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PubMed2001

[Drinking behaviors of Japanese adolescents' problem drinker--report of 1996 national survey].

The first national survey of Japanese adolescent drinking behaviors was conducted in 1996. Based on the survey results, this study focused on high risk drinking behaviors of Japanese adolescent problem drinkers. The subjects were 42,183 junior high school students and 72,396 senior high school students who responded to questions on drinking frequency and drinking quantity among the national survey subjects. The subject students were divided into three groups: normal adolescents, drinkers and problem drinkers by the QF scale. The problem drinkers according to the QF scale accounted for 3% of the junior high school students and 14% of senior high school students. Problem drinkers among both junior and senior high school students had characteristic drinking behaviors such as various drinking occasions, obtaining alcoholic drinks by various methods, drinking hard liquor, and many instances of vomiting or blackouts due to drinking. Many problem drinkers considered that the national law prohibiting minors from drinking was unnecessary because they have the right to decide whether to drink. Both junior and senior high school problem drinkers showed high risk drinking behaviors.

Adolescent↗
PubMed2003

[Japanese national survey of adolescent drinking behavior: comparison between 1996 and 2000 surveys].

This report shows Japanese adolescent drinking behavior from the national surveys conducted in 1996 and 2000. We randomly selected 120 junior high schools and 100 senior high schools nationwide. We requested the cooperation of the principals of these schools and sent questionnaires to each school. Students answered anonymously the questionnaires during school time, and sealed in envelopes by themselves; then teachers collected the envelopes. The questionnaire focused on adolescent drinking behavior. Valid responses numbered 42,798 (1996) and 47,246 (2000) from the junior high schools and 73,016 (1996) and 59,051 (2000) from the senior high schools. The number of students surveyed represented about 1% of all Japanese junior high school students, and about 2% of all senior high school students. This report covers only students who gave answers on both drinking frequency and drinking quantity. It compares adolescent drinking behavior between the 1996 and 2000 surveys, such as drinking frequency, drinking quantities, drinking occasions, methods of obtaining alcohol, kinds of alcohol drunk, alcohol-related problems, opinions on the law that prohibits minors under 20 years of age from drinking alcohol, and distribution of drinking status of the subjects by the Quantity-Frequency Scale (QF scale). In a comparison of adolescent drinking behavior between the 1996 survey and 2000 survey, non-drinkers among junior high school students increased from 45% to 55%, and those among senior high school students increased from 27% to 33%. On the other hand, ratios of female students in both junior and senior high schools who drank 1 or more times per week were higher in the 2000 survey than in the 1996 survey. Comparison of the 1996 survey and 2000 survey did not indicate that Japanese adolescent drinking has increased or decreased.

Adolescent↗
PubMed1997

Solitary drinking: a risk factor for alcohol-related problems?

This paper investigates whether solitary drinking is a risk factor for alcohol-related problems using data from a general population of drinkers in Montréal, Canada. Three indicators of solitary drinking were used: (1) having had a drink alone; (2) frequency of solitary drinking; and (3) having had five drinks or more in a solitary setting. Among the 2015 respondent drinkers of a telephone survey, 31% reported drinking alone, of whom 27% did so more than once a week, and 17% had had five drinks or more alone at least once. Problems with family or social relationships, physical health, work, budget, physical security and happiness or view of life, self-reported as being alcohol-related, were measured by seven binary items. Strong positive associations were found at the univariate level between overall alcohol-related problems and both solitary drinking and having had five or more drinks alone, whereas frequency of solitary drinking had no effect. Only the relationship with having five or more drinks alone remained statistically significant in logistic regressions controlling for potential confounders. No evidence was found that solitary drinking per se is a risk factor for alcohol-related problems unless large quantities of alcohol are involved.

Adolescent↗
PubMed2000

Is caffeine a flavoring agent in cola soft drinks?

BACKGROUND: Concern has been expressed about the nutrition and health impact of high rates of soft drink consumption. Caffeine is an added ingredient in approximately 70% of soft drinks consumed in the United States. The soft drink manufacturers' justification to regulatory agencies and the public for adding caffeine to soft drinks is that caffeine is a flavoring agent. OBJECTIVE: To examine the claim that caffeine plays an integral role in the flavor profile of soft drinks, by examining the effect of caffeine on the threshold for detection of flavor differences in cola beverages. DESIGN: Double-blind crossover study starting November 1998 and ending July 1999. SETTING: An academic research center. PARTICIPANTS: Twenty-five adult regular consumers of cola soft drinks. Based on a screening session, all were able to detect a flavor difference between cola containing sugar and diet cola. INTERVENTION: A sensitive version of a forced-choice flavor-detection procedure was used to evaluate the effects of a wide range of caffeine concentrations (range, 0.05-1.6 mg/mL) on the ability to detect flavor differences between caffeinated and caffeine-free cola beverages. Repeated tests permitted determination of significant detection at each concentration in individual subjects. MAIN OUTCOME MEASURES: Percentage of subjects significantly detecting a flavor difference and mean percentage of trials correct at each caffeine concentration. RESULTS: Detection of flavor differences increased as a function of caffeine concentration. At the 0.1-mg/mL concentration, which is the approximate concentration in the majority of cola soft drink products, 2 subjects (8%) significantly detected a flavor difference and the mean percentage correct (53%) was at chance levels. CONCLUSIONS: The finding that only 8% of a group of regular cola soft drink consumers could detect the effect of the caffeine concentration found in most cola soft drinks is at variance with the claim made by soft drink manufacturers that caffeine is added to soft drinks because it plays an integral role in the flavor profile. It is valuable for the general public, the medical community, and regulatory agencies to recognize that the high rates of consumption of caffeinated soft drinks more likely reflect the mood-altering and physical dependence-producing effects of caffeine as a central nervous system-active drug than its subtle effects as a flavoring agent. Arch Fam Med. 2000;9:727-734

Adult↗
PubMed2006

Erosion of enamel by non-carbonated soft drinks with and without toothbrushing abrasion.

OBJECTIVE: To investigate how enamel loss due to erosion, and due to cycling of erosion and abrasion, depends on compositional parameters of soft drinks, and particularly whether the thickness of the erosive softened layer is a function of drink composition. SETTING: University dental hospital research laboratory in the UK, 2004. MATERIALS AND METHODS: Six drinks were chosen based on their popularity and composition: apple juice, orange juice, apple drink, orange drink, cranberry drink and 'ToothKind' blackcurrant drink. Group A samples (n = 36) were exposed to soft drinks at 36 degrees C for six consecutive 10 minute periods. Group B samples (n = 36) were subjected to alternating erosion and toothbrushing, repeated six times. Enamel loss was measured using optical profilometry. RESULTS: Group A: significant enamel loss was seen for all drinks (p < 0.001). Erosion was correlated with pH and calcium concentration but not phosphate concentration or titratable acidity. Group B: significant additional material loss due to toothbrush abrasion occurred with all drinks. Abrasive enamel loss differed between the drinks and was positively correlated with drink erosive potential. CONCLUSION: Enamel loss by erosion is exacerbated by subsequent abrasion. The amount of softened enamel removed by toothbrushing is a function of the chemical composition of the erosive medium.

Analysis of Variance↗
PubMed2002

Drinks consumed by 18-month-old children: are current recommendations being followed?

OBJECTIVE: To examine the types of drinks consumed by children at 18 months of age, determine any associations with socio-demographic characteristics and investigate the use of a bottle for providing these drinks. DESIGN: A total of 1026 randomly chosen children from the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC) were studied. METHODS: As part of a dietary diary completed when their children were 18 months of age, mothers were asked to record all drinks consumed over a 24 h period and to report the containers used to give these drinks. Socio-demographic characteristics were obtained via self-completion questionnaire. RESULTS: Dietary records were available for 1026 children at 18 months. A wide variety of drinks were given at this age. In all, 64% of children had received at least one drink in a bottle and 10% solely used a bottle. Bottle users consumed a significantly greater volume of milk drinks compared to those who used a cup or other container. The types of drinks consumed and adherence to the guidelines on weaning were associated with several socio-demographic characteristics. In particular, children with mothers of lower educational level were more likely to receive fizzy drinks and low-calorie soft drinks, more likely to drink from a bottle, and less likely to drink from a cup. CONCLUSION: We have shown that certain groups of mothers with 18-month-old children are not following the current guidelines on weaning. Assuming these guidelines have scientific validity, it is clear that nutritional education needs to be targeted at these mothers to help them feed their children in the optimal way, to protect from nutritional deficiencies, possible later obesity and poor dental health. SPONSORSHIP: University of Bristol.

Analysis of Variance↗
PubMed1983

Iron absorption from a malted cocoa drink fortified with ferric orthophosphate using the stable isotope 58Fe as an extrinsic label.

The potential use of an extrinsic label to measure iron absorption from a ferric orthophosphate-fortified malted cocoa drink was examined by measuring the solubility of the FePO4 in 0.1 M-hydrochloric acid. The validity of using the stable isotope 58Fe as an extrinsic label was tested by comparing Fe absorption by rats from wheat flour extrinsically-labelled with 58Fe or 59Fe. Fe absorption from a malted cocoa drink (20 g powder made up with hot water) fortified with FePO4 (0.5 mg Fe/g powder) was measured in human subjects using 58Fe as an extrinsic label. Absorption was calculated by measuring unabsorbed 58Fe in faeces. Absorptions of Fe from the drink fortified with either FePO4 or ferrous sulphate were compared. The effect of the addition of ascorbic acid to the drink (1 mg/g powder) on Fe availability was also examined. The effect of fasting on Fe absorption from the drink was determined in rats by giving the drink to fasting animals or shortly after they had consumed a small meal. The FePO4 was totally soluble in 0.1 M-HCl and there were no differences in absorption between 58Fe- and 59Fe-labelled wheat flour. In the human experiment the proportion of Fe absorbed from the drink plus FePO4 and ascorbic acid was (mean with SE) 0.25 (0.02), from the drink plus FePO4 0.24 (0.02) and from the drink plus FeSO4 0.23 (0.03). Fasting had a significant effect on Fe availability; rats given the drink shortly after a small meal absorbed less than half as much Fe as those given the drink on a fasted stomach. It was concluded that the FePO4 used to fortify the malted cocoa drink was as well absorbed as FeSO4 but that the high levels of absorption were a reflection of the fasting condition of the subjects. The level of ascorbic acid was not great enough to enhance the availability of the FePO4 any further.

Adult↗
PubMedDate not supplied

Epidemiology of self-reported past heavy drinking in Hispanic adults.

OBJECTIVES: Self-reports of past heavy drinking correlate with the current drinking practices and with risk of mortality in non-Hispanic males. The prevalence of past heavy drinking has not been reported in Hispanic populations. METHODS: Using data from the Hispanic Health and Nutrition Examination Survey (HHANES) we (1) report on the prevalence, duration and severity of past heavy drinking in three Hispanic groups, (2) compare the current alcohol consumption patterns among past heavy drinkers and those who do not report a history of past heavy drinking and (3) compare the risk factor profiles and health indicators in these two groups. RESULTS: The prevalence of past heavy drinking among Mexican American and Puerto Rican males ranged from 28-35% while the rates for Cuban American males ranged from 7-16%. The rates for Hispanic women were much lower (1-8%). The average years of past heavy drinking ranged from 2.3-14.9 years, while the alcohol consumption during the past heavy drinking period ranged from 24.4-44.0 drinks per week. Past heavy drinkers tended to consume more alcohol at present than did never heavy drinkers with the greatest differences found for Mexican American females. Comparisons of the risk factors and health indicators by drinking status revealed a higher prevalence of smoking among past heavy drinkers (50-60%) versus never heavy drinkers (34-43%). Past heavy drinking Mexican American females also reported significantly more chronic conditions and depressive symptoms than did never heavy drinkers. CONCLUSIONS: Prevalence rates of past heavy drinking among Mexican American and Puerto Rican males are approximately three times higher than rates reported for non-Hispanic male populations.

Adult↗
PubMed2005

Sugar-sweetened soft drink consumption and risk of pancreatic cancer in two prospective cohorts.

BACKGROUND: A history of diabetes mellitus and a diet high in glycemic load are both potential risk factors for pancreatic cancer. Sugar-sweetened soft drinks are a prevalent source of readily absorbable sugars and have been associated with an increased risk of obesity and diabetes. We investigated whether higher consumption of sugar-sweetened soft drinks increases the risk of pancreatic cancer. METHODS: We examined the relation between consumption of sugar-sweetened soft drinks and the development of pancreatic cancer in the Nurses' Health Study and the Health Professionals Follow-up Study. Among 88,794 women and 49,364 men without cancer at baseline, we documented 379 cases of pancreatic cancer during up to 20 years of follow-up. Soft drink consumption was first assessed at baseline (1980 for the women, 1986 for the men) and updated periodically thereafter. RESULTS: Compared with participants who largely abstained from sugar-sweetened soft drinks, those who consumed more than three sugar-sweetened soft drinks weekly experienced overall a multivariate relative risk (RR) of pancreatic cancer of 1.13 [95% confidence interval (95% CI), 0.81-1.58; P for trend = 0.47]. Women in the highest category of sugar-sweetened soft drink intake did experience a significant increase in risk (RR, 1.57; 95% CI, 1.02-2.41; P for trend = 0.05), whereas there was no association between sweetened soft drink intake and pancreatic cancer among men. Among women, the risk associated with higher sugar-sweetened soft drink was limited to those with elevated body mass index (>25 kg/m(2); RR, 1.89; 95% CI, 0.96-3.72) or with low physical activity (RR, 2.02; 95% CI, 1.06-3.85). In contrast, consumption of diet soft drinks was not associated with an elevated pancreatic cancer risk in either cohort. CONCLUSION: Although soft drink consumption did not influence pancreatic cancer risk among men, consumption of sugar-sweetened soft drinks may be associated with a modest but significant increase in risk among women who have an underlying degree of insulin resistance.

Adult↗
PubMedDate not supplied

Prevention by means of fluoride of enamel erosion as caused by soft drinks and orange juice.

Fluoride has been suggested to prevent erosion of the teeth, either after a topical treatment of the teeth or by addition of fluoride to the acidic drink. The main aim of the present study was to describe the dissolution of calcium fluoride in some soft drinks and orange juice and compare it with the amounts of calcium fluoride left on the enamel surfaces after a topical treatment. A further aim was to describe the dissolution of enamel in soft drinks and juice saturated for 3 days with solid calcium fluoride. Solid calcium fluoride was suspended in each of 10 soft drinks and orange juices and gently agitated for 72 h, after which the drinks were analyzed for calcium, phosphate and fluoride and pH was determined. To examine the erosion-preventive effect of the calcium fluoride-rich drink, intact teeth were exposed to the drinks with or without calcium fluoride. It was found that from 6 to 45 mg of calcium fluoride was dissolved per liter of drink. The more acidic the drink, the more calcium fluoride was dissolved, presumably due to HF formation. The teeth exposed to the soft drinks all showed erosion-like lesions. Very little effect of the 4-6 ppm ionic fluoride dissolved in the soft drinks was observed. In orange juice, however, the dissolved calcium fluoride established a saturation with respect to fluorapatite and consequently, the erosion-like lesion was replaced by a caries-like lesion. In conclusion, the acidic soft drinks are capable of dissolving considerable amounts of calcium fluoride and the erosion-preventive effect of even high fluoride concentrations is limited.

Analysis of Variance↗
PubMed1998

Parental and peer influences on the onset of heavier drinking among adolescents.

OBJECTIVE: Less is known about heavier drinking in adolescents than about alcohol initiation. The present study examined the emergence of regular (weekly) and heavy episodic (five or more drinks at a time) adolescent drinking as a function of social influence (modeling and social control) from parents and peers. METHOD: A three-wave study was conducted using a representative household sample of families in metropolitan Buffalo, New York (N = 612). Over half (54%) of the adolescent respondents were female. Black families made up 30% of the sample. Interviews were conducted at 1-year intervals. Adolescent drinking was dichotomized at each wave into abstinence/light drinking versus regular drinking. Logistic regression including only adolescents who were abstainers/light drinkers at Wave 1 was performed to assess which Wave- variables could predict regular-drinking onset by Wave 2; a similar analysis examined the onset of heavy episodic drinking by Wave 2. Parallel analyses using Wave-2 variables to predict the onset of the drinking outcomes by Wave 3 were also conducted. RESULTS: Across the different analyses, the strongest psychosocial predictors of advancement to heavier drinking were friend's drinking and low parental monitoring. Also, white adolescents were at greater risk than their black counterparts. CONCLUSIONS: A multidimensional approach to prevention that addresses different processes of influence (e.g., modeling and social control) involving both parental and peer domains is likely to be most successful in deterring the onset of heavier drinking in adolescents.

Adolescent↗
PubMed2004

Older women's cognitive and affective response to moderate drinking.

OBJECTIVE: In this paper we investigated the question, how do older women who drink moderate amounts of alcohol differ from those who do not drink on measurements of cognitive function, memory, affect and health? METHODS: The nonprobability sample of female participants (n=182) averaged 75 years of age and had a Mini Mental State Examination scores of 28. The participants were asked to indicate whether they drank alcohol or abstained (yes/no) and if they indicated that they did drink, to describe how many drinks they consumed in a given period of time (day/week/month). RESULTS: None of the participants acknowledged drinking more than 2 drinks a day. Caucasian women had the largest number of moderate drinkers (53% vs 47%), while the majority of African-American and Hispanic women reported not drinking. The moderate drinkers reported less depression, had higher self-reported health, performed better on instrumental everyday tasks, had stronger memory self-efficacy, and used more strategies to improve memory performance. In addition, these women had higher performance on tests of executive function: attention, concentration, psychomotor skills, verbal-associative capacities, and oral fluency. CONCLUSIONS: The circumstances under which people drink are complex and were not evaluated in this study. Therefore, rather than endorsing drinking behavior, these findings suggest that future research might examine why elders make the decision to drink, the circumstances that predispose women to drink (alone/with others), and other qualities that characterize female drinkers over the age of 65.

Activities of Daily Living↗
PubMed1984

Histamine plays a major role for drinking elicited by spontaneous eating in rats.

The effects of combined antagonism of H1 (using 1 mg/kg dexbrompheniramine IP) and H2 (using 16 mg/kg cimetidine IP) receptors for histamine prior to (a) drinking after 2.5 mg/kg histamine SC, (b) drinking after 1-hr water deprivation, and (c) drinking during spontaneous eating were examined at 1 hr into the dark phase of a 12:12'-hr light/dark cycle for 14 Sprague-Dawley male rats. Such antagonism of histamine receptors abolished drinking elicited by exogenous histamine without affecting drinking after water deprivation. Histaminergic antagonism did not affect spontaneous eating, but it appeared to abolish drinking prior to a meal (for only those 3 rats which exhibited such drinking), delayed the latency to initiate drinking after initiating a meal, and inhibited drinking which occurred during and after eating but prior to postprandial resting (i.e., satiety for food). Because antagonism of peripheral histamine receptors inhibited food-related drinking by over 60%, these results provide indirect support for the hypothesis that the preabsorptive food-contingent vagally-mediated release of gastric mucosal histamine plays a major role in spontaneous food-related drinking in the rat.

Animals↗
PubMed1990

Effects of drinks sweetened with sucrose or aspartame on hunger, thirst and food intake in men.

Forty-two nondieting adult males were given 8 or 16 oz of lemonade, sweetened to equal intensity with either aspartame or sucrose, or the same volumes of water, or no drink. Subjects were separated into three groups receiving the drinks at different times: with a self-selection lunch, or 30, or 60 min before lunch. Food intakes did not differ when subjects received the drinks with lunch; however, when the calories from the drinks were included, intake was significantly greater with the sucrose-sweetened lemonades than in the other conditions. When subjects received the drinks 30 or 60 min before lunch, food intakes were not significantly different. Appetite ratings were not different among the conditions. When the drinks were consumed with the meal, the 8-oz sucrose-sweetened lemonade differed from the other drinks in that it did not significantly reduce thirst. The results indicate that in nondieting males, aspartame in concentrations similar to those in commercially available drinks did not increase hunger ratings or food intake. However, caloric drinks taken with lunch increased total energy intake in that meal. Also, sucrose-sweetened drinks may decrease thirst less than water or aspartame-sweetened drinks when taken with a meal.

Adult↗
PubMed1994

Alcohol drinking in pregnancy.

Our study attempted to determine the prevalence of regular drinking during the second half of pregnancy among prenatal patients; the characteristics that differentiate drinkers from nondrinkers; and characteristics that differentiate prenatal patients who drink 7 or fewer standard drinks per week and those who drink more than 7. In our survey of consecutive English-speaking prenatal patients over 20 weeks' gestation, women self-reported on health habits from a study questionnaire and completed the General Health Questionnaire and Fetal Health Locus of Control. Eighty-three percent (466 of 561) of women provided data on alcohol intake during the second half of pregnancy: 106 (22.7%) reported regular weekly drinking in pregnancy, and the mean number of standard drinks was 1.97 (SD 9.78, range 0.5-184) per week. Thirty-eight (8.2%) women reported drinking more than seven standard drinks, and 14 (3.0%) reported more than 14 standard drinks per week. Women who drank more than seven standard drinks per week were significantly more likely to be under 21 years of age, poorly educated, unemployed, unmarried, to have unplanned pregnancies, emotional problems, eat unhealthy diets, smoke, use illicit drugs, and be physically abused. They also were more likely to meet psychiatric case status on the General Health Questionnaire (t = 3.85, p = 0.0001) and to believe that "chance" (t = 3.41, p = 0.001) rather than "internal control" (t = -3.54, p = 0.001) affected the health of their fetuses as measured by the Fetal Health Locus of Control. We concluded that pregnant women who drink alcohol often have other health risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcohol Drinking↗
PubMed1987

Alcohol consumption and casualties; drinking in the event.

The data reported are from a 20% probability sample (n = 2516) of all adult patients seeking care in the emergency room at San Francisco General Hospital during a 60-day period. Thirty-five percent (35%) of the injured and 18% of the non-injured reported drinking prior to the event. This paper compares the following variables related to drinking-in-the-event for injured and non-injured: drinking places, drinking companions, amount consumed, time lapsed between drinking and the event, effects of drinking and causality attributed by the patient to drinking and the event. When these variables were entered into a logistic regression to evaluate their predictive value on injury status, only time lapsed since the last drink and drug use prior to the event were predictive of injury with both being negatively associated with admission to the emergency room for an injury. Injuries were more likely than non-injuries to occur in close proximity to drinking (44% of injuries occurred in less than 1 h of the last drink), and close to a third of the injured attributed a causal association of drinking with the event, with 60% of these feeling they were drunk at the time of injury.

Accidents↗
PubMed1988

The demographic distribution of drinking patterns in 1984.

The demographic distribution of drinking and heavy drinking in a 1984 survey are presented to provide updated prevalence estimates for these phenomena. Several measures of drinking patterns are used, including: the frequency of drinking, the monthly volume consumed, the frequency of drinking five or more drinks on an occasion, the frequency of drinking eight or more drinks in a day, and the frequency of self-reported drunkenness. In most cases, the present results confirm earlier findings. However, the present data give better information on Black and Hispanic drinking patterns than was available in earlier surveys. Results not consistent with earlier studies are that there are contradictory findings regarding the relationship between socio-economic status and drinking and that the drinking patterns of divorced and separated men diverge from those of divorced and separated women.

Adolescent↗
PubMed1993

Alcohol expectancies, problem drinking, and adverse health consequences.

This study evaluated a measure of positive and negative expected effects of alcohol and their subjective evaluation in the identification of college freshmen at high risk for problem drinking and associated morbidities. It was hypothesized that greater expectations of positive outcomes and fewer negative evaluations of negative outcomes would be associated with reports of heavier drinking and more alcohol-related health problems. College freshmen (n = 328) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking, and a questionnaire assessing drinking patterns and common alcohol-related health problems. Fifty-two percent of students were male and the mean age was 17.9 years (SD = 0.5). Students' expectations of positive outcomes and their subjective evaluations of both positive and negative outcomes from drinking were significantly correlated with drinking and alcohol-related health problems indices (p < 0.001). Gender, expectation of positive outcomes, and evaluation of negative outcomes explained 29% of the variance in drinking and 15% of the variance in alcohol-related health problems indices. Heavier-drinking students and those reporting more health problems expected more positive effects on their sociability and sexuality (p < 0.03) and were less concerned about cognitive and behavioral impairment as a result of drinking (p < 0.001). Students with more health problems were less concerned that drinking would lead to risk-taking or aggressive behavior (p < 0.003). Positive and negative outcome expectancies and their subjective evaluations accounted for a significant portion of the variability in drinking and alcohol-related health problems.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗