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Abstract Responsive feeding serves as an important protective factor for infant growth and overall health development. This study based on self‐determination theory (SDT) aimed to assess the effects of a responsive breastfeeding (RBF) intervention programme on maternal breastfeeding and infant growth and development. A total of 110 mother–infant pairs were recruited and randomly divided into an intervention group (n = 55) and a control group (n = 55). The primary outcomes were breastfeeding motivation score, breastfeeding self‐efficacy (BSE) and exclusive breastfeeding rate; the secondary outcomes were infant physical development at 6 weeks and 3 months. A repeated measures ANOVA indicated that the intervention group had significantly higher Enjoyment scores compared to the control group at three time points: at discharge (MD: 5.28; 95% CI: 3.68 to 6.89; p

Abstract Background Necrotizing enterocolitis (NEC) is a multifactorial gastrointestinal disease with high morbidity and mortality among premature infants. However, studies with large samples on the factors of NEC in China have not been reported. This meta-analysis aims to systematically review the literature to explore the influencing factors of necrotizing enterocolitis in premature infants in China and provide a reference for the prevention of NEC. Methods PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biomedical Literature Database (CBM), Wanfang and VIP databases were systematically searched from inception to February 2023. We used Stata14.0 software to perform the systematic review and meta-analysis. We used fixed or random effects models with combined odds ratios (ORs) and 95% confidence intervals (CIs), and quality was evaluated using the Newcastle‒Ottawa Scale (NOS). Results The total sample was 8616 cases, including 2456 cases in the intervention group and 6160 cases in the control group. It was found that 16 risk factors and 3 protective factors were related to necrotizing enterocolitis in premature infants. Septicemia (OR = 3.91), blood transfusion (OR = 2.41), neonatal asphyxia (OR = 2.46), pneumonia (OR = 6.17), infection (OR = 5.99), congenital heart disease (OR = 4.80), intrahepatic cholestasis of pregnancy (ICP) (OR = 2.71), mechanical ventilation (OR = 1.44), gestational diabetes mellitus (GDM) (OR = 3.08), respiratory distress syndrome (RDS) (OR = 3.28), hypoalbuminemia (OR = 2.80), patent ductus arteriosus (PDA) (OR = 3.10), respiratory failure (OR = 7.51), severe anemia (OR = 2.86), history of antibiotic use (OR = 2.12), and meconium-stained amniotic fluid (MSAF) (OR = 3.14) were risk factors for NEC in preterm infants in China. Breastfeeding (OR = 0.31), oral probiotics (OR = 0.36), and prenatal use of glucocorticoids (OR = 0.38) were protective factors for NEC in preterm infants. Conclusions Septicemia, blood transfusion, neonatal asphyxia, pneumonia, infection, congenital heart disease, ICP, GDM, RDS, hypoproteinemia, PDA, respiratory failure, severe anemia, history of antibiotic use and MSAF will increase the risk of NEC in premature infants, whereas breastfeeding, oral probiotics and prenatal use of glucocorticoids reduce the risk. Due to the quantity and quality of the included literature, the above findings need to be further validated by more high-quality studies.

BackgroundPreterm infants have imperfect neurological development, uncoordinated sucking-swallowing-breathing, which makes it difficult to realize effective oral feeding after birth. How to help preterm infants achieve complete oral feeding as soon as possible has become an important issue in the management of preterm infants. Non-nutritive sucking (NNS), as a useful oral stimulation, can improve the effect of oral feeding in preterm infants. This review aimed to explore the effect of NNS on oral feeding progression through a meta-analysis.MethodsWe systematically searched PubMed, CINHAL, Web of Science, Embase, Cochrane databases, China's National Knowledge Infrastructure (CNKI), Wanfang and VIP database from inception to January 20, 2024. Search terms included 'non-nutritive sucking' 'oral feeding' and 'premature.' Eligibility criteria involved randomized controlled studies in English or Chinese. Studies were excluded if they were reviews, case reports, or observational studies from which valid data could not be extracted or outcome indicators were poorly defined. The meta-analysis will utilize Review Manager 5.3 software, employing either random-effects or fixed-effects models based on observed heterogeneity. We calculated the mean difference (MD) and 95% confidence interval (CI) for continuous data, and estimated pooled odds ratios (ORs) for dichotomous data. Sensitivity and publication bias analyses were conducted to ensure robust and reliable findings. We evaluated the methodological quality of randomized controlled trials (RCTs) utilizing the assessment tool provided by the Cochrane Collaboration.ResultsA total of 23 randomized controlled trials with 1461 preterm infants were included. The results of the meta-analysis showed that NNS significantly shortened time taken to achieve exclusive oral feeding (MD = -5.37,95%CI = -7.48 to-3.26, pConclusionNNS improves oral feeding outcomes in preterm infants and reduces the time to reach full oral feeding and hospitalization length. However, this study was limited by the relatively small sample size of included studies and did not account for potential confounding factors. There was some heterogeneity and bias between studies. More studies are needed in the future to validate the effects on weight gain and growth in preterm infants. Nevertheless, our meta-analysis provides valuable insights, updating existing evidence on NNS for improving oral feeding in preterm infants and promoting evidence-based feeding practices in this population.

Gastric cancer (GC) is one of the most common malignancies, with an ever-increasing incidence and high mortality rate. Chromobox4 (CBX4), also named hPC2, is a small ubiquitin-related modifier (SUMO) E3 ligase. Previous studies have found that high CBX4 expression is associated with tumor size, pathologic differentiation and decreased patient survival in hepatocellular carcinoma (HCC). However, the expression and prognostic value of CBX4 in GC have not been clarified. In our study, ONCOMINE, UALCAN, Kaplan-Meier Plotter, cBioPortal, DAVID 6.8 and TIMER were utilized. RT-PCR, immunohistochemistry (IHC), Western blot, CCK-8 assay, cell apoptosis assay, cell cycle assay were used to further verify in GC tissue samples or cell line. The transcriptional and protein level of CBX4 in GC tissues was found significantly elevated and a significant association between the expression of CBX4 and clinicopathological parameters was found in GC patients. Low expression of CBX4 in GC patients were correlated with a significantly improved prognosis. The functions of CBX4 are primarily related to the stem cell pluripotency signaling pathway, Hippo signaling pathway, HTLV-I infection, Notch signaling pathway, and N-glycan biosynthesis. Our results may provide novel insights for the selection of therapeutic targets and prognostic biomarkers for GC.

A high prevalence of Epstein–Barr virus (EBV) infection in patients with inflammatory bowel disease (IBD) has been reported in many case reports and studies; thus, the association between EBV and IBD has gained increasing attention. Patients with IBD are at an increased risk of opportunistic EBV infection owing to the common use of immunomodulators. EBV infection in IBD patients can cause various complications, including superimposed viral colitis, which is associated with chronicity, exacerbation, and poor prognosis of refractory IBD, and can induce progression to lymphoproliferative disorders, such as EBV-positive mucocutaneous ulcer (EBVMCU), lymphomatoid granulomatosis (LYG), hemophagocytic lymphohistiocytosis (HLH) and diffuse large B-cell lymphoma (DLBCL). It has been suggested to screen for EBV before initiating immunosuppressive therapy and monitor the status of EBV infection in patients with IBD, especially those who are EBV-seronegative and have a risk of primary EBV infection. Clinicians should also be careful of misdiagnosing IBD and EBV-associated lymphoproliferative diseases due to similarities in both clinical symptoms and endoscopic manifestations. Withdrawal of immunosuppressants has been shown to be an effective strategy to achieve remission of disease at the time of EBV diagnosis, but antiviral therapy remains controversial. The present review aims to describe the characteristics of the complications caused by EBV infection and generalize the recent research progress on and challenges caused by EBV infection in IBD patients. The literature for writing this review was collected from ‘PubMed’ research engine. The keywords ‘inflammatory bowel disease and Epstein–Barr virus’ or ‘ulcerative colitis and Epstein–Barr virus’ or ‘Crohn’s disease and Epstein–Barr virus’ were used to collect the literature and relevant papers were collected to help writing this review.

Light-harvesting chlorophyll a/b binding (Lhc) proteins play a key role in the efficiency of the photosynthetic system of plants and participate in the regulation of plant growth, development, and the response to abiotic stress. In this study, 28 PbrLhc genes of the family were identified in the pear Pyrus bretschneideri genome database, which were distributed on 25 of the 27 chromosomes. Phylogenetic relationship analysis demonstrated that PbrLhc proteins could be divided into five subfamilies. Using MEME Suite, PlantRegMap, and Softberry, the conserved motifs, transcription binding sites, and predicated location of all PbrLhc proteins, respectively, were determined. A collinearity relationship using MCScanX software showed that there was a collinearity relationship between different PbrLhc genes. Using the hierarchical clustering method to develop a heat map of gene expression, five genes were found to be down-regulated under irrigation treatment and up-regulated under drought treatment; seven genes were up-regulated under irrigation treatment and down-regulated under drought treatment. Finally, the results of these analyses will provide theoretical basis for future study on the function and differential expression of PbrLhc genes in response to drought stress.

Background Methylxanthine, including caffeine citrate and aminophylline, is the most common pharmacologic treatment for apnea of prematurity. However, due to the lack of high-quality evidence, there are no clear recommendations or guidelines on how to choose between caffeine and aminophylline. Objective This meta-analysis aimed to assess the comparative efficacy and safety of caffeine and aminophylline for apnea of prematurity, and provide reliable evidence for clinical medication in the treatment for apnea of prematurity. Methods PubMed, Scopus, Embase, EBSCO, Web of Science, and Cochrane databases were systematically searched from May 1975 to June 2022. Results Ten studies including a total of 923 preterm infants were evaluated. Our results showed that there was no significant difference in the effective rate of 1-3days between caffeine and aminophylline (OR 1.05, 95%CI: 0.40–2.74, P = 0.914). However, for side effects such as tachycardia (OR 0.22, 95%CI: 0.13–0.37, PConclusion This meta-analysis reveals that caffeine citrate and aminophylline have similar therapeutic effectiveness on respiratory function, but caffeine has fewer side effects and should be considered first for treatment.

The NONEXPRESSOR OF PATHOGENESIS-RELATED GENES 1 (NPR1) plays a master regulatory role in the salicylic acid (SA) signal transduction pathway and plant systemic acquired resistance (SAR). Members of the NPR1-like gene family have been reported to the associated with biotic/abiotic stress in many plants, however the genome-wide characterization of NPR1-like genes has not been carried out in Chinese pear (Pyrus bretschneideri Reld). In this study, a systematic analysis was conducted on the characteristics of the NPR1-like genes in P. bretschneideri Reld at the whole-genome level. A total nine NPR1-like genes were detected which eight genes were located on six chromosomes and one gene was mapped to scaffold. Based on the phylogenetic analysis, the nine PbrNPR1-like proteins were divided into three clades (Clades I–III) had similar gene structure, domain and conserved motifs. We sorted the cis-acting elements into three clades, including plant growth and development, stress responses, and hormone responses in the promoter regions of PbrNPR1-like genes. The result of qPCR analysis showed that expression diversity of PbrNPR1-like genes in various tissues. All the genes were up-regulated after SA treatment in leaves except for Pbrgene8896. PbrNPR1-like genes showed circadian rhythm and significantly different expression levels after inoculation with Alternaria alternata. These findings provide a solid insight for understanding the functions and evolution of PbrNPR1-like genes in Chinese pear.

The outbreak of the COVID-19 pandemic has precipitated a surge in mask usage around the world. This situation could spur environmental consequences which when not well managed, may compound waste and waste management, and further drive the spread of viral infections. Therefore, this study explores the antecedents of mask waste separation behavior in Ghana using an integrated model composed of the theory of planned behavior and the norm activation model. With the use of the questionnaire survey approach, data was drawn from 570 respondents, and further analyzed using the structural equation modeling technique. Results revealed that the relationship between awareness of consequences and other constructs, except attitude, and the relationship between ascription of responsibility and other constructs, except attitude, are significant. Moreover, significant relationships between subjective norm and attitude, subjective norm and personal norm, and subjective norm and perceived behavior control were validated. However, no significant relationship exists between awareness of consequences and attitude, and between awareness of responsibility and attitude. On the basis of the study findings, insightful implications for policy and suggestions for future research are presented., Author(s): Vincent Ekow Arkorful [sup.1] , Benjamin Kweku Lugu [sup.2] , Zhao Shuliang [sup.3] Author Affiliations: (1) Department of Government and International Studies, HongKong Baptist University, , Kowloon Tong, Kowloon, [...]

As global governments continue to inoculate populations in the aftermath of the SARS-CoV-19 epidemic, health protection and related problems such as vaccination reluctance have sparked conflicting emotions and discourses. Stakeholder concerns about vaccination promotion have arisen in this context. Consequently, this research investigates vaccination uptake behavior using an integrated framework that includes protective motivation theory and an extended version of the theory of planned behavior. Except for perceived severity, empirical study results based on the structural equation modeling technique demonstrated a positive relationship between PMT factors (i.e. perceived vulnerability, reaction efficacy, self-efficacy, and cost response) and intention to vaccinate. TPB factors (attitude, perceived behavior control, subjective norm, personal moral norm, and descriptive norm) were also found to have a positive connection with intention. The model's utility and suitability are indicated by the predictive and explanatory potency score (R2 =.415). Study implications for COVID-19 vaccine uptake promotion and ideas for future investigations are explored in light of our findings. [ABSTRACT FROM AUTHOR]

The recent perennial spate of flooding in Ghana has over the years caused hemorrhagic loss to lives and properties. In view of the inundation phenomenon, issues of waste management have been shot into prominence. The key among dominant suggestions to counteracting the situation has essentially converged around waste separation, which is an under researched area in Ghana. Against this background, the research seeks to investigate household waste separation behavior using an integrated theory of planned behavior and the norm activation model as the theoretical framework. Data were drawn using the questionnaire survey method and further analyzed using the structural equation modeling technique. The empirical results of data analysis drawn from 707 households confirmed a significant relationship between awareness of consequences and attitude, and subjective and personal norms. Subjective norm is significantly related to attitude and perceived behavior control. Moreover, attitude has a positive relationship with behavioral intention, whereas the relationship between perceived behavior control and behavioral intention is not significant. Finally, personal norm has a significant relationship with behavioral intention. The results also confirmed that the integrated model is useful and appropriate for predicting behavior. From the results, implications for pursuing and forging household waste separation behavior and suggestions for future research are outlined. [ABSTRACT FROM AUTHOR]

Though health insurance policies remain critical to eliminating healthcare access barriers, population-wide subscription in Ghana however remains unsatisfactory. Therefore, this study, while employing a questionnaire survey to elicit data (n= 312) analyzed via the structural equation modeling technique, investigates individual health insurance subscription underpinnings using the theory of planned behavior. The results of data analysis affirmed attitude, subjective norm and perceived behavior control as positively related to health insurance subscription. Similarly, results further revealed personal norm and descriptive norm as significantly related to intention, testifying to individuals' subscription as not anchored on a single factor, but rather on a confluence of behavior-driven elements. The current study, in addition to affirming the TPB's predictive potency, also enriches health insurance research, and underscores the much often-disregarded behavior constituents as imperative to health policy design and implementation. In view of the study results, implications for augmenting subscription, and suggestions for further research are subsequently delineated. [ABSTRACT FROM AUTHOR]