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PurposeThis paper investigates if the existing degree of students' acceptance and use of mobile or m-learning may face the online shift determined by SARS-CoV-2. Based on the extended unified theory of acceptance and use of technology (UTAUT2), a new comprehensive model, SD-UTAUT (social distancing-UTAUT), is developed to better understand relationships between the original constructs, plus personal innovativeness (PI) and information quality (IQ). It identifies the key factors affecting behavioral intention (BI) and use by examining the influence of revaluated hedonic motivation (HM) and learning value (LV) importance as mediators.Design/methodology/approachThe paper opted for an exploratory study involving 311 learners, using partial least squares structural equation modeling (PLS-SEM).FindingsSD-UTAUT can be a new m-learning model in higher education. It has high predictive power and confirmed 15 out of 16 hypotheses. The most powerful relationship is between performance expectancy (PE) and HM. IQ affected LV the most, since HM the behavioral use (BU). HM impacts the use behavior (UB) more than LV, but habit (HT) affects it the most.Research limitations/implicationsBecause of the pandemic context, output may lack generalizability and reproducibility.Practical implicationsTo improve usage, staff must provide better support, course creators emphasize the objectives and competencies and developers integrate innovation. The joy and pleasure of m-learning use may stimulate the LV through interesting and interactive content, like incorporating gamification.Originality/valueThe model set-up and circumstances are previously unseen. SD-UTAUT confirms ten new hypotheses and introduces the student's grade point average (GPA) as a moderator.Peer reviewThe peer review history for this article is available at https://publons.com/publon/10.1108/OIR-01-2021-0017

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Currently, adipose tissue is considered an endocrine organ, however, there are still many questions regarding the roles of adipokines—leptin and ghrelin being two adipokines. The purpose of the study was to assess the relationship between the adipokines and their ratio with obesity and diabetes. Methods: Sixty patients (mean age 61.88 ± 10.08) were evaluated. Cardiovascular risk factors, leptin, ghrelin, and insulin resistance score values were assessed. The patients were classified according to their body mass index (BMI) as normal weight, overweight, and obese. Results: 20% normal weight, 51.7% overweight, 28.3% obese, and 23.3% diabetic. Obese patients had higher leptin values (in obese 34,360 pg/mL vs. overweight 18,000 pg/mL vs. normal weight 14,350 pg/mL, p = 0.0049) and leptin/ghrelin ratio (1055 ± 641 vs. 771.36 ± 921 vs. 370.7 ± 257, p = 0.0228). Stratifying the analyses according to the presence of obesity and patients’ gender, differences were found for leptin (p = 0.0020 in women, p = 0.0055 in men) and leptin/ghrelin ratio (p = 0.048 in women, p = 0.004 in men). Mean leptin/BMI and leptin/ghrelin/BMI ratios were significantly higher, and the ghrelin/BMI ratio was significantly lower in obese and diabetic patients. In conclusion, obesity and diabetes are associated with changes not only in the total amount but also in the level of adipokines/kg/m2. Changes appear even in overweight subjects, offering a basis for early intervention in diabetic and obese patients.

Background Diastolic dysfunction is traditionally believed to be the first subclinical manifestation of diabetic cardiomyopathy (DCM), leading to systolic dysfunction and then overt heart failure. However, in the last few years, several studies suggested that systolic subclinical dysfunction measured by speckle‐tracking echocardiography (STE) may appear ahead of diastolic dysfunction. In this review, the main endpoint is to show whether subclinical myocardial systolic dysfunction appears ahead of diastolic dysfunction and the implication this may have on the evolution and management of DCM. Materials and methods We performed a search in PubMed for all relevant publications on the assessment of DCM by STE from 1 June 2015 to 1 June 2020. Results and Conclusions The results illustrate that subclinical systolic dysfunction assessed by STE is present in early DCM stages, with or without the association of diastolic dysfunction. This could be a promising perspective for the early management of patients with DCM leading to the prevention of the overt form of disease.