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We estimated the association between the age at smoking initiation and cessation and all-cause and causespecific mortality among Japanese men (n = 41,711; age 40–79 years) by analyzing data from the Japan Collaborative Cohort Study for the Evaluation of Cancer Risks. From 1988 and 1990 to 2009, 13,429 all-cause deaths (cancers, n = 4999; cardiovascular diseases, n = 3682) occurred in this cohort. Fitted Cox proportional hazard models, with never smokers as the reference group, were created. Former smokers demonstrated a lower risk for all-cause and cause-specific mortality than current smokers, with a dose-dependent reduction in the risk based on smoking-initiation age. Among former smokers who quit smoking aged 50 years or more, the highest hazard ratios were detected for those who started smoking at <20 years of age (all-cause, cancer, and cardiovascular disease mortality, hazard ratio [95% confidence interval] 1.51 [1.29–1.77], 1.68 [1.27–2.23], and 1.48 [1.12–1.96], respectively). Former smokers who quit smoking at <50 years of age had negligible all-cause or cardiovascular disease mortality regardless of the smoking-initiation age, whereas the cancer mortality risk remained significantly high among those who quit smoking at 40–49 years of age. Thus, smoking cessation significantly reduces the all-cause mortality risk; however, early initiation and later cessation do not provide a huge benefit, which earlier cessation does. Therefore, all smokers should be encouraged to quit smoking earlier in life regardless of their age at smoking initiation. [ABSTRACT FROM AUTHOR]

Introduction: The disease activity associated with the drug-utilization patterns of biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs) is poorly investigated in real-world studies on rheumatoid arthritis (RA) patients. To investigate the relationship between biologic DMARD initiation/discontinuations in RA patients identified in the healthcare administrative databases of Tuscany and the Disease Activity Score 28 (DAS28) reported in the medical charts. Methods: This retrospective population-based study included RA’s first-ever biologic DMARD users of the Pisa University Hospital from 2014 to 2016. Patients were followed up until 31 December 2019. We evaluated the DAS28 recorded before (T0) and after (T1) the biologic DMARD initiation and before (TD0) and after (TD1) discontinuations. Patients were classified as “off-target” (DAS28 > 3.2) or “in-target” (DAS28 ≤ 3.2). We described the disease activity trends at initiation and discontinuation. Results: Ninety-five users were included (73 women, mean age 59.6). Among 70 patients (74%) with at least three DAS28 measures, 28 (40.0%) were off-target at T0 and 38 (54.3%) in-target at T1. Thirty-three (47%) patients had at least one discontinuation, among those with at least three DAS28 assessments. In the disease activity trend, disease stability or improvement was observed in 28 out of 37 (75.7%) patients at initiation and in 24 out of 37 (64.9%) at discontinuation. Discussion: Biologic DMARD discontinuations identified in the healthcare administrative databasese of Tuscany are frequently observed in situations of controlled RA disease. Further studies are warranted to confirm that these events can be used in studies using healthcare administrative databases as proxies of treatment effectiveness. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Educational Studies (1673-1298) is the property of Journal of Educational Studies Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The main objective of the EU-funded project mitigating environmentally-assisted cracking through optimisation of surface condition (MEACTOS) was to gain knowledge on the ability of different surface machining procedures to mitigate environmentally-assisted cracking (EAC) in typical light water reactor structural materials and environments. Surfaces of cold-worked (CW) type 316L austenitic stainless steel and nickel-based weld metal Alloy 182 flat tapered tensile specimens were machined using different processes. EAC initiation susceptibility of these specimens was evaluated using constant extension rate tensile (CERT) tests under simulated boiling water reactor (BWR) and pressurized water reactor (PWR) conditions and assessed using constant load experiments. More than a hundred tests were performed covering about 10 years of autoclave testing time. Only minor or no measurable improvements in EAC initiation susceptibility as a function of surface treatments (grinding or advanced machining) compared to the standard industrial face milling were demonstrated. In most cases, the stress thresholds for EAC initiation determined in constant load tests confirmed the trend obtained from CERT tests. This paper summarises the most important results and conclusions concerning the EAC initiation behaviour for the CW 316L and Alloy 182 under reducing PWR and oxidizing BWR conditions. [ABSTRACT FROM AUTHOR]

Objective: Aloe elegans Tod. is an ecologically, environmentally, medicinally, and commercially useful aloe species in Ethiopia and Eritrea. Unfortunately, it is highly threatened due to industrial and urban expansion and traditional mining and agricultural activities. As a consequence, it is included in the IUCN List of Threatened Species since 2013. The plant is getting thinly populated in many parts of the Tigrai floristic region since it is being exploited for traditional and commercial purposes. Therefore, this study was aimed to develop a reproducible, large-scale micropropagation protocol using offshoot cuttings in Murashige and Skoog (MS) media enriched with plant growth regulators (PGRs). Results: Sterilized explants cultured in full-strength MS media enriched with 0.25 mg/L benzyl amino purine (BAP) and 0.10 mg/L naphthaleneacetic acid (NAA) resulted in 100% healthy and live (i.e., initiated) explants after four weeks of initiation study. Unsupplemented initiation media (control) yielded only 14.3% initiated explants. The initiated explants were tested for their shooting response to produce microshoots by incubating in different concentrations and combinations of BAP and NAA for four weeks. Fewer days to shooting (13.0 ± 1.0 days), higher mean shoot number (5.0 ± 1.0), and higher mean shoot length (9.20 ± 2.35 cm) were observed with 1.0/0.50, 1.0/0.25, and 1.0 /0.50 mg/L BAP/NAA combinations, respectively. The rooting responses of the microshoots toward producing plantlets were also tested by incubating them in half-strength MS media enriched with different concentrations of NAA and indole-3-butyric acid (IBA) for four weeks. Fewer mean days to rooting (12.0 ± 1.0 days), higher mean root number (8.0 ± 4.0), and higher mean root length (7.53 ± 3.03 cm) were observed in MS media enriched with 0.75, 0.75, and 1.25 mg/L IBA, respectively. The responses of A. elegans plantlets to primary (in greenhouse) and secondary (in nursery shade and direct sunlight) acclimatization in coco peat, composted soil, and manured soil media were high – with survival percentages of 87.5–97.8% in three to four weeks. [ABSTRACT FROM AUTHOR]

In Women Who Run with Wolves, Clarissa Pinkola Estes goes after the ‘creative, talented, and immersed woman symbol’ which has been ignored by psychoanalysis for a long time, where she chases the pure reality of women whose internal nature has been damaged, whose souls have been tossed to the most pathetic lands, and who have taken on unnatural rhythms over their natural cycles just to please others. While women continue to instinctively share archetypes, Betül Tarıman, who displays an internal womanhood stance in the Anatolian geography, raises the mythical era narrative voices for us women, from her work Hadde, that is sensitive to her emotions, conscious, and tactile pleasures, and creatively transforms them into modern poetry. As Estes breaks the silence regarding issues surrounding her style, knowledge, and creative fire for women’s different eras, which can be defined as archetypical, intuitive, sexual, and cyclic. With this analysis, which follows in the footsteps of the wild woman archetype, added to the literature by Estes, I added poetry to the existing myths and fairy tales. I emphasize that poetry can too be just as long lasting as they are while being an enunciation leading to wisdom. This archetypical perspective, like mythical stories, poetry sets forth the sharp realization that can help conceptualize our visual power to see nature’s naiveté. Betül Tarıman, a woman who found her voice in nature, is a wild spirit. She moves forward in an alchemical cycle of loss, disjunction, and enlightenment during her journey that ends with wisdom. She awakens in a sacred location in eternity, independent of time and place, created by poetic language and word. This way, she creates the myth of the modern woman hero. By connecting with the wild woman archetype, she transforms into an eternal inner voice, calling out to women in search of themselves during their journey of initiation.

Un condamné à mort s’est échappé or Le vent souffle ou il veut (1956), by Robert Bresson, Le Trou (1960) by Jacques Becker and Un Prophète (2009) by Jacques Audiard, are three films where the prison dimension is not a narrative device at the service of striking and adventurous actions, but constitutes a universe where we witness the radicalization of some human dynamics, a form of dramatic condensation that it reveals the qualities, potentials and miseries of human beings, thanks to the conditions of coercion and the claustrophobia in which the characters are forced to live.

Ngugi Wa Thiong'o's literary work "The River Between" is a novel that participates in the description of space by using language as a system of signs for the encoding and decoding of information. The fictional space in the novel is organized around two spatial cores physically determined and metaphorically evoked by an omniscient narrator; both banks Kameno and Makuyu. In this article, we will apply the categories in style in a fiction selectively to the description of the world of TRB. The procedure in this case will be to start with a general impression of the ridges and then to make selective use of the checklist in order to draw the readers' attention to what seems significant in the description of the Space.

The paper analyzes the literature data on the role of cytokines in the pathogenesis of malignant neoplasms (MN). Cytokines are biologically active, hormone-like proteins that regulate a wide range of processes occurring in the body. Cytokines determine the type and duration of the immune response, stimulation or suppression of cell growth, their differentiation, and functional activity. The complex of cytokines produced in the tumor microenvironment plays an important role in the pathogenesis of MN. The spectra of biological activities of cytokines overlap in most cases. The same process in a cell can be stimulated by more than one cytokine, creating a favorable environment for the initiation and progression of MN. The immune system can recognize transformed cells. Various cytokines correspond to specifc pathways activated by receptors on the cell surface, which in turn cause intracellular signaling cascades that affect target cellular functions. Cytokine genes are mutually related to oncogenes. Cytokines, which are released in response to infection, inflammation, or during an immune response to an antigen, can inhibit tumor development. In turn, cytokines, which weaken apoptosis and promote invasion and metastasis, promote tumor growth. Cytokines are involved in the initiation, development and metastasis of malignant neoplasms through various mechanisms.

AIM: To determine initial medication adherence in newly diagnosed glaucoma patients treated with anti-glaucoma drugs. METHODS: This retrospective and observational study included all patients diagnosed with glaucoma in the Primary Health Care units in Portugal during the years 2012 and 2013, which in consequence received a first prescription for anti-glaucoma drugs. Data was collected from electronic prescribing records of the primary care units and from pharmacy claims records. Initiation of glaucoma treatment and early discontinuation were measured, and the combination of (non)-initiation and early discontinuation accounted for initial medication (non)-adherence. RESULTS: A total of 3548 new glaucoma patients (40.1% male; 59.9% female) were included. The 1133 (31.9%) patients were initially classified as non-users, since there was no pharmacy claim found for their first prescription for glaucoma treatment. Additionally, 277 (11.5%) patients early discontinued their treatment, acquiring only their first prescription. Overall, the initial medication non-adherence rate was 39.7% since 1410 patients either didn't initiate treatment or discontinued it early. CONCLUSION: This study, reveals a major opportunity to improve glaucoma treatment and its control, since a large proportion of patients fail to engage with their prescribed therapy, which implies that implementation of individual or group strategies that enable patients with glaucoma to correctly perform their treatment is still needed.

The use of electronic cigarettes, or “e-cigarettes”, among youths has sparked worries about the possibility of nicotine dependence as a serious public health issue. Dental practitioners play a critical role in helping their patients quit smoking. Dental schools across the globe have policies encouraging their students to help patients quit smoking. Current research, however, indicates that a significant portion of dental students smoke combustible cigarettes and use e-cigarettes. According to studies, using e-cigarettes has resulted in the subsequent initiation of combustible cigarette smoking among its users. The aim of this study was to determine the association between the use of electronic cigarettes and the subsequent initiation of combustible cigarette smoking among dental students who were not attitudinally susceptible to smoking combustible cigarettes. A longitudinal cohort study was conducted among 121 study participants who were never combustible cigarette users and were attitudinally non-susceptible to smoking at baseline. At baseline, 66 (54.6%) study participants were categorized as e-cigarette users who were attitudinally non-susceptible to combustible cigarette smoking, and 55 (45.4%) study participants were categorized as non-users who were attitudinally non-susceptible to combustible cigarette smoking. The initiation of combustible cigarette smoking was assessed at 6- and 12-month intervals. Binomial regression analysis of the outcome at the end of one-year follow-up, when analyzed with independent variables, revealed a significant influence of e-cigarette use on taking up combustible cigarette smoking [Relative Risk: 9.395; 95% CI: 3.03–29.04]. Chi-squared analysis of independent variables revealed e-cigarette use to be significantly associated with fathers’ education level (p = 0.00), parental cigarette smoking status (p = 0.00), cigarette smoking among friends (p = 0.00), and family income (p = 0.00). E-cigarette users are more likely to believe it to be healthier (p = 0.00) than combustible smoking. In the present study, e-cigarette usage demonstrated a significant influence on taking up combustible cigarette smoking among its users. Educational institutions should implement stringent policies and regulations to prevent health professionals from using these products.

Abstract The involvement of endothelial barrier function in abdominal aortic aneurysm (AAA) and its upstream regulators remains unknown. Single‐cell RNA sequencing shows that disrupted endothelial focal junction is an early (3 days) and persistent (28 days) event during Angiotensin II (Ang II)‐induced AAA progression. Consistently, mRNA sequencing on human aortic dissection tissues confirmed downregulated expression of endothelial barrier‐related genes. Aldehyde dehydrogenase 2 (ALDH2), a negative regulator of AAA, is found to be upregulated in the intimal media of AAA samples, leading to testing its role in early‐stage AAA. ALDH2 knockdown/knockout specifically in endothelial cells (ECs) significantly increases expression of EC barrier markers related to focal adhesion and tight junction, restores endothelial barrier integrity, and suppresses early aortic dilation of AAA (7 and 14 days post‐Ang II). Mechanically, ELK3 acts as an ALDH2 downstream regulator for endothelial barrier function preservation. At the molecular level, ALDH2 directly binds to LIN28B, a regulator of ELK3 mRNA stability, hindering LIN28B binding to ELK3 mRNA, thereby depressing ELK3 expression and impairing endothelial barrier function. Therefore, preserving vascular endothelial barrier integrity via ALDH2‐specific knockdown in ECs holds therapeutic potential in the early management of AAAs.

Two contemporary novels dealing with the beekeeper’s social type, Le Maître des abeilles by Henri Vincenot and Maxence Fermine’s L’Apiculteur, reshape the social representations which are linked with this character in an original way. We shall show how each novel proceeds to join external images to the collective ideas we commonly build to figure out the beekeeper’s tasks (either congruent or not with the reality of this job) in order to create a new literary universe. The representations (or even stereotypes) of the adventurer, for instance, or of the religious officiant give a new sense to the reading according to the poetical choice of the two writers.

This article explores the cultural significance of initiation rites among the Northern Sotho in South Africa, with a particular focus on the blending of symbolic gender motifs in rock art. Scholars on Northern Sotho rock art have associated initiation with specific genders. A close analysis of Northern Sotho rock art, together with a nuanced reading of ethnographic material on initiation rites, shows that a motif may be a mnemonic device in initiation but communicate a symbolism unique to either group. In my research, I observed that rock art sites have imagery that can be argued to be symbolic for both males and females, often juxtaposed or superimposed on the same panels. I refer to this as a form of blending of gender categories, possible during rites of transition. Thus I suggest that the symbolism for gender could resonate or change depending on who was using the site. Based on this, I suggest that such rock art sites should be categorized as initiation sites without specific gendered coding. This article contends that while gender boundaries exist in Northern Sotho culture, initiation rites often create a fluidity that challenges and probably blends these categories, as reflected in the rock art.

Introduction: The disease activity associated with the drug-utilization patterns of biologic Disease Modifying Anti-Rheumatic Drugs (DMARDs) is poorly investigated in real-world studies on rheumatoid arthritis (RA) patients. To investigate the relationship between biologic DMARD initiation/discontinuations in RA patients identified in the healthcare administrative databases of Tuscany and the Disease Activity Score 28 (DAS28) reported in the medical charts.Methods: This retrospective population-based study included RA’s first-ever biologic DMARD users of the Pisa University Hospital from 2014 to 2016. Patients were followed up until 31 December 2019. We evaluated the DAS28 recorded before (T0) and after (T1) the biologic DMARD initiation and before (TD0) and after (TD1) discontinuations. Patients were classified as “off-target” (DAS28 > 3.2) or “in-target” (DAS28 ≤ 3.2). We described the disease activity trends at initiation and discontinuation.Results: Ninety-five users were included (73 women, mean age 59.6). Among 70 patients (74%) with at least three DAS28 measures, 28 (40.0%) were off-target at T0 and 38 (54.3%) in-target at T1. Thirty-three (47%) patients had at least one discontinuation, among those with at least three DAS28 assessments. In the disease activity trend, disease stability or improvement was observed in 28 out of 37 (75.7%) patients at initiation and in 24 out of 37 (64.9%) at discontinuation.Discussion: Biologic DMARD discontinuations identified in the healthcare administrative databasese of Tuscany are frequently observed in situations of controlled RA disease. Further studies are warranted to confirm that these events can be used in studies using healthcare administrative databases as proxies of treatment effectiveness.

Background: Based on the Japan Adjuvant Study Group of Pancreatic Cancer-01 results, S-1 adjuvant chemotherapy has been the standard in resected pancreatic ductal adenocarcinoma (PDAC) patients in Japan and elsewhere, initiated within 10 weeks after surgery. To assess the clinical impact of this timing, we conducted a secondary analysis of a nationwide survey by the Japan Pancreas Society. Methods: A total of 3361 patients were divided into two groups: 2681 (79.8%) initiating the therapy within 10 weeks after surgery (standard) and 680 (20.2%) after 10 weeks (delayed). We compared recurrence-free survival (RFS) and overall survival (OS) using the log-rank test and Cox proportional hazards model with conditional landmark analysis between the groups. Results were verified by adjustment with inverse-probability-of-treatment weighting (IPTW) analysis. Results: The median timing of S-1 adjuvant chemotherapy initiation was 50 days (interquartile range: 38–66). In the standard group, 5-year RFS and OS rates were 32.3–48.7%, respectively, compared with 25.0–38.7% in the delayed group. Hazard ratios (HRs) and 95% confidence intervals were 0.84 (0.76–0.93) for RFS (p < 0.001) and 0.77 (0.69–0.87) for OS (p < 0.001). The IPTW analysis yielded 5-year RFS rates of 32.1% and 25.3% in the standard versus delayed group, respectively [HR = 0.86 (0.77–0.96), p < 0.001] and 5-year OS rates of 48.3% and 39.8%, respectively [HR = 0.81 (0.71–0.92), p < 0.001]. Conclusions: Initiation of S-1 adjuvant chemotherapy in resected PDAC patients within 10 weeks after surgery may offer survival benefit over later initiation. [ABSTRACT FROM AUTHOR]

Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia. We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019–2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer' factors. Tobacco was the most commonly experimented substance with a prevalence rate of 17.5 % (CI 95 %: 14.8–18.8 %). The prevalence of alcohol and illicit drugs use were 3.3 % [CI 95 %: (2.1–3.9 %)] and 2 % [CI 95 %: (1.1–2.6 %)] respectively. Being male (Adjusted (AOR)=4.09, p<0.001), being a high school pupil (AOR=2.81, p<0.001), having experiencing academic failure (AOR=1.60, p=0.007) and having a father and siblings who use tobacco (AOR=1.72, p=0.002; AOR=2.03, p=0.001 respectively) were the predictors of tobacco experimentation in the multivariate logistic regression analysis. Additionally, being male (AOR=8.40, p<0.001), having experienced academic failure (AOR=2.76, p=0.017) as well as having a father and siblings who use alcohol (AOR=5.90, p<0.001; AOR=3.03, p=0.045 respectively) and having experienced tobacco (AOR=4.28, p<0.001) were the determinants of alcohol experimentation. Similarly, having a history of academic failure (AOR=3.44, p=0.041), having peers who use illicit drugs (AOR=3.22, p=0.028), having a history of tobacco and alcohol experimentation (AOR=6.52, p<0.001; AOR=3.49, p=0.046 respectively) were the predictors of illicit drug experimentation among adolescents. A substantial number of socio-demographic and environmental factors have been identified as being involved in experimentation with psychoactive substance during adolescence. Therefore, further prevention programs targeting not only adolescents, but also all risk factors are needed. [ABSTRACT FROM AUTHOR]

Eukaryotic DNA replication must occur exactly once per cell cycle to maintain cell ploidy. This outcome is ensured by temporally separating replicative helicase loading (G1 phase) and activation (S phase). In budding yeast, helicase loading is prevented outside of G1 by cyclin-dependent kinase (CDK) phosphorylation of three helicase-loading proteins: Cdc6, the Mcm2-7 helicase, and the origin recognition complex (ORC). CDK inhibition of Cdc6 and Mcm2-7 is well understood. Here we use single-molecule assays for multiple events during origin licensing to determine how CDK phosphorylation of ORC suppresses helicase loading. We find that phosphorylated ORC recruits a first Mcm2-7 to origins but prevents second Mcm2-7 recruitment. The phosphorylation of the Orc6, but not of the Orc2 subunit, increases the fraction of first Mcm2-7 recruitment events that are unsuccessful due to the rapid and simultaneous release of the helicase and its associated Cdt1 helicase-loading protein. Real-time monitoring of first Mcm2-7 ring closing reveals that either Orc2 or Orc6 phosphorylation prevents Mcm2-7 from stably encircling origin DNA. Consequently, we assessed formation of the MO complex, an intermediate that requires the closed-ring form of Mcm2-7. We found that ORC phosphorylation fully inhibits MO complex formation and we provide evidence that this event is required for stable closing of the first Mcm2-7. Our studies show that multiple steps of helicase loading are impacted by ORC phosphorylation and reveal that closing of the first Mcm2-7 ring is a two-step process started by Cdt1 release and completed by MO complex formation. [ABSTRACT FROM AUTHOR]

This review summarizes current knowledge about the mechanisms of timely binding and dissociation of two nucleoid proteins, IHF and Fis, which play fundamental roles in the initiation of chromosomal DNA replication in Escherichia coli. Replication is initiated from a unique replication origin called oriC and is tightly regulated so that it occurs only once per cell cycle. The timing of replication initiation at oriC is rigidly controlled by the timely binding of the initiator protein DnaA and IHF to oriC. The first part of this review presents up-to-date knowledge about the timely stabilization of oriC-IHF binding at oriC during replication initiation. Recent advances in our understanding of the genome-wide profile of cell cycle-coordinated IHF binding have revealed the oriC-specific stabilization of IHF binding by ATP-DnaA oligomers at oriC and by an initiation-specific IHF binding consensus sequence at oriC. The second part of this review summarizes the mechanism of the timely regulation of DnaA activity via the chromosomal loci DARS2 (DnaA-reactivating sequence 2) and datA. The timing of replication initiation at oriC is controlled predominantly by the phosphorylated form of the adenosine nucleotide bound to DnaA, i.e., ATP-DnaA, but not ADP-ADP, is competent for initiation. Before initiation, DARS2 increases the level of ATP-DnaA by stimulating the exchange of ADP for ATP on DnaA. This DARS2 function is activated by the site-specific and timely binding of both IHF and Fis within DARS2. After initiation, another chromosomal locus, datA, which inactivates ATP-DnaA by stimulating ATP hydrolysis, is activated by the timely binding of IHF. A recent study has shown that ATP-DnaA oligomers formed at DARS2-Fis binding sites competitively dissociate Fis via negative feedback, whereas IHF regulation at DARS2 and datA still remains to be investigated. This review summarizes the current knowledge about the specific role of IHF and Fis in the regulation of replication initiation and proposes a mechanism for the regulation of timely IHF binding and dissociation at DARS2 and datA. [ABSTRACT FROM AUTHOR]

Background: Pre-Exposure Prophylaxis (PrEP) has demonstrated clinical efficacy in preventing HIV infection, yet its uptake remains low. This study, conducted in five PrEP implementing districts in Lesotho, examined factors motivating persons at risk of HIV infection to adopt or reject PrEP when offered freely. Methods: In-depth interviews were undertaken with stakeholders directly engaged with PrEP policy (n = 5), program implementation (n = 4), and use (current PrEP users = 55, former PrEP users = 36, and PrEP decliners (n = 6)). Focus group discussions (n = 11, 105 total participants) were conducted with health staff directly providing HIV and PrEP services. Results: Demand for PrEP was reported highest among those at greatest risk for HIV acquisition: those in serodiscordant relationships and/or engaged in sex work. Culturally sensitive PrEP counseling was described as an opportunity to transfer knowledge, build trust, and address user concerns. Conversely, top-down counseling resulted in PrEP distrust and confusion about HIV status. Key motivations for PrEP uptake revolved around sustaining core social relationships, desire for safer conception, and caring for ailing relatives. The decline of PrEP initiation was driven by a combination of individual-level factors (risk perception, perceived side effects, disbelief of the drug's efficacy and PrEP's daily pill regimen), societal factors (lack of social support and HIV-related stigma), and structural factors related to PrEP access. Conclusions: Our findings suggest strategies for effective national PrEP rollout and implementation include: (1) demand creation campaigns which highlight positive aspects of PrEP, while simultaneously addressing apprehensions for uptake; (2) strengthening health provider counseling capacity; and (3) addressing societal and structural HIV-related stigma. [ABSTRACT FROM AUTHOR]

Aims: To investigate whether a heart failure (HF) hospitalization is associated with initiation/discontinuation of guideline‐directed medical HF therapy (GDMT) and consequent outcomes. Methods and results: Among patients in the Swedish HF registry with an ejection fraction <50% enrolled in 2009–2018, initiation/discontinuation of GDMT was investigated by assessing dispensations of GDMT in those with versus without a HF hospitalization. Of 14 737 patients, 6893 (47%) were enrolled when hospitalized for HF. Initiation of GDMT was more likely than discontinuation following a HF hospitalization compared to a control group of patients without a HF hospitalization (odds ratio range 2.1–4.0 vs. 1.4–1.6 for the individual medications), although the proportion of patients not on GDMT was still high (8.1–44.0%). Key patient characteristics triggering less use of GDMT (i.e. less initiation or more discontinuation) were older age and worse renal function. Following a HF hospitalization, initiation of renin–angiotensin system inhibitors/angiotensin receptor–neprilysin inhibitors or beta‐blockers was associated with lower and their discontinuation with higher mortality risk, but no association with mortality was observed for initiation/discontinuation of mineralocorticoid receptor antagonists. Conclusions: Following a HF hospitalization, initiation of GDMT was more likely than discontinuation, although still limited. Perceived or actual low tolerance were barriers to GDMT implementation. Early re‐/initiation of GDMT was associated with better survival. Our findings represent a call for further implementing the current guideline recommendation for an early re‐/initiation of GDMT following a HF hospitalization. [ABSTRACT FROM AUTHOR]

This study explores the concept of trust in leadership, drawing on insights from the ancient Chinese classic I-Ching. Using content analysis and metaphoric interpretation, we examine the meaning of Fu (trust) in I-Ching and its relevance to modern-day business leadership. Our analysis categorizes hexagram lines that mention Fu into six stages, forming the I-Ching Trust Development Cycle: Initiation, Progressing, Testing, Growth, Maturity, and Decline. The cycle begins without trust as leaders and followers meet to share their visions and missions. As relationships between leaders and followers develop, progress is made. The third stage tests the trust relationships, while the fourth stage describes how relationships are maintained. In the fifth stage, trust reaches its peak, but in the final stage, relationships reach a crossroads that may lead to either continued Growth or Decline. We suggest management implications at the end of each stage. Finally, we discuss the limitations and suggest future research directions. [ABSTRACT FROM AUTHOR]

This article compared the behaviour of yesteryears’ initiates and the contemporary ones in Cala and Mdantsane. This study explored the policy differences informing TMC in yesteryears and those in the contemporary epoch; to identify the similarities and differences between the behaviour of the two sets of initiates; and to establish the environmental factors motivating the behaviour of initiates. The exploratory and descriptive designs were used. One-on-one interviews with the guidance of an interview guide to facilitate interviews was adopted. The findings revealed that the yesteryears’ initiates behaved meticulously compared to those of the contemporary epoch; embracement of chastity by the yesteryears’ initiates; contemporary initiates displayed wicked behaviours post initiation; the contemporary initiates’ behaviours influenced by illusionary interpretation of rights and tenets of development; Contemporary initiates entrenched culture of abusing substances. Ggovernment should ensure that traditional male circumcision achieves its objective. Training for traditional attendants; and hosting cultural events for cultural resuscitation. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Tikrit University for Humanities is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Babylon Center for Humanities Studies is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In my paper I analyze the case of the supposed shamanistic 'world tree' of the conquering Hungarians: I show how this erroneous scientific construction came into being through the coming together of the mutually reinforcing mistakes of Hungarian folkloristics, linguistics, and archaeology; how manifestations of the spurious ideas of lay pseudo-science got mixed in with scientific discourse, and how they influenced the course of 'professional' scientific inquiry. My analysis sheds light on the most flagrant methodological mistakes that lead to the mistaken construct: a) the gaining ground of ideological influences from outside 'pure' scientific considerations (in our case features symbolizing Hungarian identity that set it apart from Europeans: the quest for ancient Hungarian shamanism); b) an inverse research attitude of selectively looking for evidence to prove the researcher's preconceptions; c) the effects of a deferential research attitude which considers one or another 'great' researcher infallible and their results irrefutable, which short circuits further research on a topic. My paper has three parts: the first one deals with the emergence of the construct, the second with the errors of the construct created by highly respected scholars (Gyula Sebestyén, Géza Róheim, Sándor Solymossy, Vilmos Diószegi) and its Hungarian and international reception, while in the third part, I describe the processes of the construct's deconstruction and its parallelly occurring revival. I come to the conclusion that the world tree and the related rites connected to the initiation of shamans most likely did not exist in the worldview and ritual practices of the conquering Hungarians and that in light of the most recent research results they seem to be part of an illusionary research construct which came about through the interplay of the strivings of ethnographers, archaeologists, linguists and amateurs who started out from a certain set of preconceptions. [ABSTRACT FROM AUTHOR]

Data on the parameters of explosion and detonation of two- and three-fuel mixtures of methane, coal dust, and hydrogen (with oxygen and air) with varied fractions of the fuels are reported. The novelty of the numerical and graphical data arrays is due to previously unknown data on the critical energy of detonation initiation, characteristic size of detonation cells, detonation velocity, and energy release in detonation waves. The analysis is performed not only for stoichiometric two- and three-fuel systems, but also for rich and lean systems based on the fuels under study. [ABSTRACT FROM AUTHOR]

• In real-world clinical practice, the initiation and up-titration of sacubitril/valsartan prescription remain challenging in patients with AMI. • Early use or high dosage of sacubitril/valsartan is associated with an improvement in primary composite endpoints as well as the incidence of new-onset HFrEF or HFpEF. • The low dose of sacubitril/valsartan is well tolerated and may be associated with similar outcomes compared with high dose in some circumstances (LVEF>50% or HF at baseline). In real-world clinical practice, the initiation and up-titration of sacubitril/valsartan remain challenging due to symptomatic hypotension in patients with acute myocardial infarction(AMI). The purpose of this study was to investigate the efficacy of different initial timing and dosage of sacubitril/valsartan in AMI patients. This prospective and observational cohort study enrolled AMI patients treated with percutaneous coronary intervention(PCI), and were categorized according to the initial timing and average daily doses of sacubitril/valsartan prescription. The primary endpoint was defined as a composite of cardiovascular death, recurrent AMI, coronary revascularization, heart failure(HF) hospitalization and ischaemic stroke. Secondary outcomes included the new-onset HF, and the composite endpoints in AMI patients complicated with HF at baseline. The study population consisted of 915 AMI patients. After a median follow-up of 38 months, early use or high dosage of sacubitril/valsartan was associated with an improvement in primary endpoint as well as the incidence of new-onset HF. Early use of sacubitril/valsartan also ameliorated the primary endpoint in AMI patients with left ventricular ejection fraction(LVEF) ≤50% as well as LVEF>50%. Besides, early use of sacubitril/valsartan improved the clinical outcomes in AMI patients complicated with HF at baseline. The low dose was well tolerated and may be associated with similar outcomes compared with high dose under some circumstances(LVEF>50% or HF at baseline). Early use or high dosage of sacubitril/valsartan medication is associated with an improvement in clinical outcome. The low dose of sacubitril/valsartan is well tolerated and may be an acceptable alternative strategy. [ABSTRACT FROM AUTHOR]

Nonadherence to medicines is a global problem compromising health and economic outcomes for individuals and society. This article outlines how adherence is defined and measured, and examines the impact, prevalence and determinants of nonadherence. It also discusses how a psychosocial perspective can inform the development of interventions to optimise adherence and presents a series of recommendations for future research to overcome common limitations associated with the medication nonadherence literature. Nonadherence is best understood in terms of the interactions between an individual and a specific disease/treatment, within a social and environmental context. Adherence is a product of motivation and ability. Motivation comprises conscious decision-making processes but also from more 'instinctive', intuitive and habitual processes. Ability comprises the physical and psychological skills needed to adhere. Both motivation and ability are influenced by environmental and social factors which influence the opportunity to adhere as well as triggers or cues to actions which may be internal (e.g. experiencing symptoms) or external (e.g. receiving a reminder). Systematic reviews of adherence interventions show that effective solutions are elusive, partly because few have a strong theoretical basis. Adherence support targeted at the level of individuals will be more effective if it is tailored to address the specific perceptions (e.g. beliefs about illness and treatment) and practicalities (e.g. capability and resources) influencing individuals' motivation and ability to adhere. [ABSTRACT FROM AUTHOR]

The involvement of stakeholders along the project life cycle is crucial to the delivery of community-based projects, particularly Nigeria Kogi West Senatorial District's water projects. This is to provide safe and clean water for consumption and usage. Thus, this study examined at which stage of the cycle was involvement more important to the delivery of water projects in the study area. We rely on 234 completed questionnaires, which included employees of Lower Niger River Basin Development Authority, community leaders, and others. They all provided information through a structured questionnaire. Both descriptive (Mean Ranking) and inferential statistics (Partial Least Square Structural Equation Modelling, PLS-SEM) were deployed in the analyses. The results of the descriptive analysis showed that stakeholder involvement in the delivery of borehole water projects was the highest during the execution stages (bES), with a mean of 3.918, whereas, the lowest average was observed during the planning stages (bPS) with a mean of 2.745. The empirical results showed that stakeholders' involvement recorded the largest significant path with the execution phase on stakeholder satisfaction having a coefficient of 0.495 and a p-value of 6.366, and the least significant path with the monitoring and closing stage on budget (0.164, 2.643). This suggested that many promises from the government have mostly not been fulfilled, but those that were executed always bring satisfaction to the stakeholders, especially the host communities which may be influenced by too many empty promises. Other highlights of the results obtained showed that the paths of involvement at the initial stages were not significant with the constructs of project delivery, which implied that most water projects were pushed rather than pulled. [ABSTRACT FROM AUTHOR]

The effect of zinc (Zn) injection on the stress corrosion cracking (SCC) initiation of an Alloy 182 weld metal and a 20% cold-worked (CW) type 316L stainless steel was investigated under simulated light water reactor conditions. Accelerated SCC initiation tests revealed that under both, boiling (BWR) and pressurized water reactor (PWR) conditions without Zn injection, Alloy 182 showed a higher SCC initiation susceptibility compared to the CW 316L stainless steel. With 40 ppb Zn injection, results indicate a tendency towards higher stress thresholds or lower crack densities for SCC initiation in both materials. In other words, Zn water chemistry seems to be able to mitigate SCC initiation. The optimized, Zn-treated oxide film is believed to be responsible for the improved SCC performance. However, no clear mitigation effects were observed when the specimens were pre-exposed to high-temperature water without Zn and then tested with Zn, which is likely related to the relatively short exposure time to the Zn-containing high-temperature water. [ABSTRACT FROM AUTHOR]

Sweet potato (Ipomoea batatas) is an economically important food crop that is grown primarily for its edible storage roots. Several researchers have consequently been conducting studies to increase sweet potato yield, and an important aspect of this research involves understanding how storage root initiation occurs. Although significant progress has been made, several challenges associated with studying this crop have resulted in lagging progress compared to other crops and thus sweet potato storage root initiation is not clearly understood. This article highlights the most important aspects of the hormone signalling processes during storage root initiation that needs to be investigated further and suggests candidate genes that should be prioritized for further study, based on their importance in storage organ formation in other crops. Lastly, ways of overcoming the challenges associated with studying this crop are suggested. [ABSTRACT FROM AUTHOR]

Two-dimensional oblique detonation waves (ODWs) induced by finite wedges in a stoichiometric hydrogen–air mixture have been investigated numerically based on reactive Euler equations with a detailed chemical reaction model. The main zone affected by the expansion wave emanating from the turning point of a wedge is the flowfield downstream of the intersection point of the oblique shock wave (OSW) and the expansion wave. The ODW would be reduced to Chapman–Jouguet (CJ) detonation or decoupled combustion downstream. Three combustion regimes, detonation, decoupled combustion, and no ignition, were observed successively, as the wedge length decreases. It is found that the location of the intersection point is a key parameter for the detonation initiation. When the intersection point is located upstream of the ODW transition point, the expansion wave may quench ODW. Then, the critical wedge length is obtained by theoretical analysis of wave structures and the initiation criterion of ODWs for finite wedges is proposed. When the wedge length is greater than the critical wedge length, ODWs can be initiated. On the contrary, the initiation of ODWs do not occur. For wedge lengths small enough, no ignition occurs. Previously proposed criteria that use the induction length are also examined and compared with the present critical wedge length criterion in this study, and the latter is proven to achieve better results. [ABSTRACT FROM AUTHOR]

Men in sub-Saharan Africa are underrepresented in antiretroviral therapy (ART) programs. Our secondary analysis of 40 in-depth interviews with Malawian men living with HIV examined barriers and facilitators for ART initiation versus retention. Interviewees included men who never initiated or initiated ART late (initiation respondents, n = 19); and men who initiated ART but were late for an appointment (retention respondents, n = 21). Transcribed interviews were coded using deductive and inductive coding techniques and analyzed using constant comparison methods. Long wait times, frequent facility visits, and insufficient in-clinic privacy were barriers for initiation and retention. Poor knowledge of ART was primarily a barrier for initiation; unexpected travel was a barrier for retention. Key facilitators for initiation and retention included previous positive experiences with health facilities. Having examples of successful men using ART primarily facilitated initiation; support from spouses and male peers facilitated retention. Results may inform interventions to increase men's engagement in ART services. [ABSTRACT FROM AUTHOR]

There is evidence that the process of executing a plannedutterance involves the use of both preceding-context and top-down cues. Utterance-initial words are cued only by the top-down plan. In contrast, non-initial words are cued both bytop-down cues and preceding-context cues. Co-existence ofboth cue types raises the question of how they interact duringlearning. We argue that this interaction is competitive: itemsthat tend to be preceded by predictive preceding-context cuesare harder to activate from the plan without this predictivecontext. A novel computational model of this competition isdeveloped. The model is tested on a corpus of repetitiondisfluencies and shown to account for the influences onpatterns of restarts during production. In particular, this modelpredicts a novel Initiation Effect: following an interruption,speakers re-initiate production from words that tend to occurin utterance-initial position, even when they are not initial inthe interrupted utterance.

The article deals with the analysis of video games and the use of VR technologies in the gaming sphere. The trend towards increasing gamification of modern man's being is examined and problematized. The main question raised by the author is what is the actual status of video games in the existence of modern man. The aim of the research is to study the ontoanthropology of video games, and VR games in particular, and search for their correlates with archaic practices. This, in turn, led to the consideration of the ontoanthropology of the virtual and the ontoanthropology of the game as its variety. The author comes to a conclusion that video games are a substitute for initiation which is most fully and safely performed by means of immersive equipment and taking rite-ritual activity into virtual reality. The results of the study can be used for an expert assessment of video games, identifying the prospects for their implementation in pedagogical, psychological or other consulting activities aimed at achieving a sense of inner transformation of the person in the direction of greater completeness and authenticity of existential experience. The findings can form the basis for philosophical conceptualization of modern mechanisms of digital identity formation and contribute to the growth of socio-humanitarian reflection on the problem of human self-identification and methods of achieving a sense of ontological fundamentality and wholeness of being in a virtual reality.

The subject of the study was one of the most viral Russian trends of the turn of 2022–2023: krotovukha, a tincture on a dead mole, which attracted attention of not only the Internet users, but also of doctors, restaurateurs, historians, and legislators. The aim of the research was to identify the reasons for active participation in communication on such a topic. It was found that the image of the mole is very much in demand in world culture. This is due to its otherness, its ability to act, to change space, to link the underworld with the mundane. Analysis of a video by an alcohol blogger from Moscow revealed the presence of initiation semantics attached to tasting. These types of publications become a modified version of the ritualised round drinking, as evidenced by patriotic themes and masculine accessories. The name itself already potentially contains the semantics of the familiar, the expressive, and the dearly beloved. A large number of memes demonstrate the strength of user reactions to krotovukha. The most comical effect is produced by stylistic disruption. The incredible effects of the “national” elixir are played off. The duality of perception of the character and the drink made from his body makes the recognisable image variable, polyvalent, and suitable for multiple transformations. The article concludes by noting that the recipe that went viral reflects a belief in sympathetic magic, the ritual power of sacrifice and the cosmogonic significance of the rite – the sacred timing of information dissemination.

Abstract Background Uganda’s current guidelines recommend immediate initiation of Anti-Retroviral Therapy (ART) for persons living with HIV in order to reduce HIV/AIDS related morbidity and mortality. However, not all eligible PLHIV initiate ART within the recommended time following HIV diagnosis. We assessed the prevalence and factors associated with delayed ART initiation among PLHIV referred for ART initiation, five years since rolling out the test and treat guidelines. Methods In this cross-sectional study, we enrolled adult patients referred to Mulago Immune Suppressive Syndrome (Mulago ISS) clinic for ART initiation from January 2017 to May 2021. We collected data on socio-demographics, HIV diagnosis and referral circumstances, and time to ART initiation using a questionnaire. The outcome of interest was proportion of patients that delayed ART, defined as spending more than 30 days from HIV diagnosis to ART initiation. We performed multivariable logistic regression and identified significant factors. Results A total of 312 patients were enrolled of which 62.2% were female. The median (inter-quartile range [IQR]) age and baseline CD4 count of the patients were 35 (28–42) years and 315 (118.8–580.5) cells/μL respectively. Forty-eight (15.4%) patients delayed ART initiation and had a median (IQR) time to ART of 92 (49.0–273.5) days. The factors associated with delayed ART initiation were; 1) having had the HIV diagnosis made from a private health facility versus public, (adjusted odds ratio [aOR] = 2.4 (95% confidence interval [CI] 1.1–5.5); 2) initial denial of positive HIV test results, aOR = 5.4 (95% CI: 2.0–15.0); and, 3) having not received a follow up phone call from the place of HIV diagnosis, aOR = 2.8 (95% CI: 1.2–6.8). Conclusion There was significant delay of ART initiation among referred PLHIV within 5 years after the rollout of test and treat guidelines in Uganda. Health system challenges in the continuity of HIV care services negatively affects timely ART initiation among referred PLHIV in Uganda.

The paper was presented on 9 April 2022 at the XIV School Camp of Emergency Psychologists, held by Psicologi per i Popoli - Federazione. After a brief excursus on the concept of "humanisation", the author depicts the activity of a psychologist who for the first time faces an emergency situation as an experience of initiation into a profound humanisation of his or her psychological knowledge and action, which is experienced outside of his or her own office and outpatient clinic, away from the desk with the appointment diary, the medical history file and the tests, without the DSM manual under his or her arm and without the PTSD lens.