bluuebunny/crossref_metadata_2025_split huggingface dataset:
Breastfeeding Experiences During the COVID-19 Lockdown in the United Kingdom: An Exploratory Study Into Maternal Opinions and Emotional States
Authors: Costantini Cristina , Joyce Anna , Britez Yolanda 
Published: September 2021

Background The COVID-19 pandemic has hugely impacted upon people’s psychological and physical wellbeing; however, the effects of the COVID-19 lockdown on mothers of young children, with particular regard to breastfeeding, are unknown. Research Aims To explore: (1) Sources of advice and support available to breastfeeding mothers during and prior to the COVID-19 lockdown; (2) Mothers’ opinions on statements and recommendations made by the World Health Organization on the importance of breastfeeding and breastfeeding during the COVID-19 pandemic; (3) Maternal emotional states (i.e., anxiety and depression symptoms) experienced by breastfeeding mothers during the COVID-19 lockdown; and (4) influence of breastfeeding duration and number of children on breastfeeding opinions and emotional states. Methods Mothers of children aged 0–36 months ( N = 4018) took part in an online survey. The survey included demographic questions, as well as the Generalised Anxiety Disorder Questionnaire and the Patient Health Questionnaire. Mothers were further probed on opinions regarding breastfeeding practices during the COVID-19 pandemic. Results Participants strongly agreed with the importance of breastfeeding, even if a mother showed symptoms of COVID-19. Differences in opinions on breastfeeding practices (e.g., the use of donor human milk and relactation), were found between participants in relation to breastfeeding duration and number of children. Participants with more than one child showed higher negative emotional states, namely anxiety symptoms. Except for Internet usage, participants indicated a decline in all sources of advice and support for breastfeeding during the COVID-19 lockdown. Conclusions Health bodies and professionals should consider maternal viewpoints and opinions regarding breastfeeding during the COVID-19 pandemic. Interventions are urgently needed in order to support breastfeeding mothers and prevent the development of mental health issues.
Patient perspectives of coping with automated peritoneal dialysis
Authors: Duncanson Emily , Chur-Hansen Anna , Jesudason Shilpanjali 
Published: September 2021

Background: Patients receiving peritoneal dialysis (PD) experience poor quality of life, depression, anxiety and lifestyle changes. Insights into how patients adjust to and cope with PD from a psychological perspective will aid care. Methods: Participants were recruited purposively through the Central Northern Adelaide Renal and Transplantation Service in South Australia. Ten patients receiving automated PD (APD) (5 females and 5 males) aged 31 to 77 years (M = 59.3) participated in a semi-structured interview. Interview transcripts were analysed thematically through inductive and deductive methods. Results: Five main themes representing participants’ experiences and perspectives of adjusting to and coping with APD were identified: (1) Resigned Acceptance, (2) A Bridge to Transplant, (3) Navigating Emotions at Milestones and Transitions, (4) Professional Support (Sub-themes: Psychological Support and Education and Information Delivery and (5) Social Enablers (Sub-theme: Hidden from View and Hiding Illness). Conclusions: Patients employ cognitive, emotional and behavioural strategies and rely strongly on social supports to cope with APD. PD at home aids preservation of pre-illness identity, however, also results in feelings of isolation and being misunderstood. Psychological distress and poor coping may be heightened at key disease milestones and transition periods when professional psychological support should be offered. We provide suggestions to address patients’ psychosocial needs and coping in treatment decision-making and dialysis care.
Simulation of complex strabismus surgical procedures on goat eyes
Authors: Pujari Amar , Rakheja Vaishali , Modaboyina Sujeeth , Das Deep , Tripathi Manasi , Phuljhele Swati , Saxena Rohit , Agarwal Tushar , Sharma Namrata , Titiyal Jeewan S 
Published: September 2021

Purpose: To describe the possibility of complex strabismus surgical simulation on goat eyes. Methods: The goat eyes were procured from local slaughterhouse with retained extra ocular muscle tissues. The obtained eyes were inspected for globe integrity, muscle quality, muscle length, and the surrounding teno-conjunctival layers. The included eyes were then segregated for surgical simulation based on their insertion and orientation (as oblique or recti), and they were mounted on a mannequin head, with a fixation suture at free end to simulate the resting tension. Additionally, as per necessary, extra muscles were also transplanted along desired sites to simulate human extra ocular muscle anatomy. Results: The inferior oblique, superior oblique, and all other four recti were successfully simulated in varying proportions in more than 50 eyes. Primarily, by simulating the lateral rectus, inferior rectus, and the inferior oblique muscle, staged weakening procedures of inferior oblique were successfully practiced (Fink’s recession, Park’s recession, Elliot and Nankin procedure, total anterior positioning, and antero-nasal trans-position or Stager’s procedure). Similarly, by simulating superior rectus, inferior rectus, lateral rectus, and the medial rectus muscles, half width transposition, full width transposition, and other complex procedures were practiced (Knapp’s procedure, augmented Knapp’s, Nishida’s procedure, Faden operation, and Y splitting procedure). Furthermore, by simulating superior oblique and the superior rectus muscles, superior oblique tuck, posterior tenectomy, loop tenotomy, and Harada Ito procedures were successfully practiced. Conclusions: On goat eyes, the complex strabismus surgical procedures can be successfully simulated and practiced after re-organizing the existing muscles in different patterns.
Application of tetrad testing to the evaluation of blinding strategies for ancillary supplies used in controlled clinical trials
Authors: Dasnoy Sébastien , Fouache Maxime , White Andy 
Published: September 2021

Background/Aims: Ensuring verum and placebo cannot be visually distinguished from each other is a critical aspect of blinded controlled clinical trials. Our objective was to propose a rational approach to the visual evaluation of placebo matching candidates. Methods: Verum and placebo samples were prepared in clear clinical ancillary supplies (intravenous bags, syringes and administration lines) covered at different levels using opaque sleeves. Triangle and tetrad tests, two sensory discriminative testing methods widely used in the food industry, were applied to assess visual differences between verum and placebo. Results: Triangle and tetrad test results allowed defining the level of opaque coverage required to ensure blinding for three biological drug molecules of therapeutic interest. While the limited number of panelists did not allow a statistically sound comparison of triangle and tetrad test methodologies, tetrad test has a theoretical higher power than triangle test, meaning fewer panelists are needed to reach the same statistical conclusion. Conclusion: Tetrad test offers a rational approach to define a blinding strategy for ancillary supplies used in a controlled clinical trial.
Normal limits for oscillometric bronchodilator responses and relationships with clinical factors
Authors: Jetmalani Kanika , Brown Nathan J. , Boustany Chantale , Toelle Brett G. , Marks Guy B. , Abramson Michael J. , Johns David P. , James Alan L. , Hunter Michael , Musk Arthur W. , Berend Norbert , Farah Claude S. , Chapman David G. , Thamrin Cindy , King Gregory G. 
Published: September 2021

IntroductionWe aimed to determine normal thresholds for positive bronchodilator responses for oscillometry in an Australian general population sample aged ≥40 years, to guide clinical interpretation. We also examined relationships between bronchodilator responses and respiratory symptoms, asthma diagnosis, smoking and baseline lung function.MethodsSubjects recruited from Sydney, Melbourne and Busselton, Australia, underwent measurements of spirometry, resistance (Rrs6) and reactance (Xrs6) at 6 Hz, before and after inhalation of salbutamol 200 μg. Respiratory symptoms and/or medication use, asthma diagnosis, and smoking were recorded. Threshold bronchodilator responses were defined as the fifth percentile of decrease inRrs6and 95th percentile increase inXrs6in a healthy subgroup.ResultsOf 1318 participants, 1145 (570 female) were analysed. The lower threshold for ΔRrs6was −1.38 cmH2O·s·L−1(−30.0% or −1.42 Z-scores) and upper threshold for ΔXrs6was 0.57 cmH2O·s·L−1(1.36 Z-scores). Respiratory symptoms and/or medication use, asthma diagnosis, and smoking all predicted bronchodilator response, as did baseline oscillometry and spirometry. When categorised into clinically relevant groups according to those predictors, ΔXrs6was more sensitive than spirometry in smokers without current asthma or chronic obstructive pulmonary disease (COPD), ∼20% having a positive response. Using absolute or Z-score change provided similar prevalences of responsiveness, except in COPD, in which responsiveness measured by absolute change was twice that for Z-score.DiscussionThis study describes normative thresholds for bronchodilator responses in oscillometry parameters, including intra-breath parameters, as determined by absolute, relative and Z-score changes. Positive bronchodilator response by oscillometry correlated with clinical factors and baseline function, which may inform the clinical interpretation of oscillometry.
Towards a comprehensive breastfeeding-friendly workplace environment: insight from selected healthcare facilities in the central region of Ghana
Authors: Nkrumah Jacqueline , Abuosi Aaron Asibi , Nkrumah Rodney Buadi 
Published: September 2021

Abstract
Background
In the last three decades, Ghana has championed the objectives of Baby-Friendly Hospital Initiatives to provide pregnant women and nursing mothers with the skills and support systems necessary for attaining optimal breastfeeding. Yet, little is known in literature on how these intervention regimes practically promote breastfeeding-friendly work environment in healthcare facilities and their level of effectiveness. This study explores the extent to which healthcare facilities in Ghana’s Effutu Municipality provide breastfeeding-friendly workplace environment to breastfeeding frontline health workers.

Methods
A descriptive mixed-method approach was employed to collect data from fifty-four participants, comprising healthcare facility representatives and breastfeeding frontline health workers. A self-administered questionnaire with structured responses was administered to frontline health workers, followed by interview guides for representatives of hospital management. Thematic analysis was used to analyze interview responses. Responses to questionnaires were processed with SPSS version 23.0 and presented using frequencies and percentages.

Results
Three main themes emerged, namely, Standpoints on workplace breastfeeding support; Breastfeeding support, and Suggested future directions. Beyond this, six sub-themes emerged, including backings for workplace breastfeeding support; perceived benefits of breastfeeding support; factors of poor breastfeeding workplace support; maternity protection benefits; workplace support gaps, and awareness creation on benefits. Breastfeeding frontline health workers held that their hospitals have no breastfeeding policy (96%), no breastfeeding facility (96%), they do not go to work with baby (96%), but had 12 weeks maternity leave (96%) and worked half-day upon return to work (70%).

Conclusion
Health facilities in the study do not provide a breastfeeding-friendly work environment except for the privileges provided by the Labor Act and conditions of service. Continuous advocacy on breastfeeding workplace support and stakeholder engagement to build consensus on the mix of strategies suitable to cushion breastfeeding frontline health workers is recommended for optimal breastfeeding and improved productivity.
Prevalence and characteristics of alcohol consumption and risk of type 2 diabetes mellitus in rural China
Authors: Wu Xueyan , Liu Xiaotian , Liao Wei , Kang Ning , Dong Xiaokang , Abdulai Tanko , Zhai Zhihan , Wang Chongjian , Wang Xiaoqiong , Li Yuqian 
Published: September 2021

Abstract
Background
The study aimed to characterize the prevalence of alcohol consumption and further investigate the relationship between alcohol consumption and type 2 diabetes mellitus (T2DM).

Methods
We studied 39,259 participants aged 18 to 79 years of the Henan Rural Cohort study. The associations between alcohol consumption and T2DM were examined using the logistic regression models and restricted cubic spline.

Results
For men, alcohol abstinence was associated with an increased risk of T2DM (1.491(1.265, 1.758)), whereas current drinkers were not associated with T2DM (1.03(0.91, 1.15)). Further analysis of alcohol drinkers revealed that only high-risk drinkers of WHO drinking risk levels increased the risk of T2DM (1.289(1.061,1.566)) compared to never drinkers. The risk of T2DM increased as the age of starting to consume alcohol decreased and as the number of years of consuming alcohol and the alcohol intake increased only in men. We further found that the risk of T2DM decreased as the number of years of abstinence increases and no association between alcohol abstinence and T2DM was found after more than 10 years of abstinence among men.

Conclusions
Our results suggested that reducing the amount of alcohol consumed and adhering to abstinence from alcohol consumption are beneficial in reducing the risk of T2DM.

Trial registration
The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06. http://www.chictr.org.cn/showproj.aspx?proj=11375
Power flow adjustment for smart microgrid based on edge computing and multi-agent deep reinforcement learning
Authors: Pu Tianjiao , Wang Xinying , Cao Yifan , Liu Zhicheng , Qiu Chao , Qiao Ji , Zhang Shuhua 
Published: September 2021

AbstractIn current power grids, a massive amount of power equipment raises various emerging requirements, e.g., data perception, information transmission, and real-time control. The existing cloud computing paradigm is stubborn to address issues and challenges such as rapid response and local autonomy. Microgrids contain diverse and adjustable power components, making the power system complex and difficult to optimize. The existing traditional adjusting methods are manual and centralized, which requires many human resources with expert experience. The adjustment method based on edge intelligence can effectively leverage ubiquitous computing capacities to provide distributed intelligent solutions with lots of research issues to be reckoned with. To address this challenge, we consider a power control framework combining edge computing and reinforcement learning, which makes full use of edge nodes to sense network state and control power equipment to achieve the goal of fast response and local autonomy. Additionally, we focus on the non-convergence problem of power flow calculation, and combine deep reinforcement learning and multi-agent methods to realize intelligent decisions, with designing the model such as state, action, and reward. Our method improves the efficiency and scalability compared with baseline methods. The simulation results demonstrate the effectiveness of our method with intelligent adjusting and stable operation under various conditions.
The sleep loss insult of Spring Daylight Savings in the US is observable in Twitter activity
Authors: Linnell Kelsey , Arnold Michael , Alshaabi Thayer , McAndrew Thomas , Lim Jeanie , Dodds Peter Sheridan , Danforth Christopher M. 
Published: September 2021

AbstractSleep loss has been linked to heart disease, diabetes, cancer, and an increase in accidents, all of which are among the leading causes of death in the United States. Population-scale sleep studies have the potential to advance public health by helping to identify at-risk populations, changes in collective sleep patterns, and to inform policy change. Prior research suggests other kinds of health indicators such as depression and obesity can be estimated using social media activity. However, the inability to effectively measure collective sleep with publicly available data has limited large-scale academic studies. Here, we investigate the passive estimation of sleep loss through a proxy analysis of Twitter activity profiles. We use “Spring Forward” events, which occur at the beginning of Daylight Savings Time in the United States, as a natural experimental condition to estimate spatial differences in sleep loss across the United States. On average, peak Twitter activity occurs 15 to 30 min later on the Sunday following Spring Forward. By Monday morning however, activity curves are realigned with the week before, suggesting that the window of sleep opportunity is compressed in Twitter data, revealing Spring Forward behavioral change.
Outcomes of a culturally informed weight-loss competition for New Zealand Indigenous and Pacific peoples: a quasi-experimental trial
Authors: Glover Marewa , Kira Anette , McRobbie Hayden , Kruger Rozanne , Funaki-Tahifote Mafi , Stephen Jane , Breier Bernhard H. , Kira Geoff 
Published: September 2021

Abstract
Background
Reducing obesity prevalence among marginalised subgroups with disproportionately high obesity rates is challenging. Given the promise of incentives and group-based programmes we trialled a culturally tailored, team-based weight-loss competition with New Zealand Māori (Indigenous) and Pacific Island people.

Methods
A quasi-experimental 12-months trial was designed. The intervention consisted of three six-months competitions, each with seven teams of seven members. Eligible participants were aged 16 years and older, with a BMI ≥30 kg/m2 and being at risk of or already diagnosed with type-2 diabetes or cardiovascular disease. Height, weight and waist circumference were measured at baseline, 6 and 12 months.

Results
Recruitment of a control group (n = 29) versus the intervention (n = 132) was poor and retention rates were low (52 and 27% of intervention participants were followed-up at six and 12 months, respectively). Thus, analysis of the primary outcome of individual percentage weight loss was restricted to the 6-months follow-up data. Although not significant, the intervention group appeared to lose more weight than the control group, in both the intention to treat and complete-case analyses.

Conclusions
The intervention promoted some behaviour change in eating behaviours, and a resulting trend toward a reduction in waist circumference.

Trial registration
ACTRN12617000871347 Registered 15/6/2017 Retrospectively registered.
A characteristic-featured shock wave indicator for simulating high-speed inviscid flows on 3D unstructured meshes
Authors: Feng Yiwei , Liu Tiegang , He Xiaofeng , Zhang Bin , Wang Kun 
Published: September 2021

AbstractIn this work, we extend the characteristic-featured shock wave indicator based on artificial neuron training to 3D high-speed flow simulation on unstructured meshes. The extension is achieved through dimension splitting. This leads to that the proposed indicator is capable of identifying regions of flow compression in any direction. With this capability, the indicator is further developed to combine with h-adaptivity of mesh refinement to improve resolution with less computational costs. The present indicator provides an attractive alternative for constructing high-resolution, high-efficiency shock-processing methods to simulate high-speed inviscid flows.
Antibiotic Drug screening and Image Characterization Toolbox (A.D.I.C.T.): a robust imaging workflow to monitor antibiotic stress response in bacterial cells in vivo
Authors: Mayer Benjamin , Schwan Meike , Thormann Kai M. , Graumann Peter L. 
Published: September 2021

The search for novel drugs that efficiently eliminate prokaryotic pathogens is one of the most urgent health topics of our time. Robust evaluation methods for monitoring the antibiotic stress response in prokaryotes are therefore necessary for developing respective screening strategies. Besides advantages of common in vitro techniques, there is a growing demand for in vivo information based on imaging techniques that allow to screen antibiotic candidates in a dynamic manner. Gathering information from imaging data in a reproducible manner, robust data processing and analysis workflows demand advanced (semi-)automation and data management to increase reproducibility. Here we demonstrate a versatile and robust semi-automated image acquisition, processing and analysis workflow to investigate bacterial cell morphology in a quantitative manner. The presented workflow, A.D.I.C.T, covers aspects of experimental setup deployment, data acquisition and handling, image processing (e.g. ROI management, data transformation into binary images, background subtraction, filtering, projections) as well as statistical evaluation of the cellular stress response (e.g. shape measurement distributions, cell shape modeling, probability density evaluation of fluorescence imaging micrographs) towards antibiotic-induced stress, obtained from time-course experiments. The imaging workflow is based on regular brightfield images combined with live-cell imaging data gathered from bacteria, in our case from recombinant Shewanella cells, which are processed as binary images. The model organism expresses target proteins relevant for membrane-biogenesis that are functionally fused to respective fluorescent proteins. Data processing and analysis are based on customized scripts using ImageJ2/FIJI, Celltool and R packages that can be easily reproduced and adapted by users. Summing up, our approach aims at supporting life-scientists to establish their own imaging-pipeline in order to exploit their data as versatile as possible and in a reproducible manner.
Serum exosomal miR-122-5p, GAS, and PGR in the non-invasive diagnosis of CAG
Authors: Liu Naihua , Huang Yuancheng , Liu Fengbin , Liu Hong 
Published: September 2021

Abstract

Objective
The aim of this study was to integrate the serum exosomal miRNA miR-122-5p with canonical serological biomarkers for the non-invasive screening of chronic atrophic gastritis (CAG) patients.

Methods
miR-122-5p and U6 were amplified by the quantitative reverse transcription polymerase chain reaction (RT-qPCR), gastrin (GAS), pepsinogen I (PG-I), and PG-II and were measured by ELISA. The area under the receiver operating characteristic (ROC) curves and their correlation were analyzed.

Results
In the present study, GAS level and PG-I/PG-II ratio (PGR) were increased in CAG group, but there was no significant difference in PG-I or PG-II levels between CAG group and chronic non-atrophic gastritis (CNAG) group. Only GAS level and PG-I/PG-II ratio were significantly correlated with atrophy, and not any other clinicopathologic factors. Expression of hsa-miR-122-5p positively correlated with GAS level, PG-I level, and PGR, while it negatively correlated with PG-II level; however, none of them had significant difference. The combination of GAS, PGR, and hsa-miR-122-5p presented as a better model for non-invasive screening of CAG compared to others.

Conclusion
These results suggested that serum exosomal hsa-miR-122-5p combined with GAS and PGR would elevate accuracy and specificity in non-invasive screening of CAG.