

The purpose of this study is to identify motivational profiles in sustainable career trajectories via emerging latent class methods using a multilevel schema between engagement in sustainable career practices, developing and utilizing job competency—a key marker for human capital development—and leader–member interaction. Using latent class analysis (LCA), we further identify different types of motivational profiles that reflect the principle and adaptable nature with which individuals can relate their sustainability values to career decisions. Results indicate large practical differences within latent classes, evidencing higher career adaptability and sustainability principles congruence in some groups. These differences highlight that intrinsic motivation, adaptability, and elements connected to the sector drive sustainable career engagement that should ensure enduring satisfaction with commitment to a chosen profession. In explaining why sustainability drives career advancement, this study takes a theoretical standpoint from three overarching theories: Career Construction Theory, Social Cognitive Career Theory (SCCT), and Sustainable Career Theory. The practical recommendations are that companies must offer programs at the sector level to increase career adaptability (readiness) and help employees build sustainable careers. This study calls attention to the importance of producing participative content that is demanded by organizations seeking greater resilience, well-being in work contexts, and their long-lasting survival as institutions. Full article

For an undirected graph G, a zero-sum flow is an assignment of nonzero integer weights to the edges such that each vertex has a zero-sum, namely the sum of all incident edge weights with each vertex is zero. This concept is an undirected analog of nowhere-zero flows for directed graphs. We study a more general one, namely constant-sum $\mathbb{A}$-flows, which gives edge weights using nonzero elements of an additive Abelian group $\mathbb{A}$ and requires each vertex to have a constant-sum instead. In particular, we focus on two special cases: $\mathbb{A}={\mathbb{Z}}_k$, the finite cyclic group of integer congruence modulo k, and $\mathbb{A}=\mathbb{Z}$, the infinite cyclic group of integers. The constant sum under a constant-sum $\mathbb{A}$-flow is called an index of G for short, and the set of all possible constant sums (indices) of G is called the constant sum spectrum. It is denoted by $I_k\left(G\right)$ and $I\left(G\right)$ for $\mathbb{A}={\mathbb{Z}}_k$ and $\mathbb{A}=\mathbb{Z}$, respectively. The zero-sum flows and constant-sum group flows for regular graphs regarding cases $\mathbb{Z}$ and ${\mathbb{Z}}_k$ have been studied extensively in the literature over the years. In this article, we study the constant sum spectrum of nearly regular graphs such as wheel graphs $W_n$ and fan graphs $F_n$ in particular. We completely determine the constant-sum spectrum of fan graphs and wheel graphs concerning ${\mathbb{Z}}_k$ and $\mathbb{Z}$, respectively. Some open problems will be mentioned in the concluding remarks. Full article

We carried out four timed judgement experiments investigating whether bilingual speakers differ in their sensitivity to different kinds of filler–gap dependency violation in L1 German and L2 English. Using a within-subjects design and parallel experimental designs for both languages, we manipulated either the availability of a gap (“filled-gap paradigm”) or the semantic congruency between the filler and its licensing verb. We examined whether participants exhibited consistent judgement patterns for syntactic (i.e., filled wh-gaps) and semantic (i.e., implausible wh-fillers) violations within and across their languages. Our results showed that participants’ sensitivity to filled gaps correlated positively with their sensitivity to a filler’s semantic fit in their L1 but not in their L2, and that participants’ sensitivity to semantic fit was positively correlated in their two languages whilst their sensitivity to gap availability was not. Further analyses of the L2 data showed that participants’ sensitivity to semantic fit but not to filled gaps increased with L2 proficiency. Our findings are in line with earlier findings indicating reduced sensitivity to structural gaps even at advanced L2 proficiency levels. They also highlight the need for L2 processing research to look beyond group-level performance and consider bilinguals’ sensitivity to different types of linguistic constraints at the individual level. Full article