bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving parenting knowledge through caregiver education in China
Authors: Chen Yafan , Tu Bin , Huang Chien‐Chung , Huang Can
Published: December 2020

Background

Caregivers' parenting knowledge is of importance to child development and to achieve positive child outcomes. Even though some caregiver education programs have demonstrated positive effects, most of them are carried out in developed countries and among western samples. As a developing country with the second‐largest child population worldwide, China has initiated caregiver education programs to promote parenting knowledge among caregivers since 2016. This study examines the effect of an innovative caregiver education program on caregivers' perceived increase of parenting knowledge.

Methods

A total of 310 caregivers with a child aged between 0 and 3 from Z city, China, were randomly selected to complete a survey. Caregivers' perceived increase of parenting knowledge was assessed by five specified knowledge dimensions, namely, child growth, feeding behaviours, daily care, disease prevention and safety. The independent variable was program participation, measured by respondents' use of program services. OLS regression was employed to assess the association between caregivers' program participation and their perceived increase of knowledge, controlling basic demographic and socio‐economic factors.

Results

In general, program participation had statistically significant associations with caregivers' perceived increase of parenting knowledge. The associations varied by service type. Particularly, online development evaluations and in‐home sessions showed relatively consistent and positive effects on caregivers' perceived increase of parenting knowledge.

Conclusions

This caregiver education program had a positive effect on caregivers' perceived increase of parenting knowledge, particularly through the use of the online development evaluations and in‐home sessions. As one of the earliest initiatives of this kind in China, the findings reveal the promise of an innovative program to advance caregivers and children.
The effect of semaglutide 2.4 mg once weekly on energy intake, appetite, control of eating, and gastric emptying in adults with obesity
Authors: Friedrichsen Martin , Breitschaft Astrid , Tadayon Sayeh , Wizert Alicja , Skovgaard Dorthe
Published: December 2020

Aim

To investigate the effects of once‐weekly subcutaneous (s.c.) semaglutide 2.4 mg on gastric emptying, appetite, and energy intake in adults with obesity.

Materials and Methods

A double‐blind, parallel‐group trial was conducted in 72 adults with obesity, randomized to once‐weekly s.c. semaglutide (dose‐escalated to 2.4 mg) or placebo for 20 weeks. Gastric emptying was assessed using paracetamol absorption following a standardized breakfast. Participant‐reported appetite ratings and Control of Eating Questionnaire (CoEQ) responses were assessed, and energy intake was measured during ad libitum lunch.

Results

The area under the concentration–time curve (AUC) for paracetamol 0 to 5 hours after a standardized meal (AUC0–5h,para; primary endpoint) was increased by 8% (P = 0.005) with semaglutide 2.4 mg versus placebo at week 20 (non‐significant when corrected for week 20 body weight; P = 0.12). No effect was seen on AUC0–1h,para, maximum observed paracetamol concentration, or time to maximum observed paracetamol concentration. Ad libitum energy intake was 35% lower with semaglutide versus placebo (1736 versus 2676 kJ; estimated treatment difference −940 kJ; P <0.0001). Semaglutide reduced hunger and prospective food consumption, and increased fullness and satiety when compared with placebo (all P <0.02). The CoEQ indicated better control of eating and fewer/weaker food cravings with semaglutide versus placebo (P <0.05). Body weight was reduced by 9.9% with semaglutide and 0.4% with placebo. Safety was consistent with the known profile of semaglutide.

Conclusions

In adults with obesity, once‐weekly s.c. semaglutide 2.4 mg suppressed appetite, improved control of eating, and reduced food cravings, ad libitum energy intake and body weight versus placebo. There was no evidence of delayed gastric emptying at week 20, assessed indirectly via paracetamol absorption.
Prediction of heart failure outcomes in patients with type 2 diabetes mellitus: Validation of the Thrombolysis in Myocardial Infarction Risk Score for Heart Failure in Diabetes (TRS‐HFDM) in patients in the ACCORD trial
Authors: Elharram Malik , Ferreira João Pedro , Huynh Thao , Ni Jiayi , Giannetti Nadia , Verma Subodh , Zannad Faiez , Sharma Abhinav
Published: December 2020

Aim

To investigate the ability of the Thrombolysis in Myocardial Infarction Risk Score for Heart Failure in Diabetes (TRS‐HFDM) to stratify patients with type 2 diabetes mellitus (T2DM) and high cardiovascular risk for heart failure (HF) hospitalization.

Materials and Methods

We used data from the control group of the Action to Control Cardiovascular Risk in Diabetes Study Group (ACCORD) trial (n = 5123; mean follow‐up 4.8 years). The TRS‐HFDM includes: prior HF (2 points), atrial fibrillation (1 point), coronary artery disease (1 point), estimated glomerular filtration rate <60 mL/min/1.73 m2 (1 point), and urine albumin‐to‐creatinine ratio (>300 mg/g: 2 points; 30–300 mg/g: 1 point). We evaluated the discrimination (Harrell's C‐index) and calibration (Nam‐D'Agostino calibration statistic) of the TRS‐HFDM with regard to time to HF hospitalization or death due to HF.

Results

The mean age of the participants was 62.8 ± 6.6 years, and 38% were women. The prevalences of TRS‐HFDM 0, 1, 2, 3 and ≥4 were 42.1%, 34.9%, 14.6%, 6.0% and 2.5%, respectively. Increasing TRS‐HFDM corresponded to an increasing HF risk: 1.3 per 1000 person‐years for a TRS‐HFDM of 0 to 64.7 per 1000 person‐years for TRS‐HFDM of ≥4. The TRS‐HFDM demonstrated robust discrimination of HF outcomes (C‐index 0.78). Furthermore, the score was well calibrated for HF outcomes (calibration statistic P = 0.13). Similar results were seen in participants without baseline HF (C‐index 0.75).

Conclusion

The TRS‐HFDM discriminates HF‐specific risk among people with T2DM. The use of TRS‐HFDM to identify those who would maximally benefit from therapies that reduce HF risk warrants evaluation.
Large female song repertoires and within‐pair song type sharing in a temperate breeding songbird
Authors: Sikora Jonathan G. , Moyer Michelle J. , Omland Kevin E. , Rose Evangeline M.
Published: December 2020

Female song has been significantly understudied in songbirds. While male song has been studied for centuries, female song has only begun to be explored in the last few decades. This is especially true in relation to understanding repertoire size and function. In male songbirds, song repertoires are thought to function primarily in mate attraction and territory defense. Only a few studies to date have explored repertoire size in female songbirds, and many of those focused on tropical duetting species. We quantified the size and explored the function of song repertoires in a temperate breeding songbird, the eastern bluebird. Female song in eastern bluebirds functions primarily in communication with a social mate in order to maintain long‐term pair bonds. Previous work in this species also documented that males have large repertoires serving a variety of purposes. We found that female bluebirds have similar song repertoire sizes to males. Also, females share their repertoires and song types more closely with their mate than shared with non‐mates. This is one of the first studies to document large female repertoires in a non‐duetting temperate species. Our findings indicate that large female repertoires and song type sharing in this species is integral to communication between social mates. Additionally, the large effect size of song type sharing with newly formed mates suggests open‐ended learning may be present in this songbird, a previously under‐documented phenomenon in females. This study provides the groundwork to explore the ontogeny and evolution of song repertoire size in female songbirds and to expand our understanding of song repertoires beyond their functions in males as an indicator of male fitness.
Potential of ultra‐highly sensitive immunoassays for hepatitis B surface and core‐related antigens in patients with or without development of hepatocellular carcinoma after hepatitis B surface antigen seroclearance
Authors: Suzuki Fumitaka , Hosaka Tetsuya , Imaizumi Masayasu , Kobayashi Mariko , Ohue Chiharu , Suzuki Yoshiyuki , Fujiyama Shunichiro , Kawamura Yusuke , Sezaki Hitomi , Akuta Norio , Kobayashi Masahiro , Saitoh Satoshi , Arase Yasuji , Ikeda Kenji , Kumada Hiromitsu
Published: December 2020

Aims

Hepatitis B surface antigen (HBsAg) seroclearance indicates a “functional cure” in chronic hepatitis B (CHB) virus infection. However, several cases of hepatocellular carcinoma (HCC) development have been reported after HBsAg seroclearance. We evaluated the potential of HBsAg and hepatitis B core‐related antigen (HBcrAg), measured by the ultra‐highly sensitive assays, in cases with HCC development after HBsAg seroclearance.

Methods

We enrolled 17 patients with CHB who achieved HBsAg seroclearance, defined by the conventional assay using Architect HBsAg QT kit (five HCC patients and 12 non‐HCC patients). HBsAg and HBcrAg were measured in their stored serum samples using ultra‐highly sensitive assays featuring “immunoassay for total antigen including complex via pretreatment (iTACT)” technology.

Results

All five patients who developed HCC were positive for HBsAg or HBcrAg by iTACT‐HBsAg or iTACT‐HBcrAg at all follow‐up points. HBcrAg levels in the HCC group, using iTACT‐HBcrAg, were significantly higher than those in the non‐HCC group at HBsAg seroclearance (3.6 LogU/ml (2.8–4.2) versus 2.6 (<2.1–3.8), p = 0.020). The best cutoff value of iTACT‐HBcrAg for predicting HCC development was 2.7 LogU/ml by receiver operating characteristic curve analysis. The prevalence of HBcrAg ≥2.7 in the HCC group was significantly higher than that in non‐HCC group (100% [5/5] versus 33% [4/12], p = 0.029).

Conclusions

Residual low viral antigen might predict HCC development even if HBsAg seroclearance was achieved according to a conventional assay. The results suggest that iTACT assays of HBsAg and HBcrAg would be useful for monitoring CHB patients.
Is periodontal disease associated with increased risk of colorectal cancer? A meta‐analysis
Authors: Xuan Kun , Jha Ankush R. , Zhao Tianming , Uy John Patrick , Sun Chenyu
Published: December 2020

Objective

Colorectal cancer (CRC) is a commonly diagnosed cancer. Previous studies investigating the relationship between periodontal disease (PD) and CRC showed controversial conclusions. This meta‐analysis is to explore the association between PD and CRC.

Methods

Observational studies that explore the association between CRC and PD were included in this meta‐analysis. A comprehensive literature search in 7 electronic databases to identify all relevant studies published prior to February 2020. The Newcastle‐Ottawa Quality Assessment Scale was used to evaluate the quality each study. The pooled relative risk (RR) and 95% confidence interval (CI) were used to estimate the association between the PD and CRC risk.

Results

A total of 838 articles were obtained from database searching and 4 articles were obtained from other sources, and 13 articles with 14 studies involving 634,744 participants were included. An association between PD and increased CRC incidence was found, periodontal disease patients were 21% (95%CI, [1.06, 1.38], I2=83.9%) more likely to develop colorectal cancer than people with healthy oral cavity. But there is no significant association between PD and CRC mortality. The heterogeneity of this meta‐analysis was relatively high, I2 was 83.9% (95%CI, [72.7%, 90.5%]), chi‐squared of Q test was 62.18, but sensitivity analysis confirmed the stability of the result. Funnel plot, Eggerʼs test and Beggʼs test found no publication bias of analysis.

Conclusion

The current meta‐analysis demonstrates an association between PD and CRC, indicating that early CRC screening is necessary for people with poor oral health, and oral health improvement might be beneficial for reducing CRC risk.
COGNITION, OPTIMISM, AND THE FORMATION OF AGE‐DEPENDENT SURVIVAL BELIEFS
Authors: Grevenbrock Nils , Groneck Max , Ludwig Alexander , Zimper Alexander
Published: December 2020

This article investigates the roles of psychological biases for deviations between subjective survival beliefs (SSBs) and objective survival probabilities. We model these deviations through age‐dependent inverse S‐shaped probability weighting functions. Our estimates suggest that implied measures for cognitive weakness increase and relative optimism decrease with age. Direct measures of cognitive weakness and optimism share these trends. Our regression analyses confirm that these factors play strong quantitative roles in the formation of SSBs. Our main finding is that cognitive weakness instead of optimism becomes with age an increasingly important contributor to the well‐documented overestimation of survival chances in old age.
Evaluation and comparison of the new Mindray BC‐6200 hematology analyzer with ADVIA 2120i
Authors: Kulik Katarzyna , Kwiecień Iwona , Chełstowska Beata , Rutkowska Elżbieta , Rzepecki Piotr
Published: December 2020

Background

The Mindray BC‐6200 is a new automatic hematology analyzer that quantifies the parameters of blood morphology and leukocyte differential in five populations (5‐Diff). The aim of the study was to evaluate the BC‐6200 and compare it with the Siemens ADVIA 2120i analyzer.

Materials and Methods

The comparison between BC‐6200 and ADVIA 2120i analyzers was performed using 390 whole blood samples collected on K3EDTA. For the BC‐6200, the carryover effect, precision, and linearity were evaluated. 138 samples were used to assess the sensitivity and flag ability, suggesting the presence of abnormal cells such as blasts, immature granulocytes, or atypical lymphocytes. Flagging results were compared with microscopic evaluation of blood smears.

Results

The BC‐6200 analyzer showed a high correlation (r ≥ .97) with ADVIA 2120i for most of the compared parameters except RDW (r = .8350), MPV (r = .7634), Mon# (r = .8366), Baso# (r = .9205), and NRBC (r = .3768). The BC‐6200 had better correlation with microscopic evaluation for NRBC (r = .8902) compared with ADVIA 2120i (r = .5677). The BC‐6200 has shown high efficiency for flagging blasts (80.4%), immature granulocytes (80.5%), and atypical lymphocytes (69.0%).

Conclusion

The new Mindray BC‐6200 hematology analyzer provides high measurements precision and good correlation with ADVIA 2120i for most of the morphology and 5‐diff parameters.
Development of a proxy‐reported scale to assess motor function in infants and young children with early‐onset neuromuscular disorders
Authors: Capella‐Peris Carlos , Emile‐Backer Magalie , Shelton Monique O. , Chrismer Irene C. , Cosgrove Mary M. , Bendixen Roxanna M. , Meilleur Katherine G.
Published: December 2020

Aim

To develop a novel proxy‐reported scale of motor function in infants and young children with early‐onset neuromuscular disorders (NMD), entitled the Proxy Motor Outcome Measure (PMOM).

Design

A mixed method design was employed, applying both qualitative and quantitative research.

Methods

A framework technique using sensitivity analyses guided the development of the most appropriate and relevant subset of items, modelled after 30 neuromuscular disease instruments/scales. The PMOM was designed based on semi‐structured interviews with 16 proxies; a focus group of 11 experts in neuromuscular diseases and scale development, 10 of whom also gave quantitative data using a two‐round Delphi method survey; and cognitive interviews with five proxies. These processes were conducted between January 2014–March 2019.

Results

Nine themes and 32 subthemes were derived from the semi‐structured interviews. Five domains and three subdomains of potential items were identified by the focus group. An initial version of the PMOM scale was created with 121 items. Using the two‐round Delphi method, 43 items met agreement on pre‐defined requirements. The second version of the PMOM scale included these 43 and two additional items based on expert feedback. Proxies gave 114 suggestions on cognitive interviews, 99 of which were successfully addressed by the research team. The final version of the PMOM scale included 43 items.

Conclusion

We developed a preliminary proxy‐reported instrument, the PMOM, to evaluate motor function in infants and young children with early‐onset NMD.

Impact

Proxies hold a wealth of knowledge on their child's motor function during early development, which may complement clinic‐based motor function testing. However, there is no validated measure of motor function that incorporates the observation of proxies of infants and young children with NMD. Future work will be focused on assessing the reliability, validity and responsiveness of the PMOM scale and implementing this tool in clinical studies.
Triumphal narratives in the American Civil War: A new nursing professional identity
Authors: Choperena Ana
Published: December 2020

Aims

To analyse the evolving social role of female nurses in the American Civil War context in terms of gender, class and race and to examine whether their caring efforts correspond to the beginnings of a new nursing professional identity.

Design

Historical research.

Methods

Thirteen American Civil War nurses’ triumphal narratives written between 1865–1902 were analysed. The search and work were carried out between 2012–2020. Women's history and thematic analysis provided, respectively, the theoretical and analytical frameworks.

Results

The arrival of the war was the catalyst for change. The nurses’ autobiographies were written in a hostile environment where class and racial tensions had to be released. This analysis points to nursing care being transformed from its traditional domestic traits to a progressive and intentional professional dimension.

Conclusion

American Civil War nurses’ autobiographies offer an innovative vision of their lives and their nursing work. Specifically, the autobiographical accounts provide new perspectives on the evolution of the authors’ social dimension in terms of class, race and gender as well as the development of a new nursing professional identity in that context.

Impact

Illuminating overlooked meanings hidden in nurses’ autobiographies improves women's visibility and their contribution to the history of nursing
Left atrial hypertension and the risk of early incident heart failure after atrial fibrillation ablation
Authors: Gilge Jasen L. , Ahmed Asim , Clark Brad A. , Slaten Alexander , Devathu Rahul , Olson Jeffrey A. , Padanilam Benzy J. , Nair Girish V. , Joshi Sandeep A. , Ravichandran Ashwin K. , Patel Parin J.
Published: December 2020

Introduction

Elevated left atrial pressure (LAP) during catheter ablation of atrial fibrillation (AF) is associated with an increased risk of AF recurrence, but it is unknown if this correlates with heart failure (HF). The objective of the study was to determine if elevated LAP after AF ablation correlates with HF events.

Methods

Prospective, single‐center, cohort study measuring LAP and right atrial pressure (RAP) during AF ablation in 100 patients. The primary endpoint was clinical HF within 30 days of ablation. The secondary outcome was AF‐free HF.

Results

One hundred patients (63% male, mean age 64.5) were enrolled and 20% had clinical HF within 30 days. Bivariate correlates included mitral valve (MV) disease, persistent AF, class III antiarrhythmics, LAP, and recurrent AF. Multivariate analysis revealed class III antiarrhythmics were protective (odds ratio [OR]: 0.24 [0.1–0.5], p = .04), while MV disease (OR: 8.7 [3.3–23], p = .03) and loop diuretics (OR: 4.8 [2.6–9.1], p = .01) were hazardous. AF‐free HF occurred in 9% of patients and correlated with higher LAP and RAP, and chronic kidney disease.

Conclusion

Patients with HF after AF ablation had higher LAP. MV disease, diuretic use, and class III antiarrhythmics also correlated to HF. These present opportunities to target future interventions to reduce a common complication of AF ablation.
Relationship between dietary patterns and non‐alcoholic fatty liver disease: A systematic review and meta‐analysis
Authors: Hassani Zadeh Shirin , Mansoori Anahita , Hosseinzadeh Mahdieh
Published: December 2020

Background and Aim: Non‐alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease. Previous studies have investigated the association between dietary patterns and NAFLD, but their results are contradictory. Therefore, we carried out this meta‐analysis to examine the association between dietary patterns and NAFLD.

Methods: We searched PubMed, Web of Science, Scopus, and Google Scholar databases until November 14, 2019, to identify the observational studies on the association between dietary patterns and NAFLD. We selected three dietary patterns of Western, Prudent, and Mediterranean. A random‐effect model was used to compute the summary risk estimates. Odds ratios (ORs) that were reported for fully adjusted models and their confidence intervals (CIs) were extracted for meta‐analysis. Heterogeneity between studies was assessed using Cochran's Q‐ and I2 tests. Eighteen articles (n = 24 867 participants) were entered our systematic review and meta‐analysis.

Results: We determined that Western dietary patterns (n = 8787 participants) containing high levels of processed food, red meat, high‐fat dairy, and refined grains could significantly increase NAFLD (OR = 1.56, CI = 1.27 to 1.92; P ≤ 0.001). However, the Prudent (n = 13 023 participants) (OR = 0.78, CI = 0.71 to 0.85; P ≤ 0.001) and Mediterranean dietary patterns (n = 3057 participants) (OR = 0.77, CI = 0.60 to 0.98; P = 0.41), defined by high intake of fruits, vegetables, whole grains, fish, and olive oil decreased the risk of this disease.

Conclusions: We found that Western dietary patterns increased the risk of NAFLD by 56%, although the Prudent and Mediterranean dietary patterns reduced the risk of this disease by 22% and 23%, respectively.
A microneedling device for the treatment of spider vein: A case report
Authors: Atefeh Mohammadnejad
Published: December 2020

Spider vein is mostly seen in patients with liver disease, although the underlying problem is sometimes unknown. If spider vein appears on the face, it can affect the self‐esteem and self‐image of patients. Particularly, females are more vulnerable to these complications. Spider nevi are mostly left untreated since they are considered a cosmetic matter; in case of treatment, the procedure is costly with limited satisfaction. Therefore, this study reports the successful treatment of a spider vein case using a microneedling procedure.
Strategies to improve human papillomavirus vaccination rates among adolescents in family practice settings in the United States: A systematic review
Authors: Eisenhauer Lauren , Hansen Bryan R. , Pandian Vinciya
Published: December 2020

Aims and Objectives

To explore the interventions aimed at increasing human papillomavirus (HPV) vaccination rates among adolescents in family practice settings.

Background

HPV is the most common sexually transmitted disease in the United States, and the cause of thousands of anogenital and oropharyngeal cancers annually. Although HPV infection can be prevented with recommended vaccination during adolescence, national HPV vaccine rates remain low.

Design

Systematic review.

Methods

Four databases (MEDLINE, CINAHL, EMBASE and the Cochrane Library) were searched. The search was guided by PRISMA and by the question, ‘What are targeted interventions that improve HPV vaccination rates among adolescents in family practice settings?’ Articles were reviewed for study characteristics and appraised for quality using the revised Cochrane risk of bias tools.

Results

Eleven studies met inclusion and exclusion criteria. Individual study size samples ranged from 749–147,294, with a combined total from all included studies of 276,205; the largest sample reviewed to date from family practice settings. Interventions used to increase HPV vaccination rates included reminder systems; provider and staff education; sensory incentives such as hitting a gong or petting a puppy; and iPad tailored messaging programmes. Studies that employed interventions pre‐, during and postvisit were most effective in increasing HPV vaccination rates.

Conclusions

This review provides the largest data supporting multimodal strategies to increase HPV vaccination rates among adolescent populations. It provides strong evidence to suggest that vaccination rates can be improved using measures at varying times of the patient visit.

Relevance to Clinical Practice

Adolescents seek health care in various settings. Many studies have examined interventions to increase HPV vaccination in paediatric settings, but few have examined interventions in family practice settings. This review suggests that family practices should implement multimodal measures before, during and after visits to increase HPV vaccination among adolescent patients.
Follow‐up after oral cancer treatment—Transition to a personalized approach
Authors: Brands Marieke , Verbeek André , Geurts Sandra , Merkx Thijs
Published: December 2020

Background

Guidelines for follow‐up after oral cancer treatment are not site‐specific and encompass the entire head and neck area rather than the oral cavity alone. This one‐size‐fits‐all protocol disregards the differences in aetiology, treatment and differential distribution of new disease between the subsites. With the effectiveness of follow‐up in early detection of new disease being put into question, the focus of follow‐up programmes might shift to other aspects of survivorship care. Personalization of follow‐up is important, considering patient‐specific features and needs. Furthermore, the COVID‐19 pandemic urges us to rethink our follow‐up practice.

Findings

This paper discusses ways in which routine follow‐up in patients treated for oral cancer can be optimized. Patients with a high risk of new disease might benefit from an intensified follow‐up regimen, whilst patients with a low risk of new disease, a low chance of cure or limited life expectancy could benefit from a de‐intensified follow‐up regimen. The latter could include a shorter follow‐up period and focus on goals other than early detection of new disease. Education of patients to report new symptoms early is of vital importance as the majority of new disease presents symptomatically. Other health care professionals such as specialist nurses and dentists need to play an important leading role in survivorship care. Remote consultations may be useful to perform more efficient and patient‐centred follow‐up care.

Conclusion

Routine follow‐up needs to be seen as an integrated part of an individualized survivorship plan that is provided by the entire multidisciplinary team.
Social and Health Risk Factor Levels of Preschool Children Living Along the Texas‐Mexico Border
Authors: Treviño‐Peña Roberto , Wang Xiaohui , Wang Lin , Romero Zasha , Alanis Elizabeth , Li Huimin
Published: December 2020

BACKGROUND

Childhood obesity is a public health concern that disproportionately affects populations from low socioeconomic status (SES) and minority groups. Evaluation of social and health risk factors of preschool children living along the Texas‐Mexico border provides feedback to design health interventions.

METHODS

South Texas Early Prevention Study‐PreK (STEPS‐PreK) is a cluster randomized trial designed to assess the effect of the Bienestar coordinated school health program on children's health outcomes. Family characteristics, dietary intake, fitness, and anthropometric data were collected from 1277 preschool students enrolled in 28 preschools.

RESULTS

The response rate was 67%. Overall, 57% of families lived in poverty. The mean age of students was 4.7 years, 95% were Hispanic, and 51% were male. The average serving of fruits and vegetables per day were 1 and 1/3, respectively. Of these, students consumed 39.7% of fruits and 18.9% of vegetables. Obesity prevalence for boys was 19.2% and for girls 16.8%. Nearly one‐half reported some form of food insecurity.

CONCLUSIONS

Children living in low‐income areas are affected by high levels of social and health risk factors. It is these families who should be targeted with early‐age and culturally appropriate health programs.
Perceived Barriers and Facilitating Factors in Implementing Delayed School Start Times to Improve Adolescent Sleep Patterns
Authors: Fitzpatrick Julia M. , Silva Graciela E. , Vana Kimberly D.
Published: December 2020

BACKGROUND

Most adolescents in the United States do not obtain sufficient sleep. Early school start times play a significant role in adolescent sleep deprivation. Most primary and secondary schools begin classes earlier than the 8:30 am. Perceived barriers to implementing a delayed school start time have been suggested in the literature but have not been quantified. This study explored perceived barriers and facilitating factors for implementing delayed high‐school start times.

METHODS

A cross‐sectional study. School administrators who had delayed their school start times were invited to complete an online questionnaire ranking the perceived barriers and facilitating factors for implementing the delayed start times.

RESULTS

Most commonly cited perceived barriers were lack of a tiered bus system, school athletes missing more afternoon classes, and less time after school for athletics. Most commonly cited facilitating factors were school‐administrator involvement in the decision‐making process and sleep education for family members and school administrators.

CONCLUSIONS

Participants found that providing sleep education to fellow administrators, teachers, school staff members, families, and students and including them in the decision‐making process positively facilitated the implementation of delayed school start times. Perceived barriers to implementation may be overcome with support from stakeholders and planning committees.
Threshold model with a time‐varying threshold based on Fourier approximation
Authors: Yang Lixiong , Lee Chingnun , Chen I‐Po
Published: December 2020

Classical threshold models assume that threshold values are constant and stable, which appears overly restrictive and unrealistic. In this article, we extend Hansen's (2000) constant threshold regression model by allowing for a time‐varying threshold which is approximated by a Fourier function. Least‐square estimation of regression slopes and the time‐varying threshold is proposed, and test statistics for the existence of threshold effect and threshold constancy are constructed. We also develop the asymptotic distribution theory for the time‐varying threshold estimator. Through Monte Carlo simulations, we show that the proposed estimation and testing procedures work reasonably well in finite samples, and there is little efficiency loss by the allowance for Fourier approximation in the estimation procedure even when there is no time‐varying feature in the threshold. On the contrary, the slope estimates are seriously biased when the threshold is time‐varying but being treated as a constant. The model is illustrated with an empirical application to a nonlinear Taylor rule for the United States.
Growth patterns and their contributing factors among HIV‐exposed uninfected infants
Authors: Ndiaye Aminata , Suneson Klara , Njuguna Irene , Ambler Gwen , Hanke Tomas , John‐Stewart Grace , Jaoko Walter , Reilly Marie
Published: December 2020

With expanded HIV treatment and prevention programmes, most infants born to HIV‐positive women are uninfected, but the patterns and determinants of their growth are not well described. This study aimed to assess growth patterns in a cohort of HIV‐exposed uninfected (HEU) infants who participated in an experimental HIV vaccine trial and to test for associations with maternal and infant factors, including in‐utero exposure to antiretroviral therapy (ART), mode of delivery, exclusive breastfeeding, mother's education and receipt of the vaccine. Infants in the trial were seen at regular clinic visits from birth to 48 weeks of age. From the anthropometric measurements at these visits, weight‐for‐age z‐scores (WAZ), weight‐for‐length z‐scores (WLZ) and length‐for‐age z‐scores (LAZ) were computed using World Health Organization (WHO) software and reference tables. Growth patterns were investigated with respect to maternal and infant factors, using linear mixed regression models. From 94 infants included at birth, growth data were available for 75.5% at 48 weeks. The determinants of infant growth in this population are multifactorial: infant LAZ during the first year was significantly lower among infants delivered by caesarean section (p = 0.043); both WAZ and LAZ were depressed among infants with longer exposure to maternal ART (WAZ: p = 0.015; LAZ: p < 0.0001) and among infants of mothers with lower educational level (WAZ: p = 0.038; LAZ: p < 0.0001); the effect of maternal education was modified by breastfeeding practice, with no differences seen in exclusively breastfed infants. These findings inform intervention strategies to preserve growth in this vulnerable infant population.
Activities of nine antifungal agents against Candida auris biofilms
Authors: Chatzimoschou Athanasios , Giampani Athina , Meis Jacques F. , Roilides Emmanuel
Published: December 2020

Background

Candida auris is a newly described multidrug‐resistant fungal pathogen associated with biofilm formation and severe infections with high mortality.

Objectives

To study the activities of fluconazole, itraconazole, posaconazole, voriconazole, deoxycholate and liposomal amphotericin B, anidulafungin, caspofungin and micafungin against C auris biofilms and planktonic cells.

Materials/Methods

C auris strains originating from 5 clades (South Asian, East Asian, African, South American and Iranian) were tested for biofilm production by safranin staining of the extracellular matrix polysaccharide structure as well as biofilm (BF) and planktonic (PLK) antifungal susceptibility to nine antifungal agents using the XTT reduction assay.

Results

Candida auris isolates produced mature BF as compared to non‐C auris control (Candida albicans and Candida parapsilosis) strains. Four C auris isolates exhibited relatively high MIC’s for fluconazole (32–128 mg/L for PLK MIC and 128–1024 mg/L for BF MIC) as compared to the Iranian strain that had PLK and BF MIC’s 0.5 and 16, respectively. Itraconazole, posaconazole and voriconazole had relatively low PLK MICs but high BF MICs. A similar pattern was observed with echinocandins; relatively low PLK MIC (0.06–4 mg/L) but quite high BF MICs (4–2048 mg/L). While all isolates exhibited relatively low PLK MICs (0.06–4 mg/L) for both amphotericin B formulations, liposomal amphotericin B showed higher MICs compared to deoxycholate amphotericin B against C auris BF.

Conclusion

Triazoles, echinocandins and liposomal amphotericin B appear to have less activity against C auris biofilms than deoxycholate amphotericin B. Our in vitro model provides evidence for intrinsic C auris biofilm resistance to antifungal agents.
Friends, neighbours and enemies: an overview of the communal and social biology of plants
Authors: Bilas Roza D. , Bretman Amanda , Bennett Tom
Published: December 2020

Plants were traditionally seen as rather passive actors in their environment, interacting with each other only in so far as they competed for the same resources. In the last 30 years, this view has been spectacularly overturned, with a wealth of evidence showing that plants actively detect and respond to their neighbours. Moreover, there is evidence that these responses depend on the identity of the neighbour, and that plants may cooperate with their kin, displaying social behaviour as complex as that observed in animals. These plant–plant interactions play a vital role in shaping natural ecosystems, and are also very important in determining agricultural productivity. However, in terms of mechanistic understanding, we have only just begun to scratch the surface, and many aspects of plant–plant interactions remain poorly understood. In this review, we aim to provide an overview of the field of plant–plant interactions, covering the communal interactions of plants with their neighbours as well as the social behaviour of plants towards their kin, and the consequences of these interactions. We particularly focus on the mechanisms that underpin neighbour detection and response, highlighting both progress and gaps in our understanding of these fascinating but previously overlooked interactions.
Long‐term effectiveness of a fundamental motor skill intervention in Belgian children: A 6‐year follow‐up
Authors: Coppens Eline , Rommers Nikki , Bardid Farid , Deconinck Frederik J. A. , De Martelaer Kristine , D’Hondt Eva , Lenoir Matthieu
Published: December 2020

The aim of this study was (1) to examine the long‐term effectiveness of the “Multimove for Kids” program, a 30‐week fundamental motor skill intervention (approximately 1 hour per week) for typically developing children between 3 and 8 years, and (2) to determine the influence of participation in organized sports on motor competence (MC) six years after the intervention. Of the 992 children who took part in the “Multimove” program, 399 (intervention group: N = 228, control group: N = 171) were tested again at 6‐year follow‐up. MC was measured with the Test of Gross Motor Development, 2nd Edition. To examine the long‐term impact of “Multimove” on MC, and the effect of participation in organized sports a latent growth curve analysis was conducted. After the 30‐week intervention, the intervention group outperformed the control group (β = 5.57, P < .001). However, when the entire study period, including the 6‐year follow‐up, was considered, the intervention group made less progress in MC than the control group (β = −0.41, P < .05). Looking at the engagement in organized sports, it was found that years of experience before the intervention had no significant influence on the evolution of MC over time, whereas a positive effect was observed for children's average sports participation (h/week) during the 6‐year retention period (β = 0.14, P < .001). Finally, children practicing predominantly object control‐oriented sports during retention obtained slightly better MC scores at follow‐up (β = 0.01, P < .01). The “Multimove” intervention does not have a long‐term effect on the development of MC. However, participation in organized sports has a positive influence on MC evolution over time.
Nonlinear Partial Differential Equation Model-Based Coordination Control for a Master–Slave Two-Link Rigid–Flexible Manipulator With Vibration Repression
Authors: Cao Fangfei , Liu Jinkun
Published: December 2020

In this study, vibration control problem is considered for a coordinative master–slave two-link rigid–flexible manipulator. By the help of Hamilton's principle, the dynamic model of the master–slave two-link rigid–flexible manipulator is expressed using nonlinear partial differential equations (PDEs). Based on the nonlinear PDE model, we propose a novel coordination controller for the master–slave system. The proposed controller can achieve the following three objectives: (1) making the master manipulator track the given angles; (2) making the slave manipulator track the angles of the master manipulator; and (3) repressing the deflection and vibration of both the master and the slave flexible manipulators. Stability analysis of the closed-loop system is proven by LaSalle's invariance principle. Two simulation cases are given to validate the effectiveness of the coordination controller.
Investigation of the Fuel Distribution in a Shockless Explosion Combustor
Authors: Yücel Fatma Cansu , Habicht Fabian , Jaeschke Alexander , Lückoff Finn , Oberleithner Kilian , Paschereit Christian Oliver
Published: December 2020

Shockless explosion combustor (SEC) is a promising concept for implementing pressure gain combustion into a conventional gas turbine cycle. This concept aims for a quasi-homogeneous auto-ignition that induces a moderate rise in pressure. Since the ignition is not triggered by an external source but driven primarily by chemical kinetics, the homogeneity of the auto-ignition is very sensitive to local perturbations in equivalence ratio, temperature, and pressure that produce undesired local premature ignition. Therefore, the precise injection of a well-defined fuel profile into a convecting air flow is crucial to ensure a quasi-homogeneous ignition of the entire mixture. The objective of this work is to demonstrate that the injected fuel profile is preserved throughout the entire measurement section. For this, two different control trajectories are investigated. Optical measurement techniques are used to illustrate the effect of turbulent transport and dispersion caused by boundary layer effects on the fuel concentration profile. Results from line-of-sight measurements by tunable diode laser absorption spectroscopy indicate that the transport of the fuel-air mixture is dominated by turbulent diffusion. However, comparisons to numerical calculations reveal the effect of dispersion toward the bounds of the fuel concentration profile. The spatially resolved distributions of the fuel concentration inside the combustor gained from acetone planar laser induced fluorescence (PLIF) replicates a typical velocity distribution of turbulent pipe flow in radial direction visualizing boundary layer effects. Comparing both methods provides deep insights into the transport processes that have an impact on the operation of the SEC.
Reliability Analysis of Mechanical Systems Based on the First Four Moments of Input Parameters
Authors: Rao Singiresu S. , Zhou Yang
Published: December 2020

The performance of a mechanical or structural system can be improved through a proper selection of its design parameters such as the geometric dimensions, external actions (loads), and material characteristics. The computation of the reliability of a system, in general, requires a knowledge of the probability distributions of the parameters of the system. It is known that for most practical systems, the exact probability distributions of the parameters are not known. However, the first few moments of the parameters of the system may be readily available in many cases from experimental data. The determination of the reliability and the sensitivity of reliability to variations or fluctuations in the parameters of the system starts with the establishment of a suitable limit state equation. This work presents an approximate reliability analysis for mechanical and structural systems using the fourth-order moment function for approximating the first four moments of the limit state function. By combining the fourth-order moment function with the probabilistic perturbation method, numerical methods are developed for finding the reliability and sensitivity of reliability of the system. An automobile brake and a power screw are considered for demonstrating the methodology and effectiveness of the proposed computational approach. The results of the automobile brake are compared with those given by the Monte Carlo method.
Coated nanodiamonds interact with tubulin beta-III negative cells of adult brain tissue
Authors: Šimková Veronika , Freislebenová Hana , Neuhöferová Eva , Petráková Vladimíra , Amini Abbas , Benson Veronika
Published: December 2020

Fluorescent nanodiamonds (NDs) coated with therapeutics and cell-targeting structures serve as effective tools for drug delivery. However, NDs circulating in blood can eventually interact with the blood-brain barrier, resulting in undesired pathology. Here, we aimed to detect interaction between NDs and adult brain tissue. First, we cultured neuronal tissue with ND ex vivo and studied cell prosperity, regeneration, cytokine secretion, and nanodiamond uptake. Then, we applied NDs systemically into C57BL/6 animals and assessed accumulation of nanodiamonds in brain tissue and cytokine response. We found that only non-neuronal cells internalized coated nanodiamonds and responded by excretion of interleukin-6 and interferon-γ. Cells of neuronal origin expressing tubulin beta-III did not internalize any NDs. Once we applied coated NDs intravenously, we found no presence of NDs in the adult cortex but observed transient release of interleukin-1α. We conclude that specialized adult neuronal cells do not internalize plain or coated NDs. However, coated nanodiamonds interact with non-neuronal cells present within the cortex tissue. Moreover, the coated NDs do not cross the blood-brain barrier but they interact with adjacent barrier cells and trigger a temporary cytokine response. This study represents the first report concerning interaction of NDs with adult brain tissue.
Word frequency, predictability, and lexical class influence different aspects of Spanish tonic vowel production
Authors: Perry Scott J. , Kelley Matthew C. , Tucker Benjamin V.
Published: December 2020

The influence of lexical factors on speech production has not yet been investigated in Spanish to the same extent as for other languages such as English, French, Dutch, and German. Addressing this literature gap, the present study investigates how word frequency, predictability, and lexical class affect the duration and first two formant values of tonic monophthong vowels (hereafter vowels) produced by monolingual Spanish speakers from Madrid using the Nijmegen Corpus of Casual Spanish [Torreira and Ernestus, LREC'10 (2010), pp. 2981–2985]. A tonic vowel is defined as the most prominent vowel in a word's citation form. Word frequency and predictability based on the preceding word were calculated using the Spanish data from the OpenSubtitle corpus [Lison and Tiedemann, LREC'16 (2016), pp. 923–929]. Results of statistical modelling showed that the three aspects of vowel production under study were affected by all the examined lexical characteristics, although the effect sizes were small. Results are discussed in the context of previous work on Spanish vowels and cross-linguistic trends in speech production.
Addressing the challenges of hydrophone measurements in nonlinear ultrasonic fields
Authors: Hurrell Andrew M.
Published: December 2020

The use of hydrophones to quantify ultrasonic output of nonlinear fields may be beset with pitfalls for the unsuspecting experimentalist. This paper discusses a variety of issues that need to be considered including, but not limited to: broadband hydrophone frequency response; frequency dependent directivity; risks associated with device overload and/or damage in the context of high amplitude fields; influence of EM interference. Methods to identify such effects will be presented. These will be accompanied by a review of good experimental practice aimed at minimising undesirable measurement artefacts and reducing potential damage to metrological apparatus and instrumentation.