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Abstract Background Healthcare providers play important roles in supporting breastfeeding. Although there has been insufficient actual breastfeeding support from healthcare providers in China, little research has been conducted to understand Chinese healthcare providers’ perceived barriers to providing breastfeeding support, especially in rural China. This study aims to identify these perceived barriers to providing breastfeeding support in Northwestern rural China. Methods This study was conducted during the period from March 2018 to December 2018. Forty-one healthcare providers were recruited through purposive sampling in two rural counties in Northwest China that are in close proximity to each other and share similar demographic features. Participants included obstetrician-gynecologists, midwives, nurses, “village doctors”, and township and village maternal and child health workers. Qualitative data were collected through one-on-one in-depth semi-structured interviews and focus group discussions. Transcripts were thematically analyzed. Results Analysis of interview data resulted in four themes that the participants perceived as barriers to supporting breastfeeding: (1) lack of medical resources, within which inadequate staffing, and lack of financial incentives were discussed, (2) lack of clear and specific responsibility assignment, within which no one takes the lead, and mutual buck-passing were discussed, (3) healthcare providers’ lack of relevant expertise, within which lack of knowledge and skills, and low prestige of village healthcare providers were discussed, (4) difficulties in accessing mothers, within which medical equipment shortages reduce services utilization, mothers’ housing situation, mothers’ mobility, and cultural barriers were discussed. Conclusions The study identified HCPs perceived barriers to providing breastfeeding support. Unique to China’s Tri-Level Healthcare System, challenges like staffing and financial incentives are hard to swiftly tackle. Recommendations include mHealth enhancement and clarified responsibilities with incentives and tailored training. Further research is crucial to evaluate these strategies in rural Northwestern China and comparable underdeveloped areas nationwide.

Objective To investigate the clinical outcome of 9 very preterm infants with bronchopulmonary dysplasia (BPD)-associated pulmonary hypertension (PH) and patent ductus arteriosus (PDA) after PDA ligation. Methods A retrospective analysis was performed for the clinical data of 9 very preterm infants with BPD-associated PH and PDA, and all infants underwent PDA ligation and were followed up regularly after surgery. Results After surgical treatment, 7 infants had normal pulmonary artery pressure and were discharged after successful ventilator weaning, and all these infants were regularly followed up to June 2022 at the outpatient service, among whom the oldest infant was aged 4 years; echocardiography showed that all infants had normal heart structure and function, pulmonary artery pressure, and growth and development, without recurrent respiratory infection. Two infants died. Conclusion Very preterm infants with BPD-associated PH and PDA often have critical situations, and in case of failed pharmacotherapy, timely PDA ligation is an important method to improve prognosis.

ABSTRACTWhite tea (Camillia sinensis L.) is the least processed tea, and due to simpler processing steps involved, its flavor and nutritive compound composition is least disturbed. However, only a limited number of research has explored the key metabolomic changes during white tea processing (especially drying). The freshly harvested leaves of C. sinensis var. Tieguanyin were initially withered at room temperature for 72 h, and first-dried on fire at 70°C for 3 h. Then, they were spread at room temperature for 7 days and fully dried at 80°C for 4 h, followed by cooled at room temperature. The metabolome of the tea leaves before (CK) and after full drying (RO) were compared using UPLC-MS/MS. The LC-MS/MS analysis identified 1,253 compounds belonging to 11 classes. The highest number of accumulated compounds belonged to flavonoids, phenolic acids, and lipids. Of the 57 differentially accumulated metabolites (DAMs), 49 were up-accumulated in RO. These were classified as amino acids derivatives, lipids, organic acids, vitamins, alkaloids, nucleotides and derivatives, flavonoids, tannins, terpenoids, lignans and coumarins. We found that several health beneficial compounds showed up-accumulation in RO compared to CK. We concluded that Hot-air full drying alters white team metabolome composition.

The neutron reference radiation field of different components is the basic condition for the performance test of neutron shielding materials. In order to obtain an ideal neutron field for neutron protection material testing, a multi sphere energy spectrum measurement system based on 3He tube was constructed. The neutron radiation field slowing down condition based on 241Am-Be and 252Cf neutron sources was simulated and the energy spectrum was measured. In order to accurately judge the neutron scattering at the calibration reference position of the laboratory, the neutron scattering component measurement was carried out based on the multi sphere neutron spectrum measurement system. The dose rate conversion of the energy spectrum was carried out using the dose dose conversion coefficient recommended by ICRP. Compared with the results of the long counter, it was found that the deviation of the dose rate at the calibration position was not more than 20%. The experimental study on obtaining specific energy spectrum of polyethylene moderated isotope neutron source was carried out. The simulated calculation and experimental measurement of moderated spectrum were carried out, and the results were in good agreement. This work provides a useful neutron radiation field for the subsequent neutron metrology test and neutron protection material test.

Objective To investigate the clinical features of neonates with enterovirus encephalitis, and to prevent the outbreak of enterovirus infection by improving the early identification of this disease. Methods A total of 12 neonates with enterovirus encephalitis who were admitted to our hospital from June 2019 to June 2022 were enrolled and analyzed in terms of clinical features and laboratory examination. The key points of treatment were summarized, and their prognosis was assessed. ResultsAmong the 12 neonates, 7 were preterm infants, with the clinical manifestations of nonspecific sepsis-like symptoms and normal or mildly elevated inflammatory markers. All neonates tested positive for enterovirus nucleic acid in cerebrospinal fluid. All neonates were given standard isolation, intravenous injection of human immunoglobulin, and symptomatic supportive treatment and achieved a good prognosis after treatment. Conclusion Neonates with enterovirus encephalitis often have atypical clinical manifestations and thus require early identification and targeted strategies for the prevention and control of infection.

Summary: Studies have reported inconsistent results about the risk of incident chronic kidney disease (CKD) in people with metabolically healthy obesity (MHO). We designed this systematic review and meta‐analysis to evaluate the risk of developing CKD in people with MHO and metabolically unhealthy normal weight (MUNW). We used a predefined search strategy to retrieve eligible studies from multiple databases up to June 20, 2022. Random‐effects model meta‐analyses were implied to estimate the overall hazard ratio (HR) of incident CKD in obesity phenotypes. Eight prospective cohort studies, including approximately 5 million participants with a median follow‐up ranging between 3 and 14 years, were included in this meta‐analysis. Compared to the metabolically healthy normal weight (MHNW), the mean differences in cardiometabolic and renal risk factors in MHO, MUNW, and metabolically unhealthy obesity (MUO) were evaluated with overall HR of 1.42, 1.49, and 1.84, respectively. Compared to MHNW, the mean estimated glomerular filtration rate (eGFR) and high‐density lipoprotein (HDL) were significantly lower, and low‐density lipoprotein (LDL), blood pressure, blood glucose, and triglycerides were higher in MHO and MUNW. In conclusion, MHO and MUNW are not benign conditions and pose a higher risk for incident CKD. Obesity, whether in the presence or absence of metabolic health, is a risk factor for CKD. [ABSTRACT FROM AUTHOR]

Metabolically healthy or unhealthy obesity is closely related to metabolic syndrome (MetS). To validate a more accurate diagnostic method for obesity that reflects the risk of metabolic disorders in a pre‐clinical mouse model, C57BL/6J mice were fed high‐sucrose–high‐fat and chow diets for 12 weeks to induce obesity. MRI was performed and analysed by chemical shift‐encoded fat–water separation based on the transition region extraction method. Abdominal fat was divided into upper and lower abdominal regions at the horizontal lower border of the liver. Blood samples were collected, and the glucose level, lipid profile, liver function, HbA1c and insulin were tested. k‐means clustering and stepwise logistic regression were applied to validate the diagnosis of hyperglycaemia, dyslipidaemia and MetS, and to ascertain the predictive effect of MRI‐derived parameters to the metabolic disorders. Pearson or Spearman correlation was used to assess the relationship between MRI‐derived parameters and metabolic traits. The receiver‐operating characteristic curve was used to evaluate the diagnostic effect of each logistic regression model. A two‐sided p value less than 0.05 was considered to indicate statistical significance for all tests. We made the precise diagnosis of obesity, dyslipidaemia, hyperglycaemia and MetS in mice. In all, 14 mice could be diagnosed as having MetS, and the levels of body weight, HbA1c, triglyceride, total cholesterol and low‐density lipoprotein cholesterol were significantly higher than in the normal group. Upper abdominal fat better predicted dyslipidaemia (odds ratio, OR = 2.673; area under the receiver‐operating characteristic curve, AUCROC = 0.9153) and hyperglycaemia (OR = 2.456; AUCROC = 0.9454), and the abdominal visceral adipose tissue (VAT) was better for predicting MetS risk (OR = 1.187; AUCROC = 0.9619). We identified the predictive effect of fat volume and distribution in dyslipidaemia, hyperglycaemia and MetS. The upper abdominal fat played a better predictive role for the risk of dyslipidaemia and hyperglycaemia, and the abdominal VAT played a better predictive role for the risk of MetS. [ABSTRACT FROM AUTHOR]

Background: Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. Methods: We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses. Results: This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I–III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P= 0.001) and 5-year OS (χ2 = 5.225, P= 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P= 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P= 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant differences in either 5-year DFS (χ2 = 0.440, P= 0.507) or 5-year OS (χ2 = 1.530, P= 0.216). Conclusions: The prognostic staging system proposed in the AJCC 8th edition refines the anatomic stage group in Luminal B HER2-negative breast cancer and will lead to a more personalized approach to breast cancer treatment.

Nosema ceranae (Opisthosporidia: Microsporidia) is an emergent intracellular parasite of the European honey bee (Apis mellifera) and causes serious Nosema disease which has been associated with worldwide honey bee colony losses. The only registered treatment for Nosema disease is fumagillin-b, and this has raised concerns about resistance and off-target effects. Fumagillin-B is banned from use in honey bee colonies in many countries, particularly in Europe. As a result, there is an urgent need for new and effective therapeutic options to treat Nosema disease in honey bees. An RNA interference (RNAi)-based approach can be a potent strategy for controlling diseases in honey bees. We explored the therapeutic potential of silencing the sequences of two N. ceranae encoded spore wall protein (SWP) genes by means of the RNAi-based methodology. Our study revealed that the oral ingestion of dsRNAs corresponding to SWP8 and SWP12 used separately or in combination could lead to a significant reduction in spore load, improve immunity, and extend the lifespan of N. ceranae-infected bees. The results from the work completed here enhance our understanding of honey bee host responses to microsporidia infection and highlight that RNAi-based therapeutics are a promising treatment for honey bee diseases.

It has become increasingly clear that gut bacteria play vital roles in the development, nutrition, immunity, and overall fitness of their eukaryotic hosts. We conducted the present study to investigate the effects of gut microbiota disruption on the honey bee's immune responses to infection by the microsporidian parasite Nosema ceranae. Newly emerged adult workers were collected and divided into four groups: Group I-no treatment; Group II-inoculated with N. ceranae, Group III-antibiotic treatment, and Group IV-antibiotic treatment after inoculation with N. ceranae. Our study showed that Nosema infection did not cause obvious disruption of the gut bacterial community as there was no significant difference in the density and composition of gut bacteria between Group I and Group II. However, the elimination of gut bacteria by antibiotic (Groups III and IV) negatively impacted the functioning of the honey bees' immune system as evidenced by the expression of genes encoding antimicrobial peptides abaecin, defensin1, and hymenoptaecin that showed the following ranking: Group I > Group II > Group III > Group IV. In addition, significantly higher Nosema levels were observed in Group IV than in Group II, suggesting that eliminating gut bacteria weakened immune function and made honey bees more susceptible to Nosema infection. Based on Group IV having displayed the highest mortality rate among the four experimental groups indicates that antibiotic treatment in combination with stress, associated with Nosema infection, significantly and negatively impacts honey bee survival. The present study adds new evidence that antibiotic treatment not only leads to the complex problem of antibiotic resistance but can impact honey bee disease resistance. Further studies aimed at specific components of the gut bacterial community will provide new insights into the roles of specific bacteria and possibly new approaches to improving bee health.

Background Fluorescent detection methods are indispensable tools for chemical biology. However, the frequent appearance of potential fluorescent compound has greatly interfered with the recognition of compounds with genuine activity. Such fluorescence interference is especially difficult to identify as it is reproducible and possesses concentration-dependent characteristic. Therefore, the development of a credible screening tool to detect fluorescent compounds from chemical libraries is urgently needed in early stages of drug discovery. Results In this study, we developed a webserver ChemFLuo for fluorescent compound detection, based on two large and high-quality training datasets containing 4906 blue and 8632 green fluorescent compounds. These molecules were used to construct a group of prediction models based on the combination of three machine learning algorithms and seven types of molecular representations. The best blue fluorescence prediction model achieved with balanced accuracy (BA) = 0.858 and area under the receiver operating characteristic curve (AUC) = 0.931 for the validation set, and BA = 0.823 and AUC = 0.903 for the test set. The best green fluorescence prediction model achieved the prediction accuracy with BA = 0.810 and AUC = 0.887 for the validation set, and BA = 0.771 and AUC = 0.852 for the test set. Besides prediction model, 22 blue and 16 green representative fluorescent substructures were summarized for the screening of potential fluorescent compounds. The comparison with other fluorescence detection tools and theapplication to external validation sets and large molecule libraries have demonstrated the reliability of prediction model for fluorescent compound detection. Conclusion ChemFLuo is a public webserver to filter out compounds with undesirable fluorescent properties, which will benefit the design of high-quality chemical libraries for drug discovery. It is freely available at http://admet.scbdd.com/chemfluo/index/. [ABSTRACT FROM AUTHOR]

This study investigates the effects of family structure on status attainment using data from the National Survey of Families and Households. The findings show that living in a mother-only or mother/stepfather family lowers a child's socioeconomic attainment. Changing from a two-biological-parent family to a mother-only family lowers attainment as does change from a mother-only to a mother/stepfather family.