The COVID-19 pandemic is affecting the mental and emotional well-being of patients, family members, and health care workers. Patients in the isolation ward may have psychological problems due to long-term hospitalization, the development of the epidemic, and the inability to see their families. A medical assistive robot (MAR), acting as an intermediary of communication, can be deployed to address these mental pressures.CareDo, a MAR with telepresence and teleoperation functions, was developed in this work for remote health care. The aim of this study was to investigate its practical performance in the isolation ward during the pandemic.Two systems were integrated into the CareDo robot. For the telepresence system, a web real-time communications solution is used for the multiuser chat system and a convolutional neural network is used for expression recognition. For the teleoperation system, an incremental motion mapping method is used for operating the robot remotely. A clinical trial of this system was conducted at First Affiliated Hospital, Zhejiang University.During the clinical trials, tasks such as video chatting, emotion detection, and medical supplies delivery were performed via the CareDo robot. Seven voice commands were set for performing system wakeup, video chatting, and system exiting. Durations from 1 to 3 seconds of common commands were set to improve voice command detection. The facial expression was recorded 152 times for a patient in 1 day for the psychological intervention. The recognition accuracy reached 95% and 92.8% for happy and neutral expressions, respectively.Patients and health care workers can use this MAR in the isolation ward for telehealth care during the COVID-19 pandemic. This can be a useful approach to break the chains of virus transmission and can also be an effective way to conduct remote psychological intervention. The COVID-19 pandemic has been affecting the global population for more than 2 years since the World Health Organization’s declaration of its outbreak on March 11, 2020 . People Prior to the COVID-19 pandemic, the most important application of MARs was robotic surgery . During This paper describes a robot named CareDo with remote chatting, facial expression recognition, and teleoperation functions for telehealth care in the isolation ward, aiming to provide a safe and efficient interaction between patients and doctors during the pandemic. The primary contributions and novelties of this work are as follows: (1) an advanced MAR was developed and integrated with voice command interaction and human motion–based teleoperation; (2) a multiuser video chat system based on web real-time communication (WebRTC) was deployed with the facial expression recognition system using a trained convolutional neural network (CNN) model; and (3) a voice activation detection algorithm was designed and used during the voice command interaction, which is self-adaptive to the environment sound intensity and significantly improved voice recognition accuracy.The past 2 years have witnessed an increasing number of robots in hospitals. Robots are considered to be an effective tool for cutting off the transmission of the virus.Various robotic solutions have been implemented for reducing unnecessary physical contacts in coronavirus management. Representative robots used for these purposes are presented in A new hospital in Wuhan, China, adopted robots to deliver food, drinks, and drugs to patients in the initial stage of the COVID-19 epidemic . Some ofThe assistive robots mentioned above are mainly used for logistics and disinfection. To provide emotional care, tools with human-machine interaction capacity are being released. For instance, Podrazhansky et al  developeFrom these current related works, it can be seen that MARs are becoming ubiquitous, especially during the pandemic when people’s movement has been restricted. Nevertheless, a previous study showed that there are potential safety issues when using conversational assistants for health information purposes . AccordiThe CareDo MAR used in this work includes two main functional parts: a telepresence system and a teleoperation system. The telepresence system contains two subsystems: a multiuser video chat system and a facial expression recognition system. The former allows the patient to talk with doctors or families without physical contact, whereas the latter can be used for patient emotional monitoring. The teleoperation system is a supported physical assistance solution for noncontact telehealth care. In the teleoperation system, the main technology is the motion mapping method, which was introduced previously . With thAs shown in the schematic diagram of the system in A self-developed video chat system is integrated on the dual-arm MAR for chatting function realization. Two main technologies, a real-time speech recognition function and a noncontact telepresence GUI, are used on the video chat system of the robot. With these technologies, the robot can act as a medium for remote consultations and video chats.E. The threshold value ε is then obtained using a previously described data preprocessing method [ε represents the voice energy needed to trigger the voice recording process. In an isolation ward, the level of noise typically fluctuates because of the operation of various medical instruments. Hence, the trigger threshold ε was set to be self-adaptive to the environment sound intensity. Assuming ε=f(E), where ε ∈ {min, EmaxE}, through data set preprocessing, the threshold values minε and maxε can be set using the sound energy minE and maxE, respectively. The self-adaptive threshold value can then be expressed as:For the real-time speech recognition component, the chat system is designed to recognize the voice input of a video opening construction. Toward this end, pocketsphinx, an offline voice recognition package with a specific speech recognition acoustic model, is integrated in the robot to handle the voice input. The voice activation detection algorithm is used to enable the robot to start sound recording and the recording ends with the last word. To extract voice information from the audio information, a threshold-based decision criterion is used. When the surrounding sound is stable, it has a sound energy denoted as g method . The thrIn the sound recognizing and matching process, a pretrained dictionary file is used to save the related words about logging the live video chat GUI. Then, the pocketsphinx package will find the parameter with the most similar meaning and obtain the final recognition results to determine whether to open the GUI by comparing the input voice signal and characteristic parameter in the template library.The noncontact telepresence GUI was designed to offer a multiperson remote video platform for patient condition consulting and chatting. Therefore, the WebRTC communication technology  was usedThe entire video chat system structure is schematically presented in The proposed system can realize remote consultation as well as daily family chats without health care workers entering the isolation ward. Users can log in to this video chat system through general desktop browsers such as Google Chrome and Microsoft Edge. They do not need to download specific software. Therefore, this system is safe because of reduced exposure to any vulnerabilities that may exist on the vendor’s client.In addition to the remote video chat system, a facial expression recognition system based on CNN is used to monitor the emotional fluctuation of the patient, providing retraceable historical data for intervention therapy and promoting patients’ mental health as well as disease management. This system was achieved from our previous work on facial expression recognition for human-robot interactions . Figure To assist patients in the isolation ward, a unique teleoperation system is proposed to provide an intuitive remote-control interface for doctors to operate the MAR. As a human-cyber physical system (HCPS)-based assistive technology, three elements are included in this system. Health care workers, as the humans in this system, wear a motion capture device suit. The MAR, as the physical entity in this system, can be remotely controlled by health care workers . The cybThe human motion capture technology is mainly used on the human side of the teleoperation system. The Perception Neuro 2.0 (PN2) motion capture suit is used to capture the real-time upper limb motion of the operator. PN2 is an adaptive motion capture device that consists of multinode inertial measurement units (IMUs), which are all located on the straps in this device . IMUs caFrom the human side mentioned above, the position and posture data of the operator hands are obtained. Because the workspace of a human hand and the robotic manipulator is different, a previously proposed incremental pose-mapping strategy was used . This meApproval of all ethical and experimental procedures and protocols was granted by the Clinical Research Ethics Committee of the First Affiliated Hospital, Zhejiang University , and the study was performed in line with the full informed consent of the volunteers, in accordance with all local laws.The WebRTC-based video chat system provides essential telemedicine services. Compared with other video chat systems, this system adopts peer-to-peer connection, which is easy to manage and deploy. The GUI on the browser is used as shown in the window on the left side of The facial expression recognition performance was evaluated during clinical trials at the FAHZU. Using the camera integrated on the front screen of the CareDo robot, the facial expressions of the patients were recorded and analyzed. The facial expression recognition data set was collected from 12 subjects, including 6 female and 6 male subjects, ranging in age from 15 to 60 years and evenly distributed from three groups: the young group (15-25 years old), middle-aged group (25-45 years old), and older adult group (45-60 years old). The facial expression recognition system worked 8 hours a day and each subject’s facial expression was recorded 15 times. The final data set was composed of 180 records (12 subjects×15 times/subject), among which 152 valid records were obtained. According to the current diagnosis and treatment operation requirements of the isolation ward for COVID-19 patients, we developed a new type of the CareDo MAR to assist in the diagnosis and treatment operations of medical staff. After validation in a laboratory environment, the robot was checked by the clinical research ethics committee of the FAHZU and obtained investigator-initiated trial (IIT) ethics approval. The CareDo robot was then applied in the emergency intensive care unit (EICU) of the FAHZU for preliminary clinical function verification, as shown in Aiming at reducing the risk of infection to health care staff due to exposure to the COVID-19 virus, the robot was used in the isolation ward to perform remote care tasks through teleoperation. For the WebRTC-based video chat system, the COVID-19 patient interacted with the remote doctors using the interactive screen on the front of the robot. As shown in The emergence of COVID-19 has brought great changes to the medical industry, especially the telemedicine service. The CareDo robot offers another new form of telehealth assistance. In this work, an advanced telerobotic system was developed. Its efficient deployment in hospitals was applied by leveraging the enabling technologies of Healthcare 4.0. Techniques, including high-performance wireless communications, high-quality remote audio and video systems, an intelligent remote-controlled robot, and wearable sensors for motion capture, are used to assist and protect health care professionals.With these functions, CareDo can execute relevant operations of a remote video system according to the patient’s voice instruction, monitor patients’ mental health status, and grasp and deliver medical supplies through teleoperation. During the utilization period in a hospital, CareDo can mitigate the risk of nosocomial infection and therefore contribute to accelerated recovery of the COVID-19 epidemic.In the proposed telerobotic system, telemedical staff can use remote video to talk with patients and remotely operate the robot outside the negative pressure ward to complete nursing work, avoiding cross-infection caused by their frequent close contact with patients. The proposed system can realize the real-time monitoring and recording of patients’ emotional changes, providing retraceable historical data for intervention therapy and promoting patients’ mental health as well as disease management. The system makes significant contributions to the mitigation and suppression of COVID-19 transmission chains for impacted societies.This effort offers a quick solution of remote video and dialogue between patients and doctors during the pandemic. However, several limitations still exist. First, the user experience has not been deeply investigated or estimated during the use of a single function such as a video chat. Second, for the telepresence system, the recognition accuracy of facial expressions such as sad and fear still need to be optimized. A longer patient usage time is suggested to obtain more samples and records. During the implementation and clinical trials, the influence of wearing a mask was not considered or tested in this work. Wearing a mask will cover the lower part of the face and make most facial features invisible, which will decrease the facial expression recognition accuracy ,42. ThirFuture work could focus on the improvement of functionality and integration. Based on the exploitable functions of WebRTC, the facial expression recognition function can be integrated into the real-time communication system. The influence of wearing masks on facial expression recognition will be considered and investigated in the future. The user operation process can be simplified while the security of the remote video chat system can be evaluated. Further study can also focus on developing cost-effective MARs for applications in more generalized telehealth care scenarios.This article described the design and development of CareDo, a MAR devised to provide telehealth care to COVID-19 patients in the isolation ward. Three key technologies used on this robot are (1) a telepresence system in which the user can log in with voice input, enabling patients, doctors, and patients’ family members to have safe and real-time remote chats; (2) a facial expression recognition system that can monitor the patients’ emotional fluctuations; and (3) multinode ROS–based teleoperation technology that assists the robot in the isolation ward to perform other tasks such as delivering medical supplies. The CareDo robot was used in the EICU of the FAHZU for function verification under IIT ethics approval. The results showed that use of this MAR in the hospital can reduce the risk of cross-infection between patients and doctors. Moreover, the multiuser video chat system allows patients to talk with doctors and their family, which can relieve the patients’ mental stress from isolation.


This includes clarification that there were differences in the unadjusted measures of body mass index and IQ between the video gamers and non–video gamers and that there were no such differences after adjusting for sociodemographic variables; similar clarifications to the relevant statistical analyses have been provided. The findings were clarified to acknowledge that the reaction times were measures of cognitive performance involving response inhibition and working memory and that the differences in reaction times between the 2 groups were very small. The original Table 1 has been corrected to report the unadjusted variables separately from the adjusted variables and outcomes, which are now reported in Table 2. The original Table 2 is now Table 3. Findings of the analyses reported in Supplement 1 have been clarified in the Results section of the main text, and a summary of additional analysis to address missing or partially missing data on the screen time questionnaire for 11 non–video gamer participants (0.5% of the sample) has been added to the Results section. In addition, errors were introduced by the journal to Figures 1 and 2. Markers and text labels were omitted from Figure 1. For Figure 2, the panel for the Child Behavior Checklist (CBCL) t scores was mislabeled as the CBCL raw scores, and a footnote indicator, a panel for the CBCL raw scores, and a dashed line for the CBCL t scores were omitted. The article has been corrected.1In the Original Investigation, “Association of Video Gaming With Cognitive Performance Among Children,”


The diagnosis of RCD and EATL is often challenging, due to misleading clinical-pathological features and to significant overlap with several CD-unrelated gastro-intestinal disorders. Similarly, the treatment of RCD and EATL is an unmet clinical need for both gastroenterologists and hematologists. Moving from such premises, this review aims to provide a comprehensive view of RCD and EATL, specifically considering their pathogenesis and the many still open issues concerning their diagnosis and clinical management.Refractory celiac disease (RCD) and enteropathy-associated T-cell lymphoma (EATL) are rare, yet severe complications of celiac disease (CD). Over the last decades, several studies have addressed the biology and clinical-pathological features of such conditions, highlighting unique disease patterns and recurrent genetic events. Current classification proposals identify two forms of RCD, namely: (i) type 1 RCD (RCD-I), characterized by phenotypically normal intra-epithelial lymphocytes (IELs); and (ii) type 2 RCD (RCD-II), featuring phenotypically aberrant IELs. While RCD-I likely represents a gluten-independent dysimmune reaction against small bowel epithelial cells, RCD-II is better considered an  CD is one of the most common autoimmune diseases, affecting approximately 1% of the Western population. Although CD can occur at virtually any age, most cases are diagnosed in children and young adults , 3.The clinical presentation of CD is broad, ranging from fully asymptomatic cases to very morbid conditions. Most symptoms are related to malabsorption, micronutrient deficiency and failure to thrive, as a result of intestinal mucosa damage by gluten-induced dysimmunity. Non-classical presentations can involve extra-gastro-intestinal (GI) sites and include neurological symptoms, endocrinopathies, cutaneous lesions, osteopenia and changes in reproductive function , 5. Finai.e. anti-deamidated gliadin peptide [anti-DGP] auto-Ab; anti-tissue transglutaminase [anti-tTG] auto-Ab; anti-endomysial Ab [EMA]). Testing for IgA auto-Ab is routinely performed in the diagnostic workup of all suspected CD patients, while IgG auto-Ab are mainly tested in cases with selective IgA deficiency  . In mostAccording to international consensus reports, RCD is defined as any CD with clinical and histological unresponsiveness to ≥12 months of strict GFD , 18. ThiMoving from such premises, this review aims at providing a comprehensive view of the pathogenesis and clinical-pathological features of RCD and EATL, specifically focusing on the most recent biological achievements and on their clinical implications.22.1According to a systematic review published in 2016, RCD has a prevalence of 0.3-0.4% and a cumulative incidence of 1-4% among CD patients . RCD usuIn the last decades, the incidence of RCD has progressively decreased, possibly as a result of timelier diagnoses of CD and of wider availability of gluten free products . Besidesversus 50-60 years) : (i) RCD type I (RCD-I), characterized by normal (surface CD3 [sCD3]+/CD8+) IELs; and (ii) RCD type II (RCD-II), characterized by phenotypically aberrant (sCD3-/cytoplasmic CD3 [cCD3]+/CD8-) IELs. In most studies, RCD-I occurs one decade earlier than RCD-II (mean age at diagnosis: 40-50 0 years) –22, 25. 0 years) . The bio2.2e.g. Hashimoto’s thyroiditis; microscopic colitis; autoimmune hepatopathies), being slightly more common in RCD-II than RCD-I , small bowel strictures and occlusions are hallmark of EATL progression  to detect intestinal strictures or wall thickening that may hamper endoscopic evaluation. Imaging studies may also aid disclosing abdominal masses and mesenteric lymphadenopathies  are the first line therapies for RCD-I, being associated with clinical improvement in most cases  to eliminate the aberrant RCD-II IELs. If symptoms worsen, high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is recommended , closely related and rapidly progressing to overt EATL , due to the severity of the clinical picture and to the higher risk of EATL evolution , 25, 47.ert EATL . Malignaert EATL .3Over the last decades, several studies have explored the biology and pathophysiology of RCD. It is now clear that RCD-I and RCD-II are very different diseases, sharing a common antigenic trigger and following different pathogenic pathways. This may explain the different epidemiology, clinical features and outcome of RCD-I and RCD-II patients.3.1i.e. gluten-independent) disease  of the MYO9B (rs2041570)  . The bioAs for the immunological determinants, recent studies have shown a link between the neoplastic IELs of RCD-II/EATL and innate-like lymphocytes (ILLs) of normal intestinal mucosa. ILLs are a unique immune cell subset, deriving from immature hematopoietic precursors that migrate into the gut epithelium, start T-cell differentiation in response to NOTCH1 signals, and underwent cell fate reprogramming after IL-15 exposure. Like neoplastic IELs of RCD-II/EATL, ILLs manifest dual T and NK cell traits , lack sCi.e. JAK1 and STAT3 mutations), which enhance response to several cytokines, including IL-15. This is overexpressed in the intestinal mucosa of active CD and RCD and stimulates the proliferation of mutated ILLs (i.e. TNFAIP3 and TNIP3)  . This sud TNIP3) . Finallyd TNIP3) , by the d TNIP3)  and by ed TNIP3) .In RCD, the pathogenic role of IL-15 spans well beyond the pro-survival signals provided to neoplastic IELs. IL-15 is indeed largely responsible of GFD-independent mucosal damage and severe villous atrophy, since it induces a NK-like cytotoxic phenotype in IELs . In keep4Histology is the mainstay of RCD diagnosis. Despite this, the microscopic changes of RCD are not entirely specific and overlap with a broad range of conditions, which must be taken into account when facing long-lasting villous atrophy with or without increased IELs. In the following paragraphs the key histological findings of RCD-I and RCD-II will be addressed, specifically considering the differential diagnosis of these entities.4.1TCR gene rearrangements , drug-induced enteropathy (DIE), common variable immunodeficiency (CVID)-associated enteropathy, tropical and collagenous sprue, Giardiasis and Crohn’s disease. While the differential diagnosis with RCD-II relies on IELs phenotype (see below), distinction from other enteropathies requires integration of clinical-epidemiological, histological and laboratory data Table 2 i.e. anti-enterocyte or anti-goblet cell) auto-Ab, which are never documented in RCD  with slight male predominance (M:F ratio= 1.5) . Histolod in RCD .i.e. Methotrexate and Azathioprine-induced enteropathy), MMAE has low numbers of IELs, supporting the differential diagnosis with RCD-I  and Mycophenolate Mofetil-associated enteropathy (MMAE) closely mimic RCD-I . OAE is th RCD-I –74. In ath RCD-I .CVID-associated enteropathy may mimic CD/RCD-I both clinically and histologically . Small bi.e. main location in the villous basal third and in crypt epithelium), and increased eosinophils in the lamina propria. These findings and the history of travels to the tropics support the diagnosis  sub-epithelial band of collagen, entrapping the blood vessels and stromal cells of the lamina propria. In collagenous sprue, villous distortion is usually accompanied by severe crypt atrophy, resulting in a markedly reduced thickness of duodenal mucosa. These findings and the lack of increased IELs favor the diagnosis of collagenous sprue .TCR gene rearrangements support the diagnosis of these conditions   , 88, 89.i.e. ≥20% of total IELs for FC; ≥50% of total IELs for IHC) (Phenotypic aberrancies in RCD-II can be documented by either flow cytometry or immunohistochemistry (IHC). As a general rule, flow cytometry is more sensitive and accurate, although it is not as widely applicable as IHC . As suchfor IHC) , 90.Morphological assessment of duodenal biopsy in RCD-II shows marked villous atrophy, usually at a greater degree than RCD-I (moderate/severe villous atrophy: 96% of RCD-II and 50% of RCD-I) , togethePhenotypically, IELs of RCD-II lack CD4, CD8, sCD3 and TCRαβ/TCRγδ, while retaining CD7, CD103 and cCD3 expression . CD30 isThe differential diagnosis of RCD-II mainly includes RCD-I and EATL. Distinction from RCD-I relies primarily on IEL phenotyping, while the differential diagnosis with EATL is more challenging. In fact, RCD-II and EATL represents two ends of a biological continuum and a diagnosis of overt EATL should only be considered when the neoplastic population massively invades the duodenal/small intestinal wall, with clear-cut evidence of tumor lesions, bowel perforation or strictures (see paragraph 5.4).55.1i.e. homozygosity for HLA-DQ2; common allelic variants of MYO9B gene) , arising from IELs of the small bowel and representing the invasive form of RCD-II. In line with this, EATL and RCD-II share several pathophysiological features, including a common genetic background (9B gene) , 53 and 9B gene) . Additiond KMT2D , 97, delnd KMT2D . All of 5.2i.e. EATL diagnosed concurrently with CD) and secondary EATL (i.e. EATL arising in patients with prior diagnosis of CD or RCD-II).Despite being the most common intestinal T-cell lymphoma in Western countries, EATL is an exceedingly rare disease with a reported incidence of 0.2-1.0/1.000.000/year. It accounts for 5% of all GI lymphomas –101 and EATL affects adult to elderly patients (median age at diagnosis: 61 years)  and like5.32-IV) is present in about half of the patients . The EPI identifies the following risk groups: (i) low-risk EATL ; (ii) intermediate-risk EATL ; and (iii) high-risk EATL  (i.e. post-RCD-II) disease (5-year OS: 60% versus <5%)  will hopefully contribute to improve patient management  . In addisus <5%) . These pnagement , 109.5.4Histologically, EATL is characterized by a diffuse infiltrate of atypical T-cells in a rich inflammatory background of histiocytes, plasma cells and granulocytes. Reactive cells may be as many as to obscure the neoplastic population, which consists of medium to large cells with pleomorphic, immunoblastic or anaplastic morphology , 110. Thi.e. positivity for cCD3, CD7, NKp46 and CD103; variable expression of CD2; negativity for CD4, CD5, CD8, CD56, ALK, EBER and TCRαβ/TCRγδ)  , 111. Neβ/TCRγδ) , 102. A β/TCRγδ) . Moleculst cases .i.e. mucosa/submucosa-limited) EATL from RCD-II may be matter of subjectivity, especially on small biopsy samples. In such cases, the diagnosis of EATL should be favored in presence of B symptoms, abdominal masses, or specific phenotypic findings .The differential diagnosis of EATL mainly includes RCD-II and MEITL. As previously outlined, distinction from RCD-II relies on the degree of infiltration by neoplastic cells, which is usually massive in EATL and limited to the lamina propria in RCD-II. However, separating early-stage  and from GI involvement by systemic PTCL is usually straightforward and relies on a combination of morphology, phenotypic studies and clinical correlations.Distinction of EATL from other primary GI lymphomas (6in situ T-cell lymphoma with high risk of EATL progression. In keeping with this view, several studies have highlighted the complex pathogenesis and kinship of RCD-II and EATL. All of this has been formally acknowledged also by the 2022 WHO and ICC classifications of lymphoid tumors, which include both EATL and RCD-I/RCD-II in the list of intestinal T-cell lymphoproliferative disorders (Over the last decades, a batter characterization of the biology of RCD and EATL has improved our knowledge of these conditions. RCD-I and RCD-II are distinct disorders stemming from a disease initially driven by abnormal T-cell immune responses against gluten-derived peptides in genetically susceptible individuals. In particular, RCD-I represents a gluten-independent dysimmune reaction of the small bowel, while RCD-II can be regarded as an aggressive isorders .Despite these achievements, the diagnosis of RCD and EATL remains challenging and the prognosis of RCD-II and EATL is poor. New molecular targets for tailored therapies will hopefully compensate for such dismal outcome. For the time being, the proper recognition and management of RCD and EATL relies on a high degree of suspicion, on careful differential diagnoses, and on the collaboration of gastroenterologists, hematologists and pathologists with specific expertise on GI lymphomas and dysimmune disorders. This teamwork still represents the best strategy for any further development on these conditions and for the appropriate management of patients.FS: Writing – original draft. MP: Writing – original draft, Supervision, Writing – review & editing. FPe: Writing – review & editing. VA: Writing – review & editing. AD: Supervision, Writing – review & editing. FPi: Writing – review & editing. ES: Writing – review & editing. FZ: Supervision, Writing – original draft. MF: Supervision, Writing – original draft.


However, there is no direct evidence of Mg2+ permeation through endogenous TRPM7. To determine the physiological roles of TRPM7 in intracellular Mg2+ homeostasis, we measured the cytoplasmic free Mg2+ concentration ([Mg2+]i) in TRPM7-silenced H9c2 cells. [Mg2+]i was measured in a cluster of 8–10 cells using the fluorescent indicator, furaptra. TRPM7 silencing did not change [Mg2+]i in Ca2+-free Tyrode’s solution containing 1 mM Mg2+. Increasing the extracellular Mg2+ to 92.5 mM raised [Mg2+]i in control cells (1.56 ± 0.19 mM) at 30 min, while this effect was significantly attenuated in TRPM7-silenced cells (1.12 ± 0.07 mM). The Mg2+ efflux driven by Na+ gradient was unaffected by TRPM7 silencing. These results suggest that TRPM7 regulates the rate of Mg2+ influx in H9c2 cells, although cytoplasmic Mg2+ homeostasis at basal conditions is unaffected by TRPM7 silencing.TRPM7, a member of the melastatin subfamily of transient receptor potential channels, is suggested to be a potential candidate for a physiological Mg Mg2+ is essential for protein synthesis, the regulation of ion channels, and as a co-factor in over 600 enzymatic reactions, many of which affect cellular functions and viability [2+ concentration ([Mg2+]i) should be kept in physiological range, but the molecules responsible for Mg2+ influx pathway remain to be identified. In cardiac myocytes, several candidates, such as transient receptor potential melastatin subfamily member 7  and magnesium transporter 1 , have been proposed i according to the equation:KD is the dissociation constant, and Rmin and Rmax are R values at zero [Mg2+] and saturating [Mg2+], respectively. We used the parameter values previously estimated in rat ventricular myocytes  induced by substitution of 1 mM Ni2+ for Mg2+ of Ca2+-free Tyrode’s solution at 25 °C.Influx of Niescribed . We meas2+solution for 30 min, then were reperfused with Ca2+-free Tyrode’s solution for 30 min. [Mg2+]i was measured at ~ 5-min intervals during the perfusion. Because the [Mg2+]i rise is likely caused by the influx of Mg2+, we analyzed the rate of increase in [Mg2+]i as Mg2+ influx rate by Mg2+-loading.After furaptra loading, the cells were initially perfused with high-Mg+-dependent Mg2+ efflux was analyzed as described previously , which was prepared by substitution of 135 mM NaCl of Ca2+-free Tyrode’s solution with 101 mM NMDG-Cl (N-methyl-D-glucamine titrated HCl), 19.6 mM MgCl2 and 6.0 mM MgMs2.Cat-test or two-way repeated measure ANOVA with the significance level set at p < 0.05 .Linear and nonlinear least-squares curve fitting was performed with the program Origin . Statistical values are expressed as the mean ± SE. Differences between groups were analyzed by Student’s 2+-free Tyrode’s solution, [Mg2+]i of TRPM7-silenced H9c2 cells (shTRPM7 cells) was 0.99 ± 0.05 mM, which was similar to that of shControl cells (0.98 ± 0.08 mM) , and then partially recovered by reperfusion of Ca2+-free Tyrode’s solution containing 1 mM Mg2+. On the other hand, the increment in [Mg2+]i (1.12 ± 0.07 mM) in shTRPM7 cells was significantly smaller than that of shControl cells   Fig. A. The le5 and shTRPM7 0.98 ± 0.12 × 105 at 72 h after transfection, n = 3, p = 0.38). There was no significant difference of cell viability between shControl cells and shTRPM7 up to 144 h .We confirmed whether TRPM7 was silenced in the shTRPM7 cells compared with the shControl cells. Figure Trpm7 shRNA, the relative expression level of Trpm7 mRNA was significantly reduced to 41 ± 3% in shTRPM7 cells compared with shControl cells . To further confirm the efficiency of TRPM7 silencing, we estimated TRPM7 channel activity using Ni2+ influx monitored by quenching of intracellular furaptra. Figure 2+ quenching of fluorescence in shTRPM7 cells was significantly smaller than that of shControl cells , suggesting impairment of TRPM7 channel activity on the plasma membrane of shTRPM7 cells.Since the transfection efficiency reached about 50% in 72 h Fig. B, we use2+ efflux, as shown in Fig. 2+ in rat ventricular myocytes is mainly extruded with a Na+-gradient-dependent Mg2+-efflux system i by inflow of extracellular Mg2+ is very slow [+ solutions caused damage and morphological changes in H9c2 cells. We therefore used extremely high (92.5 mM)-Mg2+ solution to observe Mg2+ influx in a short period (30 min). TRPM7 silencing significantly decreases the rate of Mg2+ influx of the cells at high [Mg2+]o, although basal [Mg2+]i appears to still be maintained at normal [Mg2+]o. TRPM7 silencing had little effect on the activity of the Na+-dependent Mg2+ efflux. The results indicate that TRPM7 serves as a physiological Mg2+ influx pathway, but it might not be the sole key player to maintain basal [Mg2+]i in H9c2 cells.The rate of increase in [Mgery slow . A long-2+ homeostasis in DT40 (chicken B lymphocytes) has been described by Schmitz et al. [2+ deficiency [2+]i with TRPM7 silencing found in the present study. Physiological roles of TRPM7 should not be denied, as reduction of Mg2+ influx via TRPM7 might be compensated by other channels/transporters with upregulated expression levels, particularly in immature cell types. Thus, Mg2+ homeostasis is likely regulated by TRPM7 in cooperation with other channels/transporters, which varies in cell types.The necessity of TRPM7 for cellular Mgz et al. . The autficiency . In contficiency , and thaficiency  does notficiency . Maintenficiency –26 seems2+ influx induced by extracellular high Mg2+. To the best of our knowledge, this is the first report demonstrating that extracellular Mg2+ passes through endogenous TRPM7. This study also indicates that TRPM7 silencing inhibits the relatively rapid influx of Mg2+ driven by large concentration gradient of the ion across the cell membrane. It is then tempting to speculate that TRPM7 may exert a prominent role when [Mg2+]i falls rapidly. In cardiac myocytes, total Mg content or [Mg2+]i is known to markedly decrease under pathological conditions, such as hypoxia–reoxygenation [2+]i should activate TRPM7, and the channel may provide a rapid supply of Mg2+ from the extracellular space for recovery of [Mg2+]i.Although the TRPM7 gene silencing was slightly less than half in this study, it suppressed the Mggenation  and heargenation . Low [Mg2+ influx, but it might not be indispensable for Mg2+ homeostasis in H9c2 cells. It seems reasonable to assume that Mg2+ homeostasis is concertedly regulated by several Mg2+-permeant channel/transporters including TRPM7.Our results suggest that TRPM7 appreciably participates in Mg


The COVID-19 pandemic spurred public health measures to reduce viral spread. Concurrently, increases in alcohol consumption and conflict in romantic partnerships were observed. Pre-pandemic research demonstrated a bidirectional association between couples’ conflict and drinking. Recent research shows one’s drinking motives  can influence another person’s drinking in close relationships. It is possible that individuals are drinking to cope with distress following romantic conflict. The current study examined 348 cohabitating couples during the first lockdown in the spring of 2020. Our analyses examined coping motives as a mediator between dyadic conflict and drinking behavior using actor–partner interdependence models. Results showed that conflict was associated with greater reports of own drinking in gendered (distinguishable) and nongendered (indistinguishable) analyses through coping motives. Further, in mixed-gender couples, men partners’ coping motives predicted less drinking in women, while women partners’ coping motives predicted marginally more drinking in men. Partner effects may have been observed due to the increased romantic partner influence during the COVID-19 lockdown. While these results suggest that men’s coping motives may be protective against women’s drinking, more concerning possibilities are discussed. The importance of considering dyadic influences on drinking is highlighted; clinical and policy implications are identified. In the spring of 2020, businesses, travel, workplaces, and schools were closed across Canada and many jurisdictions around the world in response to the declaration of the COVID-19 virus as a pandemic , p < 0.001 and typical quantity significantly loaded at b = 0.43, 95%CIs , p < 0.001. Age was a significant covariate, b = 0.03, 95%CIs , SE = 0.001, p < 0.001.Within the latent variable of drinking, frequency was constrained to load at b = 0.90, 95%CIs , SE = 0.07, p < 0.001. A significant positive actor effect for coping motives to drinking behavior was observed, b = 0.12, 95%CIs , SE = 0.02, p < 0.001. No partner effect for coping motives to drinking behavior was observed, b = −0.01, 95%CIs , SE = −0.33, p = 0.741. Additionally, dyadic conflict directly predicted greater drinking behavior even after accounting for coping motives, b = 0.08, 95%CIs , SE = 0.03, p = 0.010. Both partners’ drinking behaviors were significantly and positively associated with each other, b = 0.55, 95%CIs , SE = 0.06, p < 0.001 . Notably, the partner paths of coping motives on drinking  were significant in predicting women’s drinking b = −0.06, 95%CIs , SE = 0.03, p = 0.041, and marginal for men’s drinking, b = 0.05, 95%CIs , SE = 0.03, p = 0.062. These associations were opposite in direction in men and women: women partners’ coping motives marginally predicted greater drinking by men, while men partners’ coping motives significantly predicted less drinking by women. Dyadic conflict did not significantly directly predict drinking behavior for men, b = 0.06, 95%CIs , SE = 0.03, p = 0.092, or women, b = 0.06, 95%CIs , SE = 0.04, p = 0.098, after accounting for coping motives.Dyadic conflict significantly predicted greater drinking to cope motives for both men, inverse of the expected direction. In other words, higher conflict was associated with more men’s coping motives which in turn predicted higher rates of men’s drinking but lower drinking in their women partners. The direct, indirect, and total effects are in Significant partner effects were found for women’s drinking and only marginal partner effects were found for men’s drinking. However, the difference between these two effects themselves was not significant as the 95% confidence intervals for the mediation pathways overlapped.Gender differences in actor effects were established by comparing 95% confidence intervals for the mediation pathway of dyadic conflict and own drinking behavior through one’s own coping motives for women versus men . The dirn = 24 couples opted to not report income, resulting in missing data, and those that did not report income were significantly different than those who did in several important ways. Those who did not report income, on average, reported drinking fewer beverages per drinking occasion, reported significantly less drinking to cope with anxiety and drinking to cope with depression motives, and were significantly older. Thus, controlling income may have introduced systemic error into the results, as well as slightly lowered the power of the analyses.The above analyses were also run with income as a covariate. Notably, b = 0.06, SE = 0.03, p = 0.063). For the indistinguishable dyad analyses, one component of the mediation pathway from conflict to women’s drinking via men’s coping motives  became marginal when controlling income, b = −0.06, SE = 0.03, p = 0.054. All other effects remained as reported in the main analyses  coping drinking motives in the indistinguishable dyad analyses. This suggests there are other mechanisms not included in the model that led members of a couple to greater drinking behavior following conflict  were significant for both genders. Contrary to H2, the mediation of conflict on drinking behavior by coping motives was not significantly stronger in women than men. While past research indicates women are more likely to modulate their drinking behavior in response to conflict ,38, thisOverall, these findings replicate previous findings that coping motives mediated the association between romantic conflict and alcohol-related problems and extend the results into a sample across adulthood, particularly with middle and late adulthood represented. However, it is worth noting the ways in which the older age of our sample may impact the variables assessed. There are inconsistent findings on whether verbal aggression decreases with age ,59, withless drinking associated with their partner’s coping motives. However, these two effects were not statistically significantly different from each other in magnitude and both likely reflected small effects. Effect sizes are typically smaller for partner effects than actor effects in dyadic analyses. Additionally, we did not find observable partner effects in the indistinguishable analyses.Our third hypothesis [H3] predicting significant and positive partner effects was not supported. Men reported marginally more drinking behavior associated with their partner’s coping motives but this effect did not reach statistical significance. The inverse pattern was true for women, in that women reported significantly protective partner crossover effect observed for women’s drinking behavior was not anticipated. While there is robust evidence of partner influence on drinking behavior [motives of important network members. This research has primarily focused on peers [positive association between a partner’s coping drinking motives and an individual’s drinking behavior regardless of gender [less women’s drinking behavior in mixed-gender couples. ‘Emotion work’ may be one explanation for this unanticipated effect. Emotion work is a broad concept that encompasses activities that enhance a partner’s emotional well-being and provide emotional support, which may also explain gender inequities in relationships in other domains [We hypothesized an adverse partner effect for both men and women, in which one partner’s coping motives would predict the other’s drinking behavior, but the behavior ,66, theron peers ,68,69, bon peers . However domains . While e domains , degree  domains ,73. Rese domains .Thus, it is possible that married/cohabiting women abstain from increased drinking in response to the coping-motivated drinking exhibited by their men partners following romantic conflict to reserve internal resources for emotion work. Indeed, a similar effect has been noted with depressive symptoms during the pandemic: women with depressive symptoms are more likely to be concerned about the impact of their symptoms on their spouse and to perform emotion work to modulate that impact compared to men with depressive symptoms . A similContrary to H3, no significant partner-coping mediation between dyadic conflict and drinking behavior was found in either the indistinguishable dyadic analyses with the full sample or for women’s coping predicting men’s drinking in the distinguishable dyadic analyses. Nonetheless, the lower limit of the confidence interval for the partner effect on men’s drinking included but did not go past zero . This finding begets further investigation, as it is possible that a larger sample or more at-risk sample may yield the hypothesized significant partner effects on men’s drinking. The absence of partner effects in the distinguishable dyads analysis may have been due to the gendered partner effects being of similar magnitude but in opposite directions. This may have resulted in the washing out of overall partner effects when collapsing across gender. This possible masking underscores the importance of our following up analyses in the full sample with gendered analyses.These findings on partner effects also have theoretical implications. Both the partner influence hypothesis and most extant evidence suggests partner influence occurs via one’s own drinking motives  and that influence occurs in the direction of risk . HoweveThere are several limitations of note. Conclusions on temporality and causality are limited by our cross-sectional design. However, our results largely replicate the Lambe et al. data, which were longitudinal . AdditioResearch has often distinguished between coping with anxiety and coping with depression drinking motives as seen in the five-factor model of drinking motives , includiGiven numerous known influences on substance use behavior, such as personality (e.g., impulsivity , adverseLastly, the current study conceptualized conflict as a dyadic variable and relied on self-reports. While this is consistent with most studies  and alloThere are several implications of these results for research, theory, and practice. Research found increased drinking during the pandemic, which was consistent with the binge drinking rates in the current sample . Our fin


Mg2+ plays a critical role in heart rhythm, muscle contraction, and blood pressure. A significant decline in Mg2+ intake has been reported in developed countries because of the increased consumption of processed food and filtered/deionized water, which can lead to hypomagnesemia (HypoMg). HypoMg is commonly observed in cardiovascular diseases, such as heart failure, hypertension, arrhythmias, and diabetic cardiomyopathy, and HypoMg is a predictor for cardiovascular and all-cause mortality. On the other hand, Mg2+ supplementation has shown significant therapeutic effects in cardiovascular diseases. Some of the effects of HypoMg have been ascribed to changes in Mg2+ participation in enzyme activity, ATP stabilization, enzyme kinetics, and alterations in Ca2+, Na+, and other cations. In this manuscript, we discuss new insights into the pathogenic mechanisms of HypoMg that surpass previously described effects. HypoMg causes mitochondrial dysfunction, oxidative stress, and inflammation. Many of these effects can be attributed to the HypoMg-induced upregulation of a Mg2+ transporter transient receptor potential melastatin 7 channel (TRMP7) that is also a kinase. An increase in kinase signaling mediated by HypoMg-induced TRPM7 transcriptional upregulation, independently of any change in Mg2+ transport function, likely seems responsible for many of the effects of HypoMg. Therefore, Mg2+ supplementation and TRPM7 kinase inhibition may work to treat the sequelae of HypoMg by preventing increased TRPM7 kinase activity rather than just altering ion homeostasis. Since many diseases are characterized by oxidative stress or inflammation, Mg2+ supplementation and TRPM7 kinase inhibition may have wider implications for other diseases by acting to reduce oxidative stress and inflammation.As the second most abundant intracellular divalent cation, magnesium (Mg Mg2+ is a co-factor of hundreds of enzymes, including ATPases, endonucleases, exonucleases, polymerases, and phosphatases i) is ~17–20 mmol/L. Much of this Mg2+ is not free. About 50% of intracellular Mg2+ binds to ATP, phosphonucleotides, and phosphometabolites, while 25% binds to ribosomes i is also associated with pulmonary hypertension, and high Mg2+ prevents the upregulated expression of NFATc3 and its nuclear translocation, which is a major Ca2+-dependent signaling pathway that regulates the proliferation and migration of pulmonary arterial smooth muscle cells in the development of pulmonary hypertension and vascular remodeling i in cardiomyocytes and vascular smooth muscle cells i in pulmonary arterial smooth muscle cells and the upregulation of TRPM7 expression, as well as the upregulation of SLC41A1, SCL41A2, CNNM2, MRS2, and MagT1 [The TRPM7 protein amount is counter-regulated to the Mgnslation , proteinnslation ,45, and currents ,82,83. And MagT1 . Furthernd MagT1 ,85,86.Many of the effects of HypoMg can be explained by elevated TRPM7 and the activation of the TRPM7 kinase. For example, the inflammation and oxidative stress that are associated with HypoMg are correlated with TRPM7 expression and function. Our recent work shows that TRPM7 kinase activation via HypoMg contributes to the inflammation activation and oxidative stress observed in HypoMg-induced seizure activity, all of which can be significantly improved in transgenic mice with a K1646R mutation in the kinase domain that results in no kinase function while leaving transport function intact [2+ signaling enhances macrophage activation in response to provocation. When selectively depleted in bone marrow macrophages, inflammatory marker IL-1β secretion was significantly reduced, and mice were resistant to peritonitis induced by a classic inflammatory mediator derived from bacteria [How TRPM7 kinase alters mitochondrial oxidative stress alongside inflammation is an area of active investigation. TRPM7-mediated Cabacteria . Silencibacteria .2+ influx and oxidative stress production in vascular smooth muscle cells [What controls TRPM7 levels is also an area that needs more investigation. The inflammatory mediator IL-18 upregulates TRPM7 expression and currents in vascular smooth muscle cells , and angle cells ,79,90.These data suggest a positive feedback loop between TRPM7 and inflammation. There is also a positive feedback loop between oxidative stress levels and TRPM7’s expression and function. Increased oxidative stress levels elevate TRPM7 expression and currents ,92, and 2+ homeostasis and other deleterious effects of HypoMg. TRPM6, like TRPM7 with both the channel and kinase function, is predominantly expressed in the kidney, cecum, and colon. It plays an important role in Mg2+ absorption in the gastrointestinal tract and Mg2+ excretion in the kidney [Other TRPM channels likely play synergistic roles in Mge kidney ,97,98. Te kidney ,100. Thie kidney ,101,102.e kidney  and can,2+ levels supports the use of Mg2+ supplementation to counteract the effect of HypoMg-related pathology. The role of TRPM7 in this pathology suggests that kinase inhibition may be another therapeutic approach. In this regard, dietary Mg2+ intake is inversely correlated to cardiovascular events, such as increased risk of heart failure, hospitalization [2+ is well-established clinically as a therapy. Nevertheless, it is unclear whether Mg2+ supplementation in pre-eclampsia demonstrates some or all of its effects through the modulation of TRPM7, oxidative stress, and inflammation.The inverse relationship between TRPM7 and Mglization , coronarlization , hypertelization ,30,31, slization ,32, and lization ,13. An oAside from genetic approaches, the modulation of TRPM7 is a possibility in humans with small molecule therapies. For TRPM7, there are inhibitors for channel activity  and for the kinase function, such as TG100-115 . TG2+ supplementation than just generalized effects on enzyme kinetics and ion homeostasis, though there are many unknowns. Some of these are: How many diseases characterized by inflammation and oxidative stress respond to Mg2+ therapy? Do these diseases need to be associated with HypoMg or TRPM7 elevation to respond? Are specific cell types, such as white cells, mediating the effects of HypoMg, or is the response generalized to most cells? To what extent does TRPM7 kinase activity explain the many effects of HypoMg, and to what extent are cation changes important? What are the downstream effectors activated by TRPM7 kinase, and how does the kinase alter mitochondrial function? How are mitochondrial dysfunction and inflammation linked? How do reductions in Mg2+ result in TRPM7 transcriptional upregulation, and could this signaling cascade be interrupted? Can oral Mg2+ supplementation be effective for treating Mg2+-responsive diseases in humans, and can sufficient doses be achieved without inducing gastrointestinal side effects? Could TRPM7 kinase inhibition be a solution to the issues related to oral Mg2+ supplementation?The discussion above suggests that there is more to the effect of Mg2+ and the related shifts in other cations and their dependent processes. We have proposed that many of the effects of HypoMg could be explained by a signaling cascade involving the TRPM7 kinase, which is upregulated by HypoMg. We have argued that Mg2+ supplementation or TRPM7 kinase inhibition can prevent HypoMg-induced mitochondrial oxidative stress and inflammation and that these treatments may be useful in such conditions as diabetes, where Mg2+ deficiency is common. We have indicated that Mg2+ may be a simple therapy for a common type of heart failure: HFpEF. Moreover, we have speculated that these therapies could be helpful in diseases characterized by oxidative stress and inflammation, but not known to be associated with HypoMg. We have pointed out just some of the unknowns when following this train of thought.Above, we have discussed the idea that the effects of HypoMg are more than just a general loss of Mg2+ than is generally appreciated, and these subtleties could lead us to new understandings of diseases and potential new therapies. What is clear is that there is more to Mg


Using a preregistered within-subject design, we assess the psychological and emotional responses to two scenarios of which one is illustrating adaptive behaviors toward reduced plastic bag usage, and the other showcasing current consumption patterns. Parametric analyses revealed a shift in emotional states, characterized by a greater experience of positive emotions and a reduced experience of negative emotions following the exposure to the optimistic future scenario video, as compared to the status quo video. Moreover, engagement with the optimistic future scenario was associated with higher levels of perceived behavioral control and behavioral intentions. No significant changes were found regarding sense of responsibility. These findings point to the potential of optimistic future visions to influence individuals at psychological and emotional levels. This renders optimistic future vision communication as an effective tool for sustainable behavior change, particularly in relation to the sustainable use of plastic shopping bags.Plastic pollution is a pressing global issue, necessitating a focus on consumer behavior to curb this problem at its source. To effectively promote sustainable practices, communication strategies that employ future visions have gained attention. This study examines the effects of a narrative video intervention depicting an optimistic future vision concerning single-use plastic bag consumption in South Africa, compared to a representation of the prevailing  Plastic pollution is a significant and pervasive issue with detrimental effects on ecosystems, socio-economic systems, and human health . GloballCan optimistic narrative future vision scenarios be effectively employed to influence the psychological factors that determine plastic behavior, thereby serving as a potential tool for shaping and influencing plastic-related behaviors?RQ: In order to address our research question, we will expound upon the current status of structural and psychological interventions pertaining to plastic bags, specifically focusing on the South African context. Our approach employs an optimistic narrative future vision scenario, conveyed through a video-based medium. Consequently, we will scrutinize the ongoing research concerning video-based communication and its effectiveness in conveying optimistic future vision scenarios, particularly in relation to the recognized psychological determinants that influence plastic behavior. Subsequently we outline the procedural and methodological aspects of our study, followed by a the presentation of the analysis outcomes, leading into a comprehensive discussion of the findings. Finally, we will deduce research and practical implications from the outcomes and provide a glimpse into potential future research endeavors. If the effectiveness of video-based narrative future visions in significantly reshaping the behavioral determinants underlying plastic behavior is established, this approach could emerge as a novel, easy to distribute, accessible and reusable tool within the arsenal of both researchers and practitioners .In a bid to address the persisting inundation of plastic, the South African government has implemented a legislative levy on plastic bags and is actively pursuing a directive to permit only the usage of plastic bags composed entirely of 100% recycled material by the year 2027 . NeverthA multitude of studies performing behavioral interventions have been presented, focusing on sustainable plastic bag behavior. In an extensive study, In recent years, there has been a growing recognition of the need for enhanced communication strategies to effectively utilize pro-environmental communication interventions and maximize their persuasive impact . In thisEvidence suggests that narratives are more easily understood and appealing to audiences than tables, infographics, or diagrams and can capture attention and evoke emotions more effectively compared to standard scientific communications . A narraWithin this section, we expound upon the variables that our project aspires to impact, considering the context of the video-based narrative we employ and formulate our hypothesis on the way. One factor that is frequently and consistently associated with intentions to engage in sustainable plastic behavior is perceived behavioral control .A common explanation for the found disparity between acknowledging environmental issues and translating that recognition into action may potentially stem from a deficiency in emotional engagement . EmotionH4a: Viewing an optimistic narrative future vision scenario increases participants’ positive emotions.H4b: Viewing an optimistic narrative future vision scenario decreases participants’ negative emotions.1 was conducted as an online survey using the SoSciSurvey platform (status quo scenario (henceforth status quo), depicting a realistic shopping process in a typical South African supermarket. Subsequently, participants answered the items measuring behavioral intentions, sense of responsibility, perceived behavioral control, and positive and negative emotions. Afterward, an optimistic narrative future vision video (henceforth Future Vision) was presented, and participants re-evaluated the same items. To ensure that participants attentively followed the videos and did not encounter any viewing problems, they were asked a question about the video’s content and whether they experienced any technical difficulties after each video.Our preregistered studyplatform . The surt-test with a mean effect of Cohen’s d = 0.2, a power of 0.95, and an alpha error rate of 0.05, we performed an a priori power analysis. The determined sample size was 272 subjects. Due to expected exclusions, the collection of 300 valid data sets was set as a target. Participants were recruited via a panel selection process (81.25%) and emails (18.75%). The inclusion criteria for this study involved attaining an age of 18 years or older and being a resident of South Africa. It was attempted to achieve a representative sample of the South African population, in terms of age and gender of the participants. We adhered to our previously established data exclusion policy (see text footnote 1), including exclusion for the following reasons: Failure to pass the attention test (incorrect answer to control questions), reporting technical problems, participants’ completion time was too short, indicating low data quality, or more than 20% of responses were missing. Overall, 384 datasets were collected, of which 42 had to be excluded due to the mentioned criteria. As a result, 342 valid datasets were available for data analysis. Gender and age distribution of the final sample are provided in To determine the required sample size for a dependent sample The animated videos employed in this study were previously published as part of the research conducted by status quo scenario was developed in collaboration with project partners from South Africa, ensuring the authenticity of the protagonists depicted in the video and the portrayed shopping experience for South African consumers. The animated clip follows the journey of Thandi, a woman in her middle years, engaging in a lifelike shopping experience. Thandi makes the choice to head to a supermarket in her car and proceeds to load up her shopping cart with a variety of items, encompassing food, sanitary goods, and bottles of wine. As she reaches the checkout counter, Thandi is presented with a range of bag options, including cotton, paper, and plastic. Opting for plastic bags, a packer begins to pack her chosen items.2 After Thandi returns home, she proceeds to unpack her groceries, and subsequently discards the bags by placing them directly into the trash. The video has a duration of approximately one and a half minutes.The video depicting the status quo video, an optimistic Future Vision video was developed in 2022 through a joint visioning workshop involving various stakeholders from the public, economy, academia, and environmental conservation sectors . She thus retrieves shopping bags from her home. As she reaches the till, Thandi is informed that the store has replaced disposable plastic bags with reusable ones as part of their efforts to minimize environmental impact. With her own bags unable to accommodate all her purchases, another customer kindly lends Thandi an extra bag. She opts to use this bag instead of buying more. Thandi’s shopping meets the criteria for the promotional discount, leaving her content as she departs the store, having both reduced her plastic waste and saved money. Upon returning home, Thandi consciously stores the bags for future use instead of discarding them. She also attached a note to the door to remember to bring them on her next shopping trip. Additionally, she ensures there’s always a bag in her car’s trunk. Motivated, Thandi talks about her shopping adventure to her family and friends, ultimately leading them to start a neighborhood initiative encouraging others to reuse bags. The press takes notice of their endeavors, and as a result, Thandi and her fellow campaigners receive media attention. The video has a duration of approximately 4 min, with a screenshot provided in As an alternative version of the The psychological and emotional impacts of the implemented communication intervention were evaluated using the variables of sense of responsibility, perceived behavioral control (PBC), behavioral intentions, as well as positive and negative emotions, including the basic emotions such as worry, anger, hope and empowerment see . ParticiThis video makes me feel responsible for plastic pollution in my community” and the latter item being “This video makes me feel that it is difficult to tackle plastic pollution as an individual.” Intentions were measured using a 5-item scale, which included items such as “This video motivates me to reduce my plastic bag consumption.” These items are derived from This video makes me feel worried” to measure negative emotions and “This video makes me feel hopeful” for positive emotions .The need to develop effective communication strategies to guide individuals and communities toward more sustainable behaviors has been highlighted in the scientific discourse. In this study, we presented an approach for fostering sustainable consumption of single-use plastic bags in South Africa using an optimistic future vision in video format. The findings from the analyses yielded four principal outcomes. It was demonstrated that engaging with an optimistic future vision scenario leads to an increased perception of behavioral control (H1) and behavioral intentions (H3). While we can assume a medium effect of the intervention for PBC see Cohen’s Our analyses indicate that the implemented intervention has a positive impact on individuals’ confidence in their ability to adopt sustainable consumption practices of plastic bags. By presenting Thandi’s proactive and environmentally responsible behavior in the optimistic scenario, viewers are not only exposed to an optimistic narrative, but are also provided with several practical examples of how they can contribute to a plastic bag-free lifestyle themselves. That the video is providing valuable behavior alternatives might increase their sense of self-efficacy. As individuals’ behavior is strongly influenced by their perceived ability to perform it , the obsFurther, our study revealed an increase in behavioral intentions toward more sustainable use of plastic bags following the exposure of the Future Vision video. Behavioral intentions are considered a crucial influence on actual behavior , as theystatus quo video, indicating a ceiling effect (see For sense of responsibility (H2), no significant changes were observed between the measurement points. As individuals tend to behave in ways consistent with the responsibility they attribute to themselves regarding specific situations and outcomes based on a corresponding sense of obligation , this fafect see . These hstatus quo video. Specifically, it is plausible that the participants experienced displeasure and anger toward Thandi’s inability to avoid plastic bags in the status quo video. This could even be when individuals themselves regularly buy single use plastic bags. Indeed, environmental “misbehavior” of others is frequently explained through factors like ignorance, naivety, or need for convenience, while one’s own unsustainable actions are justified by external factors  can be found below: Ethical approval was not required for the studies involving humans because this is a pure survey study without direct manipulation of the participants. The studies were conducted in accordance with the local legislation and institutional requirements. The participants provided their written informed consent to participate in this study.NN and SF wrote the first draft of the manuscript. IR and CR wrote sections of the manuscript. KS provided feedback to the original manuscript. LF was responsible for data analysis. All authors contributed to conception, design of the study, manuscript revision, read, and approved the submitted version.


Dense video caption is a task that aims to help computers analyze the content of a video by generating abstract captions for a sequence of video frames. However, most of the existing methods only use visual features in the video and ignore the audio features that are also essential for understanding the video. In this paper, we propose a fusion model that combines the Transformer framework to integrate both visual and audio features in the video for captioning. We use multi-head attention to deal with the variations in sequence lengths between the models involved in our approach. We also introduce a Common Pool to store the generated features and align them with the time steps, thus filtering the information and eliminating redundancy based on the confidence scores. Moreover, we use LSTM as a decoder to generate the description sentences, which reduces the memory size of the entire network. Experiments show that our method is competitive on the ActivityNet Captions dataset. A dense video caption is an abstract representation of the important events in unedited videos that may contain different scenes. Thanks to the popularity of Internet resources and mobile devices, the amount of video data is increasing, and the types of which are becoming very rich. As an important way to disseminate information, videos have become inseparable from people’s daily lives, and the use of live videos has become a trend. The tasks of dense video captions are to effectively label different types of content, and can be applied to various scenarios in videos towards extraction of higher-level semantics. For instance, monitoring traffic safety, finding target people, assisting in reviewing video content, and improving network security ,2,3. In The emergence of deep learning  first ac(1)We introduce a new framework for dense video caption generation. Such framework makes use of the Transformer’s multi-head attention module to efficiently fuse video and audio features in video sequences, thus improving the accuracy and richness of the model-generated captions.(2)We propose a confidence module to select major events, which addresses the problem of unequal recall and precision after using fused video–audio features, making the fused audiovisual features more effective in generating descriptive texts.(3)We employ LSTM as a decoder for sentence representation, which has the advantage of long-term memory to meet the requirements of text description generation, and also enhances the overall computational efficiency of the framework.(4)We show that our framework is competitive with existing methods on the ActivityNet Captions dataset.Building on previous work, we focus on how to fully integrate features into video and audio sequences as vectors of different lengths. The main contributions of this paper are as follows:We arrange the following content as below. Video captioning is an introduction to what the video contains in logical sentences. A typical video sequence is formed by playing more than a dozen frames (images) per second quickly. Therefore, the initial methods for dense video captioning were largely inspired by the image caption field, especially the encoder–decoder structure based on deep learning, which can encode the visual features and decode them into natural language sentences ,19,20. TThe emergence of convolutional three-dimension networks (C3D) has solved the above problems to a certain extent . It addsDense video caption  has raisBecause of the outstanding performance, recurrent neural networks (RNN) in the NLP field are applied to video caption tasks. Most models use the characteristics of LSTM that can remember long sequences as a decoder to generate description text. Pan et al. proposed the LSTM-E model , which iMore importantly, researchers have sought to apply the attention mechanism to the field of video captioning and achieved good results. Yao et al. proposed to introduce attention weight ormation . The evaormation  takes thIn order to solve the problem that the LSTM structure cannot be trained in parallel, the Transformer frame builds a global relationship on the semantic information of the reference description statements in the dataset based on the attention mechanism, and has achieved good results in dealing with the problem of missing details of video caption tasks ,43,44,45The description text generated only for the visual modal information in the video cannot cover all of its content ,50. The Based on the above analysis, we summarize some methods for video captioning in Therefore, how to better utilize the multi-modal data features in videos, and how to more effectively model the complex relationships and logical reasoning abilities between video and text, are still challenges that need to be focused on and solved in the future research of this field.Considering the importance of audio patterns in a video and combining the above research points, a dense video caption generation model that fully integrates visual and audio patterns is proposed. This model applies the I3D and VGGish approaches to extract visual and audio features, respectively. Moreover, the output features produced by these approaches are always presented in different sizes, we thus introduce a multi-head attention module to integrate the extracted visual and audio features. Finally, the LSTM is used as a decoder to implement a descriptive textual representation of the video content.Feature Extraction Since there are size differences between visual and audio features, they need to be extracted separately to remove noise and redundancy. For the visual pattern features, the I3D network is applied to achieve the extraction of spatial features present in the video, while optical flow features are also added to further improve the performance. Next, VGGish is used to extract a selection of audio features that can effectively convert the audio stream into a feature vector corresponding to natural language elements.Multi-Modal Feature Fusion The features extracted from visual and audio modalities produce vectors of different dimensions that cannot be directly fused. Therefore, a multi-model attention fusion module is proposed as an encoder based on the Transformer framework, aiming to fully fuse the audio and visual features for information resonance. Furthermore, a confidence module is added to filter the major information in this part.Caption Generation We employ LSTM to retain the attributes of lengthy sequences as a decoder. The proposals evaluated by the confidence module serve as the initial state input of the decoder, which simulates the distribution in the vocabulary encoded by the embedded position. Finally, a detailed textual description for the video is generated automatically.The framework of the proposed model consists of three parts: feature extraction, multi-modal feature fusion, and caption generation. Currently, there is no method to extract both visual and audio features from a video simultaneously. These features can only be extracted from different modalities. As noted in We also use the VGGish network to extract audio features from videos. Numerous studies have demonstrated that VGGish outperformed traditional methods for audio extraction. This is achieved by combining the deep structure of the VGG network with log-mel features and training on a large amount of audio data from the Audioset dataset . The preN multi-modal encoder blocks to enable full fusion of the two features. Each multi-modal encoder block consists of self-attentive, multi-head attention, and fully connected layers. The process is described as follows. First, the self-attentive layer of the Transformer processes variable-length information sequences and dynamically generates different weights for the extracted visual and auditory features.Q, K, and V denote query, key, and value, respectively. The Most dense video caption tasks rely on visual features, and a few integrate multi-modal features by concatenating or sharing the weights of different features rather than fully fusing them. As a result, multi-modal features are not fully functional in nature. To address this problem, we propose a multi-modal feature fusion approach that includes a multi-modal encoder, proposal heads, and confidence module. The multi-modal encoder stacks visual (Q) of multi-head attention are obtained to compute and produce a score for determination. These heads are concatenated as an output feature after the multi-head attentions are determined.Then, multiple queries  symbol is received. Finally, the predictions are measured against the ground truth results, the difference is calculated using the cross-entropy function g, the reference caption in the dataset is the ground truth, The decoder part of the model takes as input the feature vector output by the multi-modal feature fusion module and the previously generated word embedding representation. These inputs are then passed to the decoder layer for processing. We recommend using the LSTM as the RNN decoder part because it can effectively alleviate gradient explosion and remember long sequences. The LSTM iterates the next predicted word and generates the description text. Compared with the Transformer, LSTM also has good performance and can greatly reduce the model training time. Moreover, the output features of the last layer of the decoder can be used in the generator to predict the next caption word. The LSTM-based headline generation module is implemented by the following,essed in ,(15)ht=To evaluate the effectiveness of the proposed model, we performed experiments on the public ActivityNet Captions dataset and compared it with state-of-the-art methods.In our experiments, MSVD , Activit<BOS> and end mark <EOS> must be inserted at the beginning and end of a sentence, respectively. Due to the limited size of the vocabulary and the misleading description of low-frequency word pairs, words with a frequency of less than 5 in the text are uniformly replaced by <UNK>, whose semantics are discarded and considered to be out of the vocabulary. To prevent no input from the decoder at the beginning, the <BOS> is also inserted as the first token, and the caption will be generated verbatim until a unique end token <EOS> is also inserted.For the training preprocessing, the truecase, tokenization, and cleaning symbols must be completed, and the start mark The environment we set up was a Ubuntu 20.04 system, and we made use of PyTorch  as the nand Adam  was usedK, we used a different size. The size of the visual modality was determined after calculating the K mean. Next, the LSTM was connected to the proposed heads that received the hidden state and performed the decoding. These results were passed to For the multi-modal feature fusion module, we took features of different sizes and mapped them to an inner space with a 1024-dimensional vector. Then, we used two different sizes of features as 128 features for visual and 48 features for audio, and stacked To demonstrate the performance of the proposed framework, we performed validation on the ActivityNet Captions dataset and compared it with various state-of-the-art methods. We provide ablation studies to validate the impacts of the individual modules in our framework on the experimental results. We also report the results of the qualitative analysis, which highlights the superiority of our proposed model.We compared the proposed model with various state-of-the-art methods on the dense video caption tasks, including: EEDVC , DCE 3131, MFT , WLT 4949, SDVC N-grams between translated results of predicted and reference. It is widely used to evaluate the level of text expression in neural machine translation (NMT). Furthermore, METEOR [Among them, B@N represents the evaluation metric BLEU , which c, METEOR  consider, METEOR  mainly cAll experimental results are shown in We conducted a large number of comparative experiments to verify the impact of different components of the proposed model on the output results, including multi-modal feature extraction, a Transformer for multi-modal feature fusion, and an LSTM for caption generation.We also conducted an ablation study to verify the effectiveness of using Transformer’s multi-head attention to fully fuse multi-modal features in our model. We compared our method with a baseline method that used only multi-modal features for concatenation without attention. The results are shown in We tested the effect of using LSTM, GRU, and the Transformer as decoders on the abstract representation of the video. As shown in Furthermore, we demonstrated text description generation using the proposed multi-modal feature fusion method on the ActivityNet Captions dataset. We also compared the video captions generated with visual or audio-only features as input, as shown in As the results show in We propose a framework for enhancing the performance of dense video caption using a multi-modal feature fusion approach. The proposed framework employs I3D to extract visual features and VGGish to extract audio features from videos. The Transformer encodes the multi-modal features, and LSTM decodes them to generate descriptive text for the video. The overall framework is compact and efficient for training. To generate more accurate results, we fed the feature output from the encoder into the proposal head module. Moreover, to align the visual-audio features with different sequence lengths at each time step after the fusion, we use a Common Pool to predict and fuse each modality of every recurrent step. Furthermore, we use confidence scores to extract more consistent features for video content, which can improve the quality of the model-generated sentences.Experiments show that the proposed multi-modal feature fusion model surpasses other approaches that use only visual or audio modality features. The model is also competitive with other dense video caption models. The text generated by the proposed model follows natural language rules, highlighting the importance of audio features for this task.Our work still has shortcomings compared to the ground truth, and we cannot fully recognize the short-term killing parts. Future work could explore the addition of other modalities in video to enhance the expression of video content with more auxiliary information, increase the accuracy of computer understanding of videos, and improve the fine-grained caption generation.


Harmful use of alcohol is a worldwide public health concern. Cultural differences may affect responses to questions on alcohol problems, making international comparisons difficult. We aimed to compare self-reported alcohol consumption and problem drinking between Norwegian and Russian populations.N=17646, participation 65%), Tromsø (2015–2016), Norway, and the Know Your Heart study , Arkhangelsk and Novosibirsk (2015–2018), Russia. Alcohol consumption and problem drinking were measured by the Alcohol Use Disorders Identification Test (AUDIT) via questionnaires (Tromsø7) and interviews (KYH). We compared AUDIT scores and components between populations, by sex.We used data from women and men aged 40–69 years participating in the Tromsø Study seventh survey . In men, hazardous consumption (41.4% versus 31.5%) and problem drinking (24.8% versus 19.6%) was higher in KYH compared with Tromsø7, but opposite for women . KYH men were less likely to report problem drinking behaviours than Tromsø7 men, with the exception of needing a drink first thing in the morning (13.2% versus 2.4%). KYH women consistently reported less consumption and problem drinking than Tromsø7 women.We found between-study differences in hazardous drinking, but in men these were lower than suggested by differences in country-level statistics on alcohol consumption and alcohol-related health-harms. Study sample selection, stronger social desirability bias effects in the Russian samples, and cultural differences in responding could have affected the results. Harmful use of alcohol is a major public health problem worldwide . Norway 4The Alcohol Use Disorders Identification Test (AUDIT) is an established and well-validated internationally used tool for screening for harmful or hazardous alcohol use . While o16Amount of alcohol consumed, beliefs and attitudes to drinking, and perceptions of problem drinking are strongly influenced by culture –24. AlthWe hypothesized that differences in cultural beliefs about alcohol and the concept of problem drinking may affect how people answer questions about alcohol problems, leading to conceptual difficulties when making international comparisons. To investigate this we compared how responses to AUDIT questions differed between women and men taking part in population-based surveys within two neighbouring countries with very different drinking cultures – Norway and Russia – and how these differed by demographic factors  in each setting.In this study, our aim is to compare self-reported alcohol consumption and problem drinking in women and men in two population-based studies from Norway and Russia, including demographic differences.We used data from women and men aged 40–69 years participating in two population-based studies conducted in Norway and Russia in the same time period .N=32,591), 21,083 participated (65%) and 17,646 were aged 40–69 years, thus were included in the current analysis. The invitation letter was sent by mail including a study information brochure, a short four-page paper questionnaire, log-in details to complete questionnaires online, and a suggested time for clinical examinations and biological sampling at the study site, which could also be a drop-in. Completion of questionnaires could be performed at home or at attendance, with technical support from research technicians if needed.The Norwegian sample included participants from the seventh survey of the Tromsø Study , 27 (TroThe Russian sample included participants from the Know Your Heart (KYH) study  conducteSupplementary Figure 1) and the Russian KYH version .We measured alcohol consumption and alcohol-related problems using AUDIT , which in=1149 participants had incomplete AUDIT (missing data on one or more questions). In KYH AUDIT was part of the face-to-face interview conducted at the health check examination where n=10 participants had incomplete AUDIT (missing data on one or more questions). Given concerns from previous studies about how the term ‘standard drink’ was interpreted within Russia, a flashcard showing different standard drinks  was shown to participants in the KYH interview and the interviewers had standardized instructions on how to explain this concept to participants.In Tromsø7 AUDIT was included as part of the questionnaires , where We defined hazardous alcohol consumption as AUDIT-C ⩾5 and problem drinking as total AUDIT score ⩾8 in accordance with WHO . InformaWe compared the prevalence of non-drinking, non-problem drinking and problem drinking by sex and study sample (including strata of site for KYH) , distribAll participants have given written consent. Tromsø7 was approved by the Regional Committee of Medical and Health Research Ethics . KYH was approved by the ethical committees of the London School of Hygiene & Tropical Medicine , Novosibirsk State Medical University , Institute of Preventative Medicine , and Northern State Medical University  and consent for secondary data analysis was given from ethics committees in both sites.Non-drinking, drinking and problem drinking in women and men by study and site is shown in Demographic characteristics of non-drinkers, drinkers and problem drinkers in women and men by study are shown in Age-standardized prevalence of hazardous alcohol consumption and problem drinking is shown in p<0.001) with all questions on the AUDIT between studies. Tromsø7 women consistently responded in a way indicating a more hazardous drinking pattern than KYH women for every question, for both hazardous consumption and problem drinking. Tromsø7 men were more likely to respond in a manner indicating a more hazardous drinking pattern for the questions on frequency of drinking overall, and all problem drinking behaviours with the exception of needing a drink first thing in the morning to get oneself going after a heavy drinking session (Tromsø7 men 2.4% vs. KYH men 13.2%), and expressions of concern from others about drinking (Tromsø7 men 9.7% vs. KYH men 11.8%). Compared with Tromsø7 men, a higher proportion of KYH men reported non-drinking, but also higher numbers of drinks per occasion and more frequent high alcohol consumption.The answers to each AUDIT item for women and men by study are presented in In this comparison study of self-reported alcohol consumption and problem drinking in women and men from two population-based studies conducted in Norway and Russia we found that abstaining was more commonly reported in the sample of Russian women and men, compared with Norwegian women and men. At the same time, both hazardous alcohol consumption and problem drinking was more common in the Russian men than the Norwegian men, while the opposite was seen for women with higher prevalence of hazardous alcohol consumption and problem drinking in the Norwegian women compared with the Russian women.Our findings are consistent with a recent study with comparisons of AUDIT scores from hospital in-patients in Oslo and Moscow . This stThe WHO global status report on alcohol with data from 2016 . It is aCultural beliefs about alcohol and the concept of problem drinking may affect how people answer question about alcohol problems –24. An aWhile Russian men reported more hazardous alcohol consumption (defined by AUDIT-C score), Norwegian men were more likely to report most of the specified alcohol problem behaviours than Russian men, with the exception of morning drinking which was more common in Russian compared with Norwegian men. The difference in reporting here is likely to relate to differences in social acceptability of drinking in the morning. In response to concerns about some aspects of the AUDIT in the Russian context, a new Russian-specific version of the AUDIT was recently developed and validated  for use While a Russian-specific AUDIT may resolve some of these issues within the clinical context, within the global health research, context standardization of measurements between geographic locations is a key goal in order to make valid comparisons between populations. To date the impact of differences in cultural interpretation of AUDIT questions on findings from comparative studies such as this one is not clear, but our findings support including a detailed breakdown of the AUDIT score components as well as using summary scores when comparing alcohol use between different populations.There are several limitations to interpretation of the findings from this study.First is the difference in data collection methods between the studies. In the Russian study AUDIT was part of a face-to-face interview conducted by a health professional at the examination site, whereas in the Norwegian study AUDIT was part of a self-administered online questionnaire that most participants completed at home before visiting the examination site. Thus, the effect of social desirability bias cannot be ruled out. Another but related factor is cultural differences in answering the questions. An example is the inverse reporting pattern in the sample of Russian men, with fewer symptoms of problem drinking compared with Norwegian men, but not for morning drinking, which has higher social acceptance in Russia but is considered socially unacceptable in Norway. Also, the difference in completeness of AUDIT is likely a reflection of the difference in the data collection method.Another limitation is the risk of selection bias in both studies. Response proportions were lower for the Russian study, and in particular for the Novosibirsk site. The lower AUDIT scores found in the Novosibirsk study sample than the Arkhangelsk study may indicate higher levels of selection bias in the Novosibirsk study sample. However, they may also reflect genuine geographic variation, given that national statistics from Russia show higher levels of mortality from alcohol poisonings in Arkhangelsk than Novosibirsk. Selection of participants with a healthier lifestyle is a risk in all population-based studies, and both heavy drinkers and abstainers are less likely to re-attend , and it Selection bias and social desirability bias are likely to affect all population-based surveys, but because of differences in data collection methods and participation proportions in the two studies, the impact may have been stronger for the Russian sample than the Norwegian sample, leading to an underestimate of the between-study differences. Therefore, the lack of validation of AUDIT categories with biomarkers is an important study limitation.Although our study findings should be treated with caution given the limitations described above, we have identified here several differences in drinking patterns and behaviours between participants in population-based studies in Russia and Norway. Further work investigating the impact of drinking culture on responses to AUDIT in different settings and contexts is important to ensure validity in cross-country studies.Click here for additional data file.Supplemental material, sj-docx-1-sjp-10.1177_14034948211063656 for Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015–2016 and the Know Your Heart study 2015–2018 by Laila A. Hopstock, Alexander V. Kudryavtsev, Sofia Malyutina and Sarah Cook in Scandinavian Journal of Public HealthClick here for additional data file.Supplemental material, sj-docx-2-sjp-10.1177_14034948211063656 for Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015–2016 and the Know Your Heart study 2015–2018 by Laila A. Hopstock, Alexander V. Kudryavtsev, Sofia Malyutina and Sarah Cook in Scandinavian Journal of Public HealthClick here for additional data file.Supplemental material, sj-docx-3-sjp-10.1177_14034948211063656 for Hazardous alcohol consumption and problem drinking in Norwegian and Russian women and men: The Tromsø Study 2015–2016 and the Know Your Heart study 2015–2018 by Laila A. Hopstock, Alexander V. Kudryavtsev, Sofia Malyutina and Sarah Cook in Scandinavian Journal of Public Health