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Background In response to the COVID-19 pandemic, family presence restrictions in neonatal intensive care units (NICU) were enacted to limit disease transmission. This has resulted in communication challenges, negatively impacting family integrated care. Aim To develop clinical care pathways to ensure optimal neonatal care to support families in response to parental presence restrictions imposed during the COVID-19 pandemic. Methods An agile, co-design process utilizing expert consensus of a large interdisciplinary team and focus groups and semi-structured interviews with families and HCPs were used to co-design clinical virtual care pathways. Results Three clinical virtual care pathways were co-designed: (1) building and maintaining relationships between family and healthcare providers; (2) awareness of resources; and (3) standardized COVID-19 messaging. Modifications were made to optimize uptake and utilization in the clinical areas. Conclusion Clinical care virtual pathways were successfully co-designed to meet these needs to ensure more equitable family centered care.

Variants of uncertain significance (VUS) are frequently reclassified but recontacting patients with updated results poses significant resource challenges. We aimed to characterize public and patient preferences for being recontacted with updated results. A discrete choice experiment (DCE) was administered to representative samples of the Canadian public and cancer patients. DCE attributes were uncertainty, cost, recontact modality, choice of results, and actionability. DCE data were analyzed using a mixed logit model and by calculating willingness to pay (WTP) for types of recontact. Qualitative interviews exploring recontact preferences were analyzed thematically. DCE response rate was 60% (n = 1003, 50% cancer patient participants). 31 participants were interviewed (11 cancer patients). Interviews revealed that participants expected to be recontacted. Quantitatively, preferences for how to be recontacted varied based on certainty of results. For certain results, WTP was highest for being recontacted by a doctor with updates ($1075, 95% CI: $845, $1305) and for contacting a doctor to request updates ($1038, 95% CI: $820, $1256). For VUS results, WTP was highest for an online database ($1735, 95% CI: $1224, $2247) and for contacting a doctor ($1705, 95% CI: $1102, $2307). Qualitative data revealed that preferences for provider-mediated recontact were influenced by trust in healthcare providers. Preferences for a database were influenced by lack of trust in providers and desire for control. Patients and public participants support an online database (e.g. patient portal) to recontact for VUS, improving feasibility, and provider-mediated recontact for certain results, consistent with usual care.

Background Presence in the neonatal intensive care unit (NICU) is a vital step for caregivers initiating involvement, such as skin-to-skin contact, holding or singing/reading to their newborn. Little is known about caregiver presence and involvement in Canadian NICU's context by caregiver type (mother, father, other), and the association between maternal presence and key maternal and newborn characteristics. Purpose The primary objective was to examine the presence and involvement of family caregivers in the NICU. The secondary objective was to examine the relationship between maternal presence and maternal and newborn characteristics. Design and methods A prospective observational cohort study in an open bay setting of an Eastern Canadian NICU. Presence (physically present at the newborn's bedside) and involvement (e.g., skin-to-skin, singing/reading) were tracked daily by families in the NICU until discharge. Demographic information was also collected. Results Participants included 142 mothers and their newborns. Mothers were present 8.7 h/day, fathers were present 4.1 h/day, and other caregivers were present 1.8 h/day in the NICU in the first 34 days. Mothers were involved in care activities 50% of the time they were present in the NICU, whereas fathers and other caregivers were spending 20% and 6% of their time respectively. Regression identified maternal age, distance to home, parity, birthweight, and length of stay to be statistically significant variables related to maternal presence. Conclusions There is variation in presence and involvement by caregiver type. Targeted interventions to maintain and increase mothers, fathers and other caregivers' presence and involvement in care throughout their stay in the NICU are recommended.

The aim of this study was to explore the learning needs of parents of infants admitted to the neonatal intensive care unit (NICU) through descriptive qualitative design. Three focus groups were conducted with thirteen parents. Three main themes were derived following content analysis: Expectations and Uncertainties, Seeking and Learning, and Desires and Preferences. Parents identified a need for greater clarity around their role in the NICU and while healthcare professionals were identified as the foremost trusted source of information in the NICU, parents also voiced concerns related to communication difficulties. Parents attempted to satisfy learning needs online and believed that traditional resources, such as hospital-based pamphlets, be replaced with resources that are virtual, readily accessible, evidence-based and tailored to their individual needs. Education through technology as a supplement to direct health care professional communication may promote optimal health outcomes for infants and families.

Genome sequencing (GS) studies involving healthy children can advance scientific knowledge of genetic variation. Little research has examined primary care providers’ views on using GS in this context. This study explored primary care provider perspectives on the use of GS in research and the care of healthy children. We conducted semi-structured interviews with 16 providers discussing their views on GS research and receiving results. Interviews were analyzed by thematic analysis and constant comparison. Participants were family physicians (11/16) and primary care pediatricians (5/16) in practice for >10 years (11/16). Participants valued GS in healthy children for research purposes; however, opinions diverged on using the results in primary care. Proponents valued using results for surveillance and prevention in healthy children. Skeptics questioned the clinical utility of results and the appropriateness of applying research data in primary care. Both groups shared concerns over opportunistic screening, validity, and interpretation of results, increased health system costs and inequities, and genetic discrimination. Primary care providers were ambivalent about the appropriateness and utility of GS in the care of healthy children. Providers feel unprepared and unsure of their obligations in disclosing these results. Providers do not feel they are equipped with the necessary resources and training to support their patients in using GS results in their care.

Beach litter destroys marine ecosystems and creates aesthetic discomfort that lowers the value of the beach. In order to solve this beach litter problem, it is necessary to study the generation and distribution pattern of waste and the cause of the inflow. However, the data for the study are only sample data collected in some areas of the beach. Also, most of the data covers only the total amount of beach litter. UAV(Unmanned Aerial Vehicle) and Deep Neural Network can be effectively used to detect and monitor beach litter. Using UAV, it is possible to easily survey the entire beach. The Deep Neural Network can also identify the type of coastal litter. Therefore, using UAV and Deep Neural Network, it is possible to acquire spatial information by type of beach litter. This paper proposes a Beach litter detection algorithm based on UAV and Deep Neural Network and a Beach litter monitoring process using it. It also offers optimal shooting altitude and film duplication to detect small beach litter such as plastic bottles and styrofoam pieces found on the beach. In this study, DJI Mavic 2 Pro was used. The camera on the UAV is a 1-inch CMOS with a resolution of 20MP. The images obtained through UAV are produced as orthoimages and input into a pre-trained neural network algorithm. The Deep Neural Network used for Beach litter detection removed the Fully Connected Layer from the Convolutional Neural Network for semantic segmentation.

Background Electronic health (e-health) learning is a potential avenue to educate health professionals about accurately using infant pain assessment tools, although little is known about the impact of e-health interventions on clinical competence. Purpose To evaluate whether an e-health learning module for teaching the accurate use of the Premature Infant Pain Profile-Revised (PIPP-R) pain assessment tool results in immediate and sustained competency to assess infant pain. Methods Neonatal intensive care unit (NICU) nurses who participated in a larger study across 2 tertiary NICUs in Canada examining the implementation and clinical utility of the PIPP-R e-learning module completed 2 follow-up evaluations at 1 week and 3 months. Participants were asked to view a video recording of an infant undergoing a painful procedure and to assess the infant's pain intensity response using the PIPP-R measure. Immediate and sustained competency was assessed via interrater consensus of participant-reported PIPP-R scores compared with those of an experienced trained coder. Results Of the 25 eligible nurses, 22 completed 1-week and 3-month follow-up evaluations. At the 1-week follow-up, 84% of nurses scored the video accurately compared with 50% at 3 months. Behavioral pain indicators were more likely to be scored incorrectly than physiological indicators. Implications for practice Follow-up training after completion of the initial e-learning module training may improve competency related to the clinical use of the PIPP-R tool to assess infant pain over time. Implications for research Additional study regarding the need and timing of e-health training to optimize sustained competency in infant pain assessment is warranted.

Background Several studies suggested association between inflammatory bowel disease (IBD) and risk of cervical cancer in women. We investigated the risk of cervical cancer in patients with ulcerative colitis (UC) using the nationwide population-based claims data in South Korea. Methods We analysed the claims data of the Korean National Health Insurance (2006–2015). UC and cervical cancer were defined using International Classification of Diseases-10 codes and UC-specific prescription. Age- and sex-matched individuals without UC (control group) were randomly selected from the general population. Hazard ratios (HRs), adjusted for different covariates, were calculated using multivariate Cox proportional hazard regression. Results In total, 30,546 and 88,829 individuals with UC and without UC, respectively, were enrolled. Cervical cancer developed in 26 (0.21%) among UC patients, and 51 (0.14%) among control group, respectively. The standardized incidence ratio (SIR) of cervical cancer in the UC and non-UC groups were 2.04(95% confidence interval [CI], 1.33–2.98), and 1.35(95% CI, 1.00–1.77). The HR of cervical cancer in UC group, with reference to the non-UC group, was 1.56 (95% CI, 0.97–2.50). Further, UC groups were stratified according to age (HR=9.89, 1.62, 0.79 and 3.65 for 0–19, 20–39, 40–59, and ≥60 years, respectively). HR was significantly higher for early-onset UC (0–19 years) and late-onset UC (≥60 years). Among UC, age≥40, low socioeconomic status, rural residence, cerebral vascular disease are risk factors for cervical cancer. Conclusion UC patients had an increased risk of cervical cancer, especially with early-onset (0–19 years) and late-onset (>59 years). Since cervical cancer incidence is higher in UC patients than in the general population, UC patients should receive the human papillomavirus vaccine prophylactically.

Objective To evaluate the relationship between the timing of infant cereal introduction between 4 and 6 months of age and growth and dietary intake in later childhood. Study design A longitudinal cohort study was conducted among healthy children 0-10 years of age participating in The Applied Research Group for Kids cohort study between June 2008 and August 2019 in Toronto, Canada. Results Of 8943 children included, the mean (SD) age of infant cereal introduction was 5.7 (2.1) months. In the primary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.17 greater body mass index z score (95% CI 0.06-0.28; P = .002) and greater odds of obesity (OR 1.82; 95% CI 1.18-2.80; P = .006) at 10 years of age. In the secondary analysis, children who were introduced to infant cereal at 4 vs 6 months had 0.09 greater height-for-age z score (95% CI 0.04-0.15; P = .002) at 1 year of age, an association that was not observed at 5 or 10 years of age. Children who were introduced to infant cereal at 4 vs 6 months had greater nutrition risk which was primarily determined by a less-favorable eating behavior score at 18 months to 5 years of age (0.18 units higher; 95% CI 0.07-0.29; P = .001). Conclusions Introduction of infant cereal at 4 vs 6 months was associated with greater body mass index z score, greater odds of obesity, similar height-for-age z score, and less favorable eating behavior. These findings support recommendations for introducing solid food around 6 months of age.

Variants of uncertain significance (VUS) are frequently reclassified but recontacting patients with updated results poses significant resource challenges. We aimed to characterize public and patient preferences for being recontacted with updated results. A discrete choice experiment (DCE) was administered to representative samples of the Canadian public and cancer patients. DCE attributes were uncertainty, cost, recontact modality, choice of results, and actionability. DCE data were analyzed using a mixed logit model and by calculating willingness to pay (WTP) for types of recontact. Qualitative interviews exploring recontact preferences were analyzed thematically. DCE response rate was 60% (n = 1003, 50% cancer patient participants). 31 participants were interviewed (11 cancer patients). Interviews revealed that participants expected to be recontacted. Quantitatively, preferences for how to be recontacted varied based on certainty of results. For certain results, WTP was highest for being recontacted by a doctor with updates ($1075, 95% CI: $845, $1305) and for contacting a doctor to request updates ($1038, 95% CI: $820, $1256). For VUS results, WTP was highest for an online database ($1735, 95% CI: $1224, $2247) and for contacting a doctor ($1705, 95% CI: $1102, $2307). Qualitative data revealed that preferences for provider-mediated recontact were influenced by trust in healthcare providers. Preferences for a database were influenced by lack of trust in providers and desire for control. Patients and public participants support an online database (e.g. patient portal) to recontact for VUS, improving feasibility, and provider-mediated recontact for certain results, consistent with usual care.

The rare decay $K_L \!\to\! \pi^0 \nu \overline{\nu}$ was studied with the dataset taken at the J-PARC KOTO experiment in 2016, 2017, and 2018. With a single event sensitivity of $( 7.20 \pm 0.05_{\rm stat} \pm 0.66_{\rm syst} ) \times 10^{-10}$, three candidate events were observed in the signal region. After unveiling them, contaminations from $K^{\pm}$ and scattered $K_L$ decays were studied, and the total number of background events was estimated to be $1.22 \pm 0.26$. We conclude that the number of observed events is statistically consistent with the background expectation. For this dataset, we set an upper limit of $4.9 \times 10^{-9}$ on the branching fraction of $K_L \!\to\! \pi^0 \nu \overline{\nu}$ at the 90% confidence level.

The rare decay K_{L}→π^{0}νν[over ¯] was studied with the dataset taken at the J-PARC KOTO experiment in 2016, 2017, and 2018. With a single event sensitivity of (7.20±0.05_{stat}±0.66_{syst})×10^{-10}, three candidate events were observed in the signal region. After unveiling them, contaminations from K^{±} and scattered K_{L} decays were studied, and the total number of background events was estimated to be 1.22±0.26. We conclude that the number of observed events is statistically consistent with the background expectation. For this dataset, we set an upper limit of 4.9×10^{-9} on the branching fraction of K_{L}→π^{0}νν[over ¯] at the 90% confidence level.

We report the first search for the KL→π0γ decay, which is forbidden by Lorentz invariance, using the data from 2016 to 2018 at the J-PARC KOTO experiment. With a single event sensitivity of (7.1±0.3stat±1.6syst)×10−8, no candidate event was observed in the signal region. The upper limit on the branching fraction was set to be 1.7×10−7 at the 90% confidence level.

Background Artemisia scoparia Waldst. et Kitaib (AS) (Oriental wormwood, known as Bissuk in Korea) is a plant used in cosmetic and pharmaceutical treatments. However, the effect of AS on atopic dermatitis (AD) has not been described. Aim To examine the inhibitory effect of AS on AD using a murine model. Methods We applied either AS, the butanol-extracted fraction of AS (Bu-OH) or 3,5-dicaffeoyl-epi-quinic acid (DEQA, a major component of Bu-OH) topically for 3 weeks to 2,4-dinitrofluorobenzene (DNFB)-induced skin lesions in BALB/c mice. Results AS, Bu-OH and DEQA suppressed the clinical symptoms of DNFB-induced skin lesions and he associated scratching behaviour. Numbers of inflammatory cells infiltrating skin lesions were significantly reduced by AS or Bu-OH application but not by DEQA. In addition, AS significantly suppressed serum levels of histamine and IgE, while Bu-OH significantly suppressed serum levels of histamine, IgE, thymic stromal lymphopoietin (TSLP), interleukin (IL)-4 and IL-6, and DEQA significantly suppressed serum levels of histamine, IgE, TSLP and IL-4 in DNFB-induced AD mice. In skin lesions, AS and Bu-OH significantly reduced inflammatory cytokines, whereas DEQA did not. AS, Bu-OH and DEQA all significantly suppressed caspase-1 activities. Conclusions These results demonstrate the anti-AD effects of AS, Bu-OH and DEQA, and suggest that all three have therapeutic potential.

Physical aggression (PA) is important to regulate as early as the preschool years in order to ensure healthy development of children. This study aims to determine the prevalence and characteristics of PA in children of immigrant and non-immigrant mothers. Secondary data analysis was conducted using the nationwide 2010 Survey for Young Canadians, limited to children 4-9 years of age. Bivariate and multivariable logistic regression was performed, with the outcome, PA, and covariates including maternal, child, household and neighbourhood characteristics. Twenty percent of children of non-immigrant mothers and 16% of children of immigrant mothers reported PA. The only common characteristic of PA between children of non-immigrant (Adj OR 1.44, 95% CI 1.09-1.89) and immigrant mothers (Adj OR 2.08, 95% CI 1.07-4.03) was viewing violent movies/shows. The characteristics of PA differ between children of immigrant versus non-immigrant mothers therefore healthcare providers, policy makers, and researchers should be mindful to address PA in these two groups separately, and find ways to tailor current recommended coping strategies and teach children alternative ways to solve problems based on their needs.

Behavioural problems in the first five years of life can lead to long-term problems and may have adverse effects on families, school, and the child’s well-being. The objective was to investigate three comprehensive models to explore the pathways that lead to behavioural problems in children of teen, middle age, and advanced age mothers in Canada. This was based on the analysis of the National Longitudinal Survey of Children and Youth. Mothers were grouped into: teen (15–19 years), middle age (20–34 years), and advanced age (35+ years). Using Bronfenbrenner’s theoretical framework, behavioural problems were the outcome measured when the child became 4–5 years old. The predictors examined when the child was 0–1-year-old, and 2–3 years old and were fitted within the systemic levels of the framework. Structural equation modeling was performed separately for each age group. A total of 4787 mothers were analyzed. In all models, neighbourhood quality significantly predicted socioeconomic status (SES), and SES significantly predicted depression. In the teen mother group, only greater depression significantly predicted greater behavioural problems for the child (p = 0.038). In the middle age group, greater depression significantly predicted greater child behavioural problems (p

The elastic scattering process for the nuclear reactions induced by the Radioactive Ion Beams Be-7 and B-8 on a Pb-208 target was measured for the first time in the energy range around the Coulomb barrier. Extensive theoretical calculations within the framework of the optical model were performed. An excellent agreement between experimental data and theoretical predictions was achieved for the reaction Be-7 + Pb-208 while a comprehensive understanding of the reaction dynamics induced by the more exotic projectile B-8 is still far to be reached. Predictions of the cross section for the breakup for both systems will also be given.

Funding Acknowledgements This study was supported by the grant of CJ healthcare 2016 research fund. Background Liver cirrhosis (LC) has been known to affect cardiovascular performance. Limited study have evaluated the alteration of myocardial function in patients with LC after liver transplantation (LT). Purpose The aim of study was to evaluate changes of cardiac function in patients with cirrhosis following LT using conventional and speckle-tracking echocardiography and late gadolinium enhancement (LGE) of cardiac magnetic resonance (MR). Methods Thirty-five patients with cirrhosis (mean age, 57.1 ± 9.0; male, 75%) who were listed for LT were prospectively enrolled. Patients underwent conventional, speckle-tracking echocardiography, and cardiac MR imaging with LGE. Echocardiography and cardiac MR were performed at pre and 1 year after LT. Cirrhotic patients were compared with normal control (n = 20, mean age, 65.0 ± 14.8; men, 11(55%)) and echocardiographic and cardiac MR data were compared pre and post LT. Results Conventional and speckle-tracking echocardiography and Cardiac MR imaging demonstrated hyperdynamic left ventricular (LV) function in patients with cirrhosis (LV ejection fraction (EF) with cardiac MR 67.8 ± 7.0% in LC vs. 63.4 ± 6.4% in control, P = 0.028; global longitudinal strain (GLS) -24.3 ± 2.6% in LC vs. -18.6 ± 2.2% in control, P 0.1). Corrected QT interval (QTc) in electrocardiogram was prolonged in LC patients (P Conclusions The present study demonstrated that cirrhotic patients showed hyperdynamic circulation and prolonged QTc interval compared with normal controls. After 1 year LT, LV size reduced and augmented LV function was normalized. Given that no LGE in cardiac MR and normalized GLS and QTc after LT, cardiac dysfunction in LC patients could be reversed by LT.

ObjectivesVitamin E is a lipid-soluble antioxidant that can inhibit lipid oxidation and improve beef color stability. The effect of vitamin E on fresh beef color, from the standpoint of lipid oxidation-induced myoglobin oxidation, have been extensively studied. However, the influence of vitamin E on sarcoplasmic proteome profile of beef skeletal muscles is yet to be investigated. Therefore, the objective of this study was to examine the effect of dietary vitamin E on sarcoplasmic proteome of postmortem beef longissimus lumborum (LL) muscle.Materials and MethodsCrossbred heifers, managed with a GrowSafe feeding system, were fed ad libitum corn-based diet containing either no supplemental (CONT) or 1000 IU vitamin E/heifer per day (VITE) for 89 d. The animals were harvested, and carcasses were chilled. The LL muscle samples were obtained from the carcasses of nine (n = 9) VITE and nine (n = 9) CONT heifers 24 h postmortem. The muscle samples were individually vacuum-packaged and frozen at –80°C for proteome analysis. Sarcoplasmic proteome was analyzed using two-dimensional electrophoresis, employing immobilized pH gradient strips (pH 3–10; 17 cm) in the first dimension and 12% sodium dodecyl sulfate polyacrylamide gel electrophoresis in the second dimension. The gels were scanned, and the digital gel images were analyzed. The protein spots exhibiting more than 1.5-fold intensity differences (P < 0.10) between VITE and CONT were subjected to in-gel tryptic digestion and were identified by tandem mass spectrometry.ResultsFive differentially abundant spots were identified using mass spectrometry, and all the spots were over-abundant in CONT. The proteins in the differentially abundant spots were antioxidant proteins (thioredoxin-dependent peroxide reductase, peroxiredoxin-6, and serum albumin) and glycolytic enzymes (β-enolase and triosephosphate isomerase). The antioxidant proteins minimize oxidation of lipids and proteins in muscle matrix, whereas the glycolytic enzymes generate NADPH, which helps maintain the antioxidant proteins in their reduced forms.ConclusionThe strong antioxidant protection offered by vitamin E could have possibly led to less expression of antioxidant proteins as well as glycolytic enzymes that generate antioxidant metabolites in the VITE group, whereas the lack of such protection in CONT group may have led to increased expression of these proteins in the skeletal muscles.

Benefits of Internet use for older adults include the ability to access informational resources, facilitate social connections and use online communication resources. Further research on identifying the characteristics of older adult Internet non-users is warranted. The present study aims to examine the prevalence and characteristics of Internet non-use among Canada’s older adult populations. The analysis was based on the 2016 General Social Survey (GSS)– Canadians at Work and Home. Analysis was restricted to Canadians of 65 years of age or older. The outcome was Internet non-use, which was defined as having not used the Internet in the 30-day period prior to survey data collection. Demographic, socio-economic, health related, and social support and relationship factors were considered for a multivariable logistic regression analysis. Overall, the prevalence of Internet non-use among Canadian older adults was 31.9%. Characteristics significantly associated with Internet non-use included: lower educational achievement, decreased socioeconomic status, poor mental and physical health, having a partner / significant other, and being a cigarette smoker. The province of residence was significantly associated with non-internet use with residents of Quebec being at increased odds of non-internet use compared to residents of British Columbia (OR =2.09, 95% CI= 1.51-2.88). Additionally, increased age among older adults was associated with increased likelihood of not using the Internet. The findings from this study can be used as the basis for future research and to aid in the development of effective policies and programs directed towards the needs of this unique population.

Aims Advances in arthroscopic techniques for rotator cuff repair have made the mini-open approach less popular. However, the mini-open approach remains an important technique for repair for many surgeons. The aims of this study were to compare the integrity of the repair, the function of the shoulder and satisfaction post-operatively using these two techniques in patients aged > 50 years. Patients and Methods We identified 22 patients treated with mini-open and 128 patients treated with arthroscopic rotator cuff repair of July 2007 and June 2011. The mean follow-up was two years (1 to 5). Outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) scores, and satisfaction. The integrity of the repair was assessed using ultrasonography. A power analysis ensured sufficient enrolment. Results There was no statistically significant difference between the age, function, satisfaction, or pain scores (p > 0.05) of the two groups. The integrity of the repair and the mean SST scores were significantly better in the mini-open group (91% of mini-open repairs were intact versus 60% of arthroscopic repairs, p = 0.023; mean SST score 10.9 (standard deviation (sd) 1.3) in the mini-open group; 8.9 (sd 3.5) in arthroscopic group; p = 0.003). The ASES scores were also higher in the mini-open group (mean ASES score 91.0 (sd 10.5) in mini-open group; mean 82.70 (sd 19.8) in the arthroscopic group; p = 0.048). Conclusion The integrity of the repair and function of the shoulder were better after a mini-open repair than after arthroscopic repair of a rotator cuff tear in these patients. The functional difference did not translate into a difference in satisfaction. Mini-open rotator cuff repair remains a useful technique despite advances in arthroscopy. Cite this article: Bone Joint J 2017;99-B:245–9.

In humans, the composition of gut commensal bacteria is closely correlated with obesity. The bacteria modulate metabolites and influence host immunity. In this study, we attempted to determine whether there is a direct correlation between specific commensal bacteria and host metabolism. As mice aged, we found significantly reduced body weight and fat mass in Atg7ΔCD11c mice when compared with Atg7f/f mice. When mice shared commensal bacteria by co-housing or feces transfer experiments, body weight and fat mass were similar in both mouse groups. By pyrosequencing analysis, Bacteroides acidifaciens (BA) was significantly increased in feces of Atg7ΔCD11c mice compared with those of control Atg7f/f mice. Wild-type C57BL/6 (B6) mice fed with BA were significantly more likely to gain less weight and fat mass than mice fed with PBS. Of note, the expression level of peroxisome proliferator-activated receptor alpha (PPARα) was consistently increased in the adipose tissues of Atg7ΔCD11c mice, B6 mice transferred with fecal microbiota of Atg7ΔCD11c mice, and BA-fed B6 mice. Furthermore, B6 mice fed with BA showed elevated insulin levels in serum, accompanied by increased serum glucagon-like peptide-1 and decreased intestinal dipeptidyl peptidase-4. These finding suggest that BA may have potential for treatment of metabolic diseases such as diabetes and obesity.

Noninvasive fat reduction is claimed by many device manufacturers, but proof of efficacy has been difficult to establish. This prospective study was designed to measure the reduction of fat thickness and actual volume reduction in 20 female patients treated with an external radiofrequency (RF) device. This device combines RF heat, suction coupled vacuum, and oscillating electrical pulses that induce adipocyte death over time. Patients underwent pre- and post-treatment and intercurrent measurements of weight, body mass index, ultrasonic transcutaneous fat thickness, and 2D and 3D Vectra photography with independent calculation of circumferential and volumetric change. Mean transcutaneous ultrasound thickness at reproducible points was 2.78 cm; at 1-month post-treatment, the mean fat thickness was 1.71 cm. At 3-month post-treatment, the mean fat thickness reduction was 39.6%. Vectra circumference measurements were taken at 10-mm intervals, with postural and breathing cycle control. Independent analysis of serial measurements from + 60 to - 70 mm showed mean abdominal circumference measurement of 2.3 cm. Mean abdominal volume loss was 202.4 and 428.5 cc at 1- and 3-month post-treatment, respectively. Scanning electron microscopy confirmed that permanent cell destruction was caused by irreversible electroporation. Pyroptosis appears to be the mechanism of action.

To date, there have been no objective measurements of subcutaneous volume loss following treatments with a noninvasive radiofrequency (RF)-based device. Twenty female patients were treated with a suction-coupled bipolar RF device using external RF energy combined with pulsed electromagnetic RF energy for subcutaneous fat reduction. Parameters followed included weight, Vectra measurements of abdominal circumference and torso volume, and high-definition ultrasound measurements of fat thickness. Measurements were taken before treatment and three times following treatment. Analysis of the measured parameters showed that mean circumference reduction of 2.30 cm was noted at three months post-treatment. Independent volumetric analysis showed a mean subcutaneous volume reduction of 428 cc three months following RF treatment. High-resolution ultrasound fat thickness was reduced by a mean of 39.6% three months following the final BodyFX treatment. Independent and paired-sample t-tests showed a p value of < 0.05. Repeated measures of analysis of covariance (ANCOVA) adjusted for differences in age, as well as height and weight (proxy for body mass index) to minimize individual differences and control for extraneous variables that may affect the pre- and post-treatment results were analyzed. No confounding variables were found. All analyses were conducted using IBM SPSS 21.0.

We report the performance of a new scintillator array Downstream Charged Veto (DCV) for the J-PARC KOTO experiment to suppress the K L → π + π − π 0 decay background. Since the background originates from undetected charged pions passing through the beam hole of the electromagnetic calorimeter, the DCV detector was installed in vacuum downstream of the calorimeter. The DCV is composed of two plastic scintillator pipes read out by Multi Pixel Photon Counters through wavelength shifting fibers. The light yield was found to be 60 photoelectrons/0.8 MeV in a test bench when cosmic-rays pass through the center of the DCV. Energy calibration was performed using cosmic-rays after installation.

KEY POINTS Much of the previously published theories and evidence supporting patient engagement in research has focused on improving engagement in individuals with chronic disease who are participating in treatment interventions.[1][1]–[3][2] Less is known about engaging parents as “patient

Objective To describe obstetrical and neonatal outcomes including neonatal abstinence syndrome (NAS) in a Canadian cohort of methadone-maintained pregnant women. Methods We conducted a retrospective chart review at three integrated care programs in Vancouver, Toronto, and Montreal. Pregnant women on methadone maintenance treatment (MMT) who attended for care between 1997 and 2009 were included in this multisite study. Maternal and neonatal outcomes in each of the three contributing centres were compared. Results A total of 94 pregnant methadone-maintained women were included in the final analysis: 36 from Toronto, 36 from Vancouver, and 22 from Montreal. Maternal demographics showed inter-site differences in ethnicity and marital status. Obstetrical complications were not frequent; the most frequent was antenatal hemorrhage, which occurred in 14% of the total cohort. The incidence of premature labour was significantly higher in Vancouver and Montreal than in Toronto. The mean gestational age at delivery for the entire cohort was 38weeks; mean birth weight was 2856 grams. The average length of hospital stay for babies with NAS was 19days, with 27% of neonates requiring pharmacological treatment for NAS. Approximately 60% of neonates were discharged from hospital to the care of their mother. Conclusion Integrated care programs resulted in satisfactory obstetrical and neonatal outcomes for pregnant women on MMT. Policies promoting maternal–newborn contact, rooming-in, and breastfeeding may help to decrease the severity of NAS and the need for pharmacological treatment of NAS. We strongly recommend the development of similar programs across Canada to address gaps in services.

Background Positive-interaction parenting early in childhood is encouraged due to its association with behavioural development later in life. The objective of this study was to examine if the level of positive-interaction parenting style differs among teen, optimal age, and advanced age mothers in Canada, and to identify the characteristics associated with positive-interaction parenting style separately for each age group. Methods This was a cross-sectional secondary analysis of the National Longitudinal Survey of Children and Youth. First-time mothers with children 0–23 months were grouped into: teen (15–19 years, N = 53,409), optimal age (20–34 years, N = 790,960), and advanced age (35 years and older, N = 106,536). The outcome was positive-interaction parenting style (Parenting Practices Scale); maternal socio-demographics, health, social, and child characteristics were considered for backward stepwise multiple linear regression modeling, stratified for each of the age groups. Results Teen, optimal age, and advanced age mothers reported similar levels of positive- interaction parenting style. Covariates differed across the three age groups. Among optimal age mothers, being an ever-landed immigrant, childcare use, and being devoted to religion were found to decrease positive-interaction parenting style, whereas, higher education was found to increase positive-interaction parenting style. Teen mothers were not found to have any characteristics uniquely associated with positive-interaction parenting. Among advanced age mothers, social support was uniquely associated with an increase in positive-interaction parenting. Very good/excellent health was found to be positively associated with parenting in teens but negatively associated with parenting in advanced age mothers. Conclusion Characteristics associated with positive-interaction parenting varied among the three age groups. Findings may have public health implications through information dissemination to first-time mothers, clinicians, researchers, and public health facilities.

Background Anthropometric data and dietary intake pattern are poorly known in Asian inflammatory bowel disease (IBD) patients. The aim of this study was to investigate the nutritional status and nutrient intake of IBD patients compared with control population. Methods From February to June 2018, a total of 65 outpatients, including 33 ulcerative colitis (UC) and 32 Crohn’s disease (CD) were prospectively enrolled in Gangnam Severance Hospital. As a control group, age- and gender-matched 260 subjects were included among the Korean National Health and Nutrition Examination Survey (KNHANES) data. Anthropometry and body composition data were collected by bioelectrical impedance analysis(BIA); meanwhile, nutrient intake was measured based on diet diary. Results Based on Asia Pacific criteria, more than half of both UC and control group were obese or overweight, on the other hands, CD was relatively low, about 1/3. Compared with the UC group, body fat index including both fat mass index (FMI) and body fat percentage (BFP) were significantly lower in the CD group. Following nutrients intake including intake of energy, carbohydrate, niacin, sodium and potassium were significantly lower in UC than the control group. Meanwhile, intake of carbohydrate, thiamine, niacin, sodium, potassium and iron was significantly lower in CD than the control group. In addition, the ratio of energy intake through protein and fat was significantly higher in the IBD than the control group. Conclusion Similar to the control group, more than half of UC patients were overweight or obesity, meanwhile, the proportion of obese patients in CD was lower than in the control group. The ratio of energy intake through protein and fat was significantly higher in IBD than in the control group. Our results may have clinical implications for risk of IBD development in terms of dietary pattern and further direction of nutritional intervention.

Ractopamine is a beta-adrenergic agonist that is approved for use in beef cattle, pigs and turkeys as a repartitioning agent to increase lean muscle deposition and decrease lipogenesis. Although the effects of dietary ractopamine on the proteome profile of post-mortem pork muscles have been examined, its influence on beef muscle proteome has not been studied. Therefore, the objective of this study was to examine the effect of ractopamine on the proteome profile of post-mortem beef longissimus lumborum (LL) muscle. LL muscle samples were obtained from the carcasses of six (n = 6) steers fed ractopamine (RAC; 400 mg ractopamine hydrochloride for 28 days) and six (n = 6) steers fed no ractopamine (CON). The muscle proteome was analysed using two-dimensional gel electrophoresis and tandem mass spectrometry. Five differentially abundant spots were identified, and all the spots were over-abundant in RAC. The identified proteins were involved in muscle structure development (F-actin-capping protein subunit beta-2; PDZ and LIM domain protein-3), chaperone activity (heat shock protein beta-1), oxygen transport (myoglobin), and glycolysis (L-lactate dehydrogenase A chain). These results suggested that dietary ractopamine could influence the abundance of enzymes associated with muscle development and muscle fibre type shift in beef LL muscle. Keywords: growth promotants, meat quality, proteomics