bluuebunny/crossref_metadata_2025 huggingface dataset:
Natural CO2 seeps reveal adaptive potential to ocean acidification in fish
Authors: Petit‐Marty Natalia , Nagelkerken Ivan , Connell Sean D. , Schunter Celia
Published: April 2021

Volcanic CO2 seeps are natural laboratories that can provide insights into the adaptation of species to ocean acidification. While many species are challenged by reduced‐pH levels, some species benefit from the altered environment and thrive. Here, we explore the molecular mechanisms of adaptation to ocean acidification in a population of a temperate fish species that experiences increased population sizes under elevated CO2. Fish from CO2 seeps exhibited an overall increased gene expression in gonad tissue compared with those from ambient CO2 sites. Up‐regulated genes at CO2 seeps are possible targets of adaptive selection as they can directly influence the physiological performance of fishes exposed to ocean acidification. Most of the up‐regulated genes at seeps were functionally involved in the maintenance of pH homeostasis and increased metabolism, and presented a deviation from neutral evolution expectations in their patterns of DNA polymorphisms, providing evidence for adaptive selection to ocean acidification. The targets of this adaptive selection are likely regulatory sequences responsible for the increased expression of these genes, which would allow a fine‐tuned physiological regulation to maintain homeostasis and thrive at CO2 seeps. Our findings reveal that standing genetic variation in DNA sequences regulating the expression of genes in response to a reduced‐pH environment could provide for adaptive potential to near‐future ocean acidification in fishes. Moreover, with this study we provide a forthright methodology combining transcriptomics and genomics, which can be applied to infer the adaptive potential to different environmental conditions in wild marine populations.
Fruit category classification by fractional Fourier entropy with rotation angle vector grid and stacked sparse autoencoder
Authors: Zhang Yu‐Dong , Satapathy Suresh Chandra , Wang Shui‐Hua
Published: April 2021

Aim

Fruit category classification is important in factory packing and transportation, price prediction, dietary intake, and so forth.

Methods

This study proposed a novel artificial intelligence system to classify fruit categories. First, 2D fractional Fourier entropy with rotation angle vector grid was used to extract features from fruit images. Afterwards, a five‐layer stacked sparse autoencoder was used as the classifier.

Results

Ten runs on the test set showed our method achieved a micro‐averaged F1 score of 95.08% for an 18‐category fruit dataset.

Conclusion

Our method gives better micro‐averaged F1 score than 10 state‐of‐the‐art approaches.
Impact of the COVID‐19 Pandemic on Parent, Child, and Family Functioning
Authors: Feinberg Mark E. , A. Mogle Jacqueline , Lee Jin‐Kyung , Tornello Samantha L. , Hostetler Michelle L. , Cifelli Joseph A. , Bai Sunhye , Hotez Emily
Published: April 2021

To quantify the impact of the COVID‐19 pandemic and public health interventions on parent and child mental health and family relationships, we examined change in individual and family functioning in a sample of parents enrolled in a prevention trial; we examined change before the pandemic (2017–2019) when children were an average of 7 years old to the first months after the imposition of widespread public health interventions in the United States (2020) with paired t tests and HLM models. We examined moderation by parent gender, education, family income, and coparenting conflict. We found large deteriorations from before the pandemic to the first months of the pandemic in child internalizing and externalizing problems and parent depression, and a moderate decline in coparenting quality. Smaller changes were found for parent anxiety and parenting quality. Mothers and families with lower levels of income were at particular risk for deterioration in well‐being. Results indicate a need for widespread family support and intervention to prevent potential family “scarring,” that is, prolonged, intertwined individual mental health and family relationship problems.
Meta‐analysis of yield and nitrous oxide outcomes for nitrogen management in agriculture
Authors: Maaz Tai M. , Sapkota Tek B. , Eagle Alison J. , Kantar Michael B. , Bruulsema Tom W. , Majumdar Kaushik
Published: April 2021

Improved nitrogen (N) use is key to future food security and environmental sustainability. While many regions still experience N shortages, agriculture is the leading global emitter of N2O due to losses exacerbated by N surpluses in other regions. In order to sustainably maintain or increase food production, farmers and their advisors need a comprehensive and actionable understanding of how nutrient management affects both yield and N2O emissions, particularly in tropical and subtropical agroecosystems. We performed a meta‐analysis to determine the effect of N management and other factors on N2O emissions, plant N uptake, and yield. Our analysis demonstrates that performance indicators—partial N balance and partial factor productivity—predicted N2O emissions as well as or better than N rate. While we observed consistent production and environmental benefits with enhanced‐efficiency fertilizers, we noted potential trade‐offs between yield and N2O emissions for fertilizer placement. Furthermore, we observed confounding effects due to management dynamics that co‐vary with nutrient application practices, thus challenging the interpretation of the effect of specific practices such as fertilization frequency. Therefore, rather than providing universally prescriptive management for N2O emission reduction, our evidence supports mitigation strategies based upon tailored nutrient management approaches that keep N balances within safe limits, so as to minimize N2O emissions while still achieving high crop yields. The limited evidence available suggests that these relationships hold for temperate, tropical, and subtropical regions, but given the potential for expansion of N use in crop production, further N2O data collection should be prioritized in under‐represented regions such as Sub‐Saharan Africa.
Classifying ecosystem stressor interactions: Theory highlights the data limitations of the additive null model and the difficulty in revealing ecological surprises
Authors: Burgess Benjamin J. , Purves Drew , Mace Georgina , Murrell David J.
Published: April 2021

Understanding how multiple co‐occurring environmental stressors combine to affect biodiversity and ecosystem services is an on‐going grand challenge for ecology. Currently, progress has been made through accumulating large numbers of smaller‐scale empirical studies that are then investigated by meta‐analyses to detect general patterns. There is particular interest in detecting, understanding and predicting ‘ecological surprises’ where stressors interact in a non‐additive (e.g. antagonistic or synergistic) manner, but so far few general results have emerged. However, the ability of the statistical tools to recover non‐additive interactions in the face of data uncertainty is unstudied, so crucially, we do not know how well the empirical results reflect the true stressor interactions. Here, we investigate the performance of the commonly implemented additive null model. A meta‐analysis of a large (545 interactions) empirical dataset for the effects of pairs of stressors on freshwater communities reveals additive interactions dominate individual studies, whereas pooling the data leads to an antagonistic summary interaction class. However, analyses of simulated data from food chain models, where the underlying interactions are known, suggest both sets of results may be due to observation error within the data. Specifically, we show that the additive null model is highly sensitive to observation error, with non‐additive interactions being reliably detected at only unrealistically low levels of data uncertainty. Similarly, plausible levels of observation error lead to meta‐analyses reporting antagonistic summary interaction classifications even when synergies co‐dominate. Therefore, while our empirical results broadly agree with those of previous freshwater meta‐analyses, we conclude these patterns may be driven by statistical sampling rather than any ecological mechanisms. Further investigation of candidate null models used to define stressor‐pair interactions is essential, and once any artefacts are accounted for, the so‐called ‘ecological surprises’ may be more frequent than was previously assumed.
Dental plaque control strategies for the elderly population: A scoping review
Authors: Ruiz Núñez María del Rosario , da Luz Raulino Mariane , Goulart Castro Renata , Schaefer Ferreira de Mello Ana Lúcia
Published: April 2021

Objective

To review the scientific literature and identify dental plaque control strategies focussed on elderly people that improve plaque indices.

Design

Scoping review (Joanna Briggs protocol).

Data sources

Individual search strategies developed for six databases. The selection of the manuscripts in two phases: title and abstract review, and complete review.

Eligibility criteria

Studies on interventions for plaque control in elderly people (60y+). Epidemiological studies and those focussed on caregivers, health professionals and periodontal maintenance therapies were excluded.

Results

The initial search yielded 2803 studies, 26 were included. The results were classified into: exclusively chemical (10), educational (9), exclusively mechanical (6), and combined mechanical and chemical (1). The studies reported different types of interventions: sugarless chewing gum, chlorhexidine (CHX) in different preparations and concentrations, mouthwash based on essential oils, stannous/sodium fluoride dentifrice and lactoferrin/lactoperoxidase tablets. Additionally, conventional and alternative toothbrushes and professional brushing were tested. Educational interventions included oral hygiene guidance, verbal information, and demonstrations of dental and denture cleaning procedures, and lifestyle changes. Many studies have reported strategies that improve dental plaque indices but without statistical significance when compared to control groups. Promising results were found with the use of CHX, sugarless chewing gum, professional brushing and educational strategies with demonstration, but the results were not long‐lasting.

Conclusion

The literature reports that mechanical, chemical and educational strategies have some efficacy in dental plaque control in the elderly population. The results should be viewed with caution, considering the type of intervention (isolated or combined) and the maintenance of the results obtained.
Effects of a cognitive rehabilitation programme on cognitive function, self‐management and quality of life in patients with chronic obstructive pulmonary disease
Authors: Park Myoung Ok , Oh Hyun Soo , Seo Wha Sook
Published: April 2021

Aim

The study purpose was to investigate effects of a cognitive rehabilitation programme on cognitive function, self‐management and quality of life in patients with chronic obstructive pulmonary disease.

Background

Cognitive impairment is frequently observed in chronic obstructive pulmonary disease patients, and it interferes with many aspects of self‐management, which is fundamental to disease management and quality of life.

Design

The design is quasi‐experimental.

Methods

Data collection was performed between June 2018 and March 2019. Study participants were 60 in‐ or out‐patients with chronic obstructive pulmonary disease. The cognitive rehabilitation programme involved six 30‐min sessions administered over a period of 2 weeks and consisted of six areas: attention, memory, language, visuospatial perception, executive function and problem solving. Cognitive function, self‐management and quality of life were measured at three times (preintervention and immediately and 4 weeks after intervention).

Results

Cognitive function, self‐management and quality of life were found to be significantly improved over time after administration of the cognitive rehabilitation programme. However, no significant improvement was observed in the control group.

Conclusions

Our findings support the potential usefulness of cognitive intervention to promote cognitive function, self‐management ability and quality of life in patients with chronic obstructive pulmonary disease.
Misperceptions about added sugar, non‐nutritive sweeteners and juice in popular children's drinks: Experimental and cross‐sectional study with U.S. parents of young children (1‐5 years)
Authors: Harris Jennifer L. , Pomeranz Jennifer L.
Published: April 2021

Background

Experts recommend against serving sugary drinks and non‐nutritive sweeteners to young children, but misperceptions about drink ingredients may contribute to consumption.

Objectives

Assess parents' ability to identify added sugar, non‐nutritive sweeteners and juice in children's drinks.

Methods

Researchers recruited U.S. parents of young children (1‐5 years) through an online survey panel (N = 1603). In a randomized experiment, participants indicated whether eight popular children's drink products contained added sugar or non‐nutritive sweeteners and percentage of juice after viewing (a) front‐of‐package alone or (b) front‐of‐package plus nutrition/ingredient information. Participants also viewed common statements of identity on children's drinks to identify product ingredients.

Results

When viewing front‐of‐packages alone, most participants accurately identified products with (83%‐90%) and without (51%‐65%) added sugar. Showing nutrition/ingredient information increased accuracy. However, the majority could not identify drinks with non‐nutritive sweeteners (53%‐58%), and many incorrectly believed that unsweetened juices contained added sugar (38%‐43%), sweetened flavoured waters had no added sugar (24%‐25%), and 100% juice contained less than 100% juice (37%). Furthermore, the majority could not identify product ingredients from statement of identity terms.

Conclusions

Misperceptions about product ingredients under current labelling practices indicate that updated regulations are necessary, including clear disclosures of sweetener and juice content on package fronts.
The early school leaving issue among Chinese students in the super‐diverse city of Prato
Authors: Ianniello Piero
Published: April 2021

Prato, located in central Italy, is the most multi‐ethnic city in the country, hosting 20 per cent foreigner residents. It is home of one of the largest Chinese communities in Europe, specialising in the textile sector. Yet economic success does not translate into educational success for the first‐ and second‐generation Chinese students living in Prato. Early school leavings represent a pressing issue in Prato's educational system, with 16.2 per cent of all students leaving school before graduating from high school. Among foreigner students, the problem is even more alarming, reaching 50 per cent. The highest leaving rate is recorded among Chinese students.

This paper examines the phenomenon of early school leavings within the Chinese community in Prato – a super‐diverse city with highly interrelated migrant dynamics. The article works to critically assess educational policies, local statistics, and ethnographic findings derived from participant observation and in‐depth interviews with headmasters, teachers, and students from one middle school (Scuola Mazzoni), three high schools (Liceo Copernico, Dagomari High School, Datini High School), and one Chinese school (Istituto Internazionale di Educazione e Mediazione Culturale) in Prato.

The paper aims to explore and analyse causes for early school leaving within the Chinese community, such as flaws in the Italian legislation in conjunction with the chronic shortage of funds for schools, the clash of educational style, and the lack of parental involvement. Finally, the paper examines strategies implemented by schools in Prato in an effort to redress the phenomenon and how the low educational engagement affects the cultural, social, economic, and symbolic capital of Chinese students.
Fabrication of high‐efficiency anatase TiO2 photocatalysts using electrospinning with ultra‐violet treatment
Authors: Song Chan‐Geun , Won Jonghan , Jang Inhoon , Choi Hyeunseok
Published: April 2021

In metal oxide nanofiber fabrication using the electrospinning method, heat treatment is performed at temperatures of 500°C or higher for crystallization and polymer desorption. Therefore, it is difficult to fabricate low‐temperature phase metal oxides that crystallize at low temperatures. TiO2, a representative metal oxide often used as photocatalysts, is known to have higher photocatalytic activity in the low‐temperature phase (anatase structure) than in the high‐temperature phase (rutile structure). Studies on the fabrication of TiO2 anatase nanofibers using conventional electrospinning have reported disadvantages such as the partial expression of rutile structures and low crystallinity. This study developed an anatase TiO2 nanofiber as a high‐efficiency catalyst based on the electrospinning method and a residual organic matter cleaning method that employs ultra‐violet (UV) light. We fabricated nanofibers using the electrospinning method and implemented TiO2 nanofibers with the anatase structure through heat treatment at 260°C. Residual organics remaining after heat treatment of the fabricated crystalized TiO2 nanofibers were removed by exposing them to UV light, thereby improving photocatalytic efficiency. The photocatalytic efficiency of the fabricated TiO2 nanofibers was confirmed through a methylene blue (MB) decomposition experiment under visible light irradiation. The photocatalytic efficiency (time taken for the concentration of the MB solution to reach 50%) of the UV‐treated TiO2 nanofibers was approximately six times higher than of P25 and the heat‐treated nanofibers.
Influence of oxygen vacancies on core‐shell formation in solid solutions of (Na,Bi)TiO3 and SrTiO3
Authors: Steiner Sebastian , Heldt Jonas , Sobol Oded , Unger Wolfgang , Frömling Till
Published: April 2021

Solid solutions of (Na,Bi)TiO3 (NBT) and SrTiO3 (ST) are materials of interest for high‐strain or high‐energy density capacitor applications. Often, they exhibit chemical heterogeneity and develop core‐shell structures during regular solid‐state synthesis with an NBT‐rich core. In this case, the NBT forms first so that the strontium needs to diffuse into the material to reach chemical homogeneity. Depending on the presence of core‐shell structures, the electrical properties can vary drastically. In this work, we rationalize the effect of variations in oxygen vacancy concentration by Fe‐acceptor and Nb‐donor doping. It can be shown that a diffusion couple of strontium and oxygen is responsible for chemical homogenization and that the oxygen vacancy content can control the formation of a core‐shell structure.
Intersectionality and fatherhood: Theorizing non‐hegemonic fatherhoods
Authors: Strier Roni , Perez‐Vaisvidovsky Nadav
Published: April 2021

Contemporary research on fatherhood describes fatherhood as a multifaceted, dynamic social, and cultural construction, deeply affected by class, race, and gender inequalities. However, critics claim that dominant theories on fatherhood have been mostly elaborated based on middle‐class, Anglo‐centered, dominant, and mainstream fatherhood, whereas non‐hegemonic, marginalized father groups have remained undertheorized. This article echoes this shortfall and proposes to theorize non‐hegemonic fatherhood through a more inclusive theoretical framework capable of describing the social contexts that shape fathers' identities, behaviors, and cultures. Based on intersectional theories, the article argues for a theoretical revision of the ways in which these groups of non‐hegemonic fathers are represented in research. To illustrate this, we provide some examples of studies based on case studies of marginalized fathers in Israel. Israel is rich ground for such research since it is characterized by traditional models of fatherhood, expressed through hegemonic models of masculinity, as well as normative family models in the context of high levels of ethnic and class inequality.
Sex‐specific alterations in NAD+ metabolism in 3xTg Alzheimer’s disease mouse brain assessed by quantitative targeted LC‐MS
Authors: van der Velpen Vera , Rosenberg Nadia , Maillard Vanille , Teav Tony , Chatton Jean‐Yves , Gallart‐Ayala Hector , Ivanisevic Julijana
Published: April 2021

Levels of nicotinamide adenine dinucleotide (NAD+) are known to decline with age and have been associated with impaired mitochondrial function leading to neurodegeneration, a key facet of Alzheimer's disease (AD). NAD+synthesis is sustained via tryptophan‐kynurenine (Trp‐Kyn) pathway as de novo synthesis route, and salvage pathways dependent on the availability of nicotinic acid and nicotinamide. While being currently investigated as a multifactorial disease with a strong metabolic component, AD remains without curative treatment and important sex differences were reported in relation to disease onset and progression. The aim of this study was to reveal the potential deregulation of NAD+metabolism in AD with the direct analysis of NAD+precursors in the mouse brain tissue (wild type (WT) versus triple transgenic (3xTg) AD), using a sex‐balanced design. To this end, we developed a quantitative liquid chromatography‐tandem mass spectrometry (LC‐MS/MS) method, which allowed for the measurement of the full spectrum of NAD+precursors and intermediates in all three pathways. In brain tissue of mice with developed AD symptoms, a decrease in kynurenine (Kyn) versus increase in kynurenic acid (KA) levels were observed in both sexes with a significantly higher increment of KA in males. These alterations in Trp‐Kyn pathway might be a consequence of neuroinflammation and a compensatory production of neuroprotective kynurenic acid. In the NAD+ salvage pathway, significantly lower levels of nicotinamide mononucleotide (NMN) were measured in the AD brain of males and females. Depletion of NMN implies the deregulation of salvage pathway critical for maintaining optimal NAD+ levels and mitochondrial and neuronal function.

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Factors associated with time to first analgesic medication in the emergency department
Authors: Hughes James A. , Alexander Kimberly E. , Spencer Lyndall , Yates Patsy
Published: April 2021

Aim and Objective

To examine the factors associated with time to first analgesic medication in the emergency department.

Background

Pain is the most common symptom presenting to the emergency department, and the time taken to deliver analgesic medication is a common outcome measure. Factors associated with time to first analgesic medication are likely to be multifaceted, but currently poorly described.

Design

Retrospective cohort study.

Methods

Cox proportional hazards regression modelling was undertaken to evaluate the associations between person, environment, health and illness variables within Symptom Management Theory and time to first analgesic medication in a sample of adult patients presenting with moderate‐to‐severe pain to an emergency department over twelve months. This study was completed in line with the STROBE statement.

Results

383 patients were included in the study, 290 (75.92%) of these patients received an analgesic medication in a median time of 45 minutes (interquartile range, 70 minutes). A model containing nine explanatory variables associated with time to first analgesic medication was identified. These nine variables (employment status, discharge location, triage score, Charlson score, arrival pain score, socio‐economic status, first location, daily total treatment time and patient time to be seen) represent all of the domains of the Symptom Management Theory.

Conclusions

Person, environment, health and illness factors are associated with the time taken to deliver analgesic medication to those in pain in the emergency department. This study demonstrates the complexity of factors associated with pain care and the applicability of Symptom Management Theory to pain care in the emergency department.

Relevance to Clinical Practice

Identifying a model of factors that are associated with the time in which the most common symptom presenting to the emergency department is treated allows for targeted interventions to groups likely to receive poor care and a framework for its evaluation.
Cluster analysis of self‐concept and job satisfaction in Chinese nurses with master’s degree to identify their turnover intention: A cross‐sectional study
Authors: Li Xiaodan , Guo Yue , Zhao Tiyu , Zhang Shiyi , Yue Xiao , Liu Yang
Published: April 2021

Aims and objectives

This study aimed to implement cluster analysis of self‐concept and job satisfaction to identify subgroups in nurses with master's degree and explore the associations of turnover intention with characteristics among these clusters.

Design

A cross‐sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

Methods

A convenience sample of 408 nurses with master's degree in China filled out the survey from 19 November 2019 to 30 December 2019. A sociodemographic questionnaire, the Nurses’ Self‐Concept Questionnaire (NSCQ), Job Satisfaction Scale (JSS) and Turnover Intention Questionnaire (TIQ) were adopted to collect the data. K‐means cluster analysis was implemented on the R software, and data were analysed using SPSS 24.0.

Results

Three subgroups were identified based on cluster analysis of NSCQ and JSS subscales in 405 nurses (99.3%) available for statistical analysis, among whom 30.9%, 17% and 48.1% were allocated to these clusters respectively. Turnover intention significantly differed among the three clusters, with cluster 2 having the highest turnover intention and cluster 1 having the lowest turnover intention. Working department, position, professional title, clinical nurse specialist and annual income were factors differentiating TIQ scores in each cluster.

Conclusions

This study identified three clusters of nurses with master's degree and showed that each cluster was associated with the level of turnover intention. The unique characteristics of the three clusters may be also helpful in identifying and providing specific managerial or social support to reduce turnover rates in nurses with master's degree.

Relevance to clinical practice

Cluster analysis is s an unsupervised machine learning method to identify meaningful subgroups within heterogeneous population based on variables distributions and patterns underlying in the data set. Through clustering, nurses with multi‐dimensional characteristics could be allocated into subgroups associated with turnover intention. As a result, nursing managers could provide approaches for each subgroup to reduce turnover intention.
Hospital and home care nurses’ experiences and perceptions regarding nutritional care for older adults to prevent and treat malnutrition: A cross‐sectional study
Authors: ten Cate Debbie , Schoonhoven Lisette , Huisman – de Waal Getty , Schuurmans Marieke J. , Ettema Roelof G. A.
Published: April 2021

Aims and objectives

To gain insight into the experiences and perceptions of hospital and home care nurses regarding nutritional care for older adults to prevent and treat malnutrition.

Background

In‐depth knowledge about hospital and home care nurses’ experiences and perceptions can contribute to optimise nutritional care for older adults across the care continuum between hospital and home to prevent and treat malnutrition.

Design

Multicentre cross‐sectional descriptive study.

Method

A validated questionnaire addressing malnutrition was used. A total of 1,135 questionnaires were sent to hospital and home care nurses. The STROBE statement was followed for reporting.

Results

The response rate was 49% (n = 556). Of all the nurses, 37% perceived the prevalence of malnutrition among their care recipients between 10% and 25%. Almost 22% of the nurses neither agreed nor disagreed or disagreed with the statement that prevention of malnutrition is possible. More than 28% of the nurses reported that malnutrition is a small or no problem. Over 95% of the hospital nurses and 52.5% of the home care nurses stated they screened routinely for malnutrition. The nurses considered several interventions for treating malnutrition important. Over 81% of the nurses indicated they wanted to follow further training.

Conclusion

Most hospital and home care nurses perceived that nutritional care for older adults to prevent and treat malnutrition was important. A fair group of nurses, however, had the opposite perception.

Relevance to clinical practice

Raising the awareness of all hospital and home care nurses about the importance of nutritional care for older adults is pivotal to increase the chance of successfully providing nursing nutritional care. Nurses should follow training for consolidation of nutritional care. Nurses are well‐positioned to take a leadership role to improve continuity and quality of nutritional care across the care continuum between hospital and home.
Life with a stoma—coping with daily life: Experiences from focus group interviews
Authors: Petersén Charlotta , Carlsson Eva
Published: April 2021

Aims and objectives

To describe patients’ experiences of coping with daily life practically and emotionally during the first years after stoma surgery.

Background

For people with a stoma, a new life awaits with altered bowel function and body image. This means a profound change in a person's life.

Design

A qualitative descriptive design using focus group interviews to gain an understanding of patients’ experiences of coping with daily life. This study followed the COREQ checklist for reporting qualitative research.

Method

Six focus groups including 21 patients with a stoma experience of 1–3 years. Mean age was 65 (23–79) and comprised 9 men and 12 women. Thirteen participants had a colostomy, 8 had an ileostomy. The interviews were analysed with a qualitative content analysis.

Results

Patients lived with uncertainty due to lost control over bowel function and did not feel comfortable with the new body. They had adjusted to the new life with a positive impact, by changing their attitude, enabling a social‐ and working life and tried to take control over the situation. Patients with a temporary stoma put life on hold.

Conclusion

Patients with a stoma lived with uncertainty, not trusting their body like before. They strived to regain control of their lives according to their own resources and conditions and with support from healthcare professionals. Interacting with others in similar situations and exchanging experiences, in demanding areas such as body image, sexuality and social activities could support patients in coping with their new life with a stoma.

Relevance to clinical practice

The findings can help stoma care nurses and healthcare professionals plan themed lectures and group discussions for patients regarding coping with areas that are especially demanding. A themed evening would give patients the chance to share and exchange experiences and receive affirmation from others in the same situation.
Sugar content and nutrient content claims of growing‐up milks in Indonesia
Authors: Pries Alissa M. , Mulder Anzélle , Badham Jane , Sweet Lara , Yuen Katelyn , Zehner Elizabeth
Published: April 2021

‘Growing‐up milks’ (GUMs)—breast‐milk substitutes targeted for young children (aged 12–36 months)—are commonly consumed in Indonesia. The World Health Assembly has stated that GUMs are not necessary for proper growth and development, and recently, the American Academy of Pediatrics declared that such products are not recommended for young children due to their common use of sweeteners. To contribute to the evidence base on the composition of GUMs and their appropriateness for young child diets, this cross‐sectional study documented the declared sugar content and presence of nutrient content claims of 99 GUMs newly launched in Indonesia between January 2017 and May 2019. Sugar content was evaluated against the draft 2018 Codex Alimentarius Standard for Follow‐Up Formula guidance on sugar content and the United Kingdom Food Standard Agency's front‐of‐pack (UK FSA FOP) colour coding system for sugar. Almost all (97%) GUMs contained one or more added sugars. None of the products were fully compliant with all three sugar content recommendations in the draft Codex standard. Seventy‐one per cent of GUMs were determined to have high sugar content according to the UK FSA FOP system. Nutrient content claims were found on 97% of GUMs. Median total sugar content was 7.3 g per 100 ml, similar to sugar content levels in sugar‐sweetened beverages. Many GUMs available in Indonesia claim to offer nutritional benefits; however, the current levels of sugar content in GUMs are a serious concern and are inappropriate for inclusion in the diets of young children.
Attitudes and experiences of employed women when combining exclusive breastfeeding and work: A qualitative study among office workers in Northern Ethiopia
Authors: Gebrekidan Kahsu , Plummer Virginia , Fooladi Ensieh , Hall Helen
Published: April 2021

Evidence from different countries shows that the level of support given to mothers who return to paid employment can significantly determine the duration of exclusive breastfeeding (EBF). However, little is known about how returning to work impacts Ethiopian women's EBF practice. The aim of this study was to explore women's attitudes and experiences of EBF when they returned to work. Mothers who had an infant of less than 12 months, working in government institutions in Tigray region, Ethiopia, were invited to participate in this study. Semi‐structured, face‐to‐face interviews were used to explore mothers' perspectives of the factors that influenced EBF when they returned to work. The interview data were transcribed verbatim and thematically analysed. Twenty mothers were interviewed from 10 organizations. Three themes were identified from their accounts: mother's knowledge, attitudes and practice towards breastfeeding; workplace context and employment conditions; and support received at home. Most participants were familiar with the benefits of EBF. Most participants reported that their colleagues had more positive attitudes towards breastfeeding than their managers. In almost all the workplaces, there was no specific designated breastfeeding space. Participants reported that close family members including husbands and mothers were supportive. Mothers' knowledge and attitude towards breastfeeding, workplace and employment conditions and support received at home were found to be the main factors determining the duration of EBF among employed women. Participants reported that the overall support given to breastfeeding women from their employers was insufficient to promote EBF.
Endoscopic Surgery for Delayed Wound Healing After Achilles Tendon Suture Repair: A Report of Three Cases
Authors: Yang Yu‐ping , Chen Hong‐yu , Cui Guo‐qing , Xiu Xiao‐lei , Liu Xiao‐peng , An Hua , Ao Ying‐fang
Published: April 2021

Background

Delayed wound healing is a potention complication after Achilles tendon suture repair and occurs for various reasons. The conventional treatment for delayed wound healing is open surgery, but patients face long recovery times and postoperative care is difficult.

Case Presentation

This report presents three patients who were seen at our institute from April 2008 to October 2017 due to long‐term non‐healing wounds after surgery. All three patients had undergone surgery at least 2 months previously. We performed endoscopic surgery on these patients. After the operation, patients received less antibiotics and simpler care than would be required for conventional open surgery. There is no need to keep the wound open after the operation or perform wound cleaning for multiple times at the same time, which can reduce healing time. At the last follow up, all postoperative scores among the patients were significantly improved compared to before surgery. The Achilles tendon total rupture scores were excellent and the American Orthopedic Foot and Ankle Society scores were satisfactory, indicating improvements in Achilles tendon function and movement in patients after surgery.

Conclusion

Our case reports demonstrate that arthroscopic treatment for delayed wound healing after Achilles tendon suture repair is satisfactory and reliable; frequent opening of the wound for cleaning is not required after the operation, thus reducing the healing time.
Clinical symptoms of limited exercise capacity linked to AAI‐DDD functionality: An in silico and in vivo approach
Authors: Heggermont Ward , Iliodromitis Konstantinos , Van Bockstal Koen , Backers Jos , Lau Chirik‐Wah , Missiaen Dieter , De Cooman Jan , Timmermans Willy , Geelen Peter , De Potter Tom
Published: April 2021

Background

Exercise capacity is an important aspect of quality of life in patients undergoing pacemaker implantation. Device algorithms for ventricular pacing avoidance have been developed to avoid unnecessary and potentially harmful effects of right ventricular pacing. However, little data exists on the immediate response of these algorithms to sudden AV block during exercise.

Methods

The ventricular pacing avoidance algorithms of four pacemaker manufacturers were tested in an ex‐vivo model. The RSIM‐1500‐USB Device‐Interactive Heart Simulator (Rivertek Medical Systems, Inc.) was used to simulate three different scenarios: the first one starting with an initially conducted atrial pacing rate of 60 min−1, the second one starting with an atrial rate of 120 min−1 and finally a scenario starting with an atrial rate of 150 min−1. In all three scenarios, the initially conducted atrial rate was followed by a sudden, long lasting episode of third‐degree AV‐block. The response to those scenarios was recorded for each of the (brand‐specific) ventricular pacing avoidance algorithms.

Results

In the first scenario, the simulation resulted in a ventricular pause of 1333 ms (Boston Scientific), 2000 ms (Medtronic and Microport), and 2340 ms (Biotronik). In the second and third scenario, different results were observed across devices. All simulations of the second and third scenario resulted in repetitive 2:1 block response (during eight cycles) in Boston Scientific and Biotronik devices. These scenarios were confirmed in patient cases.

Conclusion

Simulator based observations of unanticipated pacemaker‐induced 2:1 block response during exercise may explain clinical symptoms experienced by some patients having a two‐chamber pacemaker.
Has the double burden of malnutrition reached pupils in rural western Kenya?
Authors: Takeuchi Rie , Njomo Doris W , Njenga Sammy M , Tomokawa Sachi , Mutua Alex , Kazama Haruki , Walema Barnett , Akiyama Takeshi , Asakura Takashi , Kamiya Yasuhiko , Kobayashi Jun
Published: April 2021

Background

Undernutrition and overnutrition have been considered separate challenges caused by the distinct factors in distinct settings. The double burden of malnutrition is defined as the coexistence of both undernutrition and overnutrition, which has now spread globally, especially in low‐ and middle‐income countries. In Kenya, the double burden of malnutrition is present in the capital city but the situation in rural areas currently remains unknown. The aim of this study was therefore to analyze nutritional status in rural Kenya.

Methods

Data from height and weight measurements conducted by teachers in the third term of school year 2013 were collected from primary schools. Teachers were trained by experts before starting the measurements. The Z‐scores of height‐for‐age, weight‐for‐age, and body mass index‐for‐age were calculated using AnthroPlus, and nutritional status was defined according to the World Health Organization guidelines.

Results

Data analyzed from 7,447 pupils (3,763 boys and 3,684 girls) showed that 12.4% were stunted and 7.8% were underweight among those ≤120 months old, and 11.7% were thin among those >120 months old. Boys were more likely to be stunted than girls. Boys were more likely to be underweight and girls were more likely to be overweight in the older age group.

Conclusion

The double burden of malnutrition was not found, and undernutrition was still common among schoolchildren in the study area. However, it is important to monitor nutritional status due to adverse effects of rapid urbanization. Height and weight measurements in schools may be useful for monitoring the nutritional status of schoolchildren.
Comprehensive RNAseq analysis for identification of genes expressed under heat stress in lentil
Authors: Kumar Jitendra , Gupta Debjyoti Sen , Kesari Ravi , Verma Renu , Murugesan Senthilkumar , Basu Partha Sarathi , Soren Khela Ram , Gupta Sanjeev , Singh Narendra Pratap
Published: April 2021

Lentils are highly sensitive to abrupt increases in temperature during the mid to late reproductive stages, leading to severe biomass and seed yield reduction. Therefore, we carried out an RNAseq analysis between IG4258 (heat tolerant) and IG3973 (heat sensitive) lentil genotypes at the reproductive stage under both normal and heat stress conditions in the field. It resulted in 209,549 assembled transcripts and among these 161,809 transcripts had coding regions, of which 94,437 transcripts were annotated. The differential gene expression analysis showed upregulation of 678 transcripts and downregulation of 680 transcripts between the tolerant and sensitive genotypes at the early reproductive stage. While 76 transcripts were upregulated and 47 transcripts were downregulated at the late reproductive stage under heat stress conditions. The validation of 12 up‐or downregulated transcripts through RT‐PCR corresponded well with the expression analysis data of RNAseq, with a correlation of R2 = 0.89. Among these transcripts, the DN364_c1_g1_i9 and DN2218_c0_g1_i5 transcripts encoded enzymes involved in the tryptophan pathway, indicating that tryptophan biosynthesis plays a role under heat stress in lentil. Moreover, KEGG pathways enrichment analysis identified transcripts associated with genes encoding proteins/regulating factors related to different metabolic pathways including signal transduction, fatty acid biosynthesis, rRNA processing, ribosome biogenesis, gibberellin (GA) biosynthesis, and riboflavin biosynthesis. This analysis also identified 6852 genic‐SSRs leading to the development of 4968 SSR primers that are potential genomic resources for molecular mapping of heat‐tolerant genes in lentil.
Effect of velocity loss during squat training on neuromuscular performance
Authors: Rodríguez‐Rosell David , Yáñez‐García Juan Manuel , Mora‐Custodio Ricardo , Sánchez‐Medina Luis , Ribas‐Serna Juan , González‐Badillo Juan José
Published: April 2021

This study aimed to compare the effects of three resistance training (RT) programs differing in the magnitude of velocity loss (VL) allowed in each exercise set: 10%, 30%, or 45% on changes in strength, vertical jump, sprint performance, and EMG variables. Thirty‐three young men were randomly assigned into three experimental groups (VL10%, VL30%, and VL45%; n = 11 each) that performed a velocity‐based RT program for 8 weeks using only the full squat exercise (SQ). Training load (55–70% 1RM), frequency (2 sessions/week), number of sets (3), and inter‐set recovery (4 min) were identical for all groups. Running sprint (20 m), countermovement jump (CMJ), 1RM, muscle endurance, and EMG during SQ were assessed pre‐ and post‐training. All groups showed significant (VL10%: 6.4–58.6%; VL30%: 4.5–66.2%; VL45%: 1.8–52.1%; p < 0.05–0.001) improvements in muscle strength and muscle endurance. However, a significant group × time interaction (p < 0.05) was observed in CMJ, with VL10% showing greater increments (11.9%) than VL30% and VL45%. In addition, VL10% resulted in greater percent change in sprint performance than the other two groups (VL10%: −2.4%; VL30%: −1.8%; and VL45%: −0.5%). No significant changes in EMG variables were observed for any group. RT with loads of 55–70% 1RM characterized by a low‐velocity loss (VL10%) provides a very effective and efficient training stimulus since it yields similar strength gains and greater improvements in sports‐related neuromuscular performance (jump and sprint) compared to training with higher velocity losses (VL30%, VL45%). These findings indicate that the magnitude of VL reached in each exercise set considerably influences the observed training adaptations.
Two good interview questions: Mobilizing the ‘good farmer’ and the ‘good day’ concepts to enable more‐than‐representational research
Authors: Sutherland Lee‐Ann
Published: April 2021

In this paper, I assess the utility of two targeted qualitative interview questions: descriptions of a ‘good farmer’ and a ‘good day’, for eliciting rich textual data. Studies where farmers have been asked to describe or define a good farmer have been utilized across a growing range of international contexts in order to identify farmers’ cultural scripts, symbolic capital and social norms. The constitution of a ‘good day’ is new to rural studies but has been employed academically to assess perceptions of well‐being and job satisfaction. I employ document analysis to analyse the multiple uses of the ‘good farmer’ question in the rural studies literature and introduce a contrasting empirical application the ‘good day’ question in a rural case study in the United Kingdom. Findings demonstrate that both interview questions can generate rich textual descriptions of embodied performances. ‘Good farmer’ definitions may also include a moral judgement, whereas the ‘good day’ question specifically yields descriptions of affect. Farmers are reluctant to identify ‘bad farmers’, but asking about a ‘bad day’ can open up discussion of the vulnerabilities of farming life. Both questions are thus suited to more‐than‐representational research, gaining utility from their congruence between common parlance and academic conceptualization.
‘“They Think We’re Just Ghetto, But Nah!”: Re‐Working Young People’s Presence
Authors: Aitken Stuart C. , Pearson Elliot , Herman Thomas
Published: April 2021

With this paper, we document aspects of a year‐long project with 11th‐grade students from a high school in City Heights, San Diego. The students chose to become present, to share their experiences, explore others' understandings of their neighborhood, and collaborate to create an online multi‐media narrative that reflected them and their relations to the neighborhood. Theoretically, we involve a transversal politics that embrace young people's multiplicities of relations. We assume multiculturalism as a foil to engage young people's community presence. We show how the project moved toward a vibrant, layered, networked, and lyrical presence for young people in City Heights.
Too Many Cooks: Bayesian Inference for Coordinating Multi‐Agent Collaboration
Authors: Wu Sarah A. , Wang Rose E. , Evans James A. , Tenenbaum Joshua B. , Parkes David C. , Kleiman‐Weiner Max
Published: April 2021

Collaboration requires agents to coordinate their behavior on the fly, sometimes cooperating to solve a single task together and other times dividing it up into sub‐tasks to work on in parallel. Underlying the human ability to collaborate is theory‐of‐mind (ToM), the ability to infer the hidden mental states that drive others to act. Here, we develop Bayesian Delegation, a decentralized multi‐agent learning mechanism with these abilities. Bayesian Delegation enables agents to rapidly infer the hidden intentions of others by inverse planning. We test Bayesian Delegation in a suite of multi‐agent Markov decision processes inspired by cooking problems. On these tasks, agents with Bayesian Delegation coordinate both their high‐level plans (e.g., what sub‐task they should work on) and their low‐level actions (e.g., avoiding getting in each other's way). When matched with partners that act using the same algorithm, Bayesian Delegation outperforms alternatives. Bayesian Delegation is also a capable ad hoc collaborator and successfully coordinates with other agent types even in the absence of prior experience. Finally, in a behavioral experiment, we show that Bayesian Delegation makes inferences similar to human observers about the intent of others. Together, these results argue for the centrality of ToM for successful decentralized multi‐agent collaboration.