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BACKGROUND AND OBJECTIVES: Falling asleep while feeding (FAF) infants is common. Our primary objectives were to examine (1) maternally reported prevalence of FAF and if planned; (2) association between FAF and sociodemographic factors, feeding method, and sleep location; and (3) if receipt of education about safe sleep and bedsharing risks was associated with FAF. METHODS: In the Social Media and Risk-reduction Training study, US mothers of newborns were randomized to educational messaging promoting infant safe sleep or breastfeeding. We analyzed data from 1259 mothers who responded to the postpartum survey (mean infant age, 11.2 weeks). We used generalized estimating equation logistic regression models to examine the extent that sociodemographic characteristics, feeding type, usual nighttime feeding location, and intervention group were associated with FAF. RESULTS: A total of 28.2% of mothers reported FAF usually or sometimes in the last 2 weeks, 83.4% of whom reported that FAF was unplanned. There were no differences in the odds of FAF by sociodemographic factors. Compared with mothers whose nighttime feeding location was their bed, mothers who reported feeding in a chair were less likely to FAF (33.6% versus 16.8%; adjusted odds ratio, 0.41; 95% confidence interval, 0.31-0.56). FAF was reported less frequently by mothers who received safe sleep interventions (15.6%), compared with mothers who received breastfeeding interventions (33.0%; adjusted odds ratio, 0.40; 95% confidence interval, 0.25-0.65). CONCLUSIONS: FAF is reported commonly among US mothers and is predominantly unplanned. Mothers who received safe sleep messaging were less likely to report FAF. New parents need guidance on planning for optimal safety during infant feeding. [ABSTRACT FROM AUTHOR]

This systematic review evaluates studies focusing on parenting and feeding practices, children's feeding behavior, and growth stunting in Asian countries. Eight electronic databases were searched to screen studies published between Jan 2015 and May 2021. There were contradictory findings related to gender differences in growth stunting and factors that reinforce/facilitate or inhibit acquisition of optimum growth in children. Theme of parenting practices showed that time spent on childcare, traditional beliefs about child-care feeding and responsive feeding were also contributing factors. Amidst economic improvement, political, social changes, and worldwide execution of various nutritional programs, stunting continues to be relentlessly persistent and widespread in Asia. Undernutrition disturbs areas of the mind involved in reasoning, reminiscence, locomotor skills and also an adverse influence on the physical and psychological growth of children and ensuing learning capabilities. Stunted children have more anxiety and depression and lower self-esteem than non-stunted children. A public health strategy is required to: (i) properly examine stunting with time through collaborated efforts of community members and various sectors, (ii) tackle malnutrition with steps to enhance maternal nutrition during pregnancy, infant feeding practices and (iii) involvement of effective multi-sectoral partnership programs for management of stunting. [ABSTRACT FROM AUTHOR]

The plastic nutritional foundations of growth and reproduction are crucial in mediating animal (insect) life histories but remain largely unexplored. Here, we investigate how the nutritional quality of dung during larval feeding affects subsequent (adult) life history traits of a coexisting guild of four closely related European sepsid dung fly species: Sepsis cynipsea (L.), Sepsis fulgens (Meigen), Sepsis punctum (Fabricius), and Sepsis thoracica (Robineau‐Desvoidy) (all Diptera: Sepsidae). Larvae were raised in standard cow dung, protein‐rich (yeast‐supplemented) dung, microbe‐depleted (autoclaved) dung, and in a combined treatment of autoclaved dung with yeast enrichment. Responses of egg‐to‐adult survival, total development time, final adult body size, and female reproductive potential in terms of age at first reproduction and offspring number were assessed. Overall survival was lower in autoclaved dung, but also tended to be reduced rather than enhanced by potentially artificial microbial additives such as supplemental yeast, which apparently cannot be metabolized effortlessly by the fly larvae. The only trait positively affected was adult body size, for which we observed an increase in three of four species when larvae were raised in yeast‐supplemented dung. Flies emerged smaller when reared in autoclaved dung, and the addition of yeast to autoclaved dung partly compensated the negative effect of autoclaving to result in a body size similar to control dung. Our results thus indicate that larval growth is likely reduced by autoclaving‐induced killing of nutritional microorganisms in the dung, which however may recolonize. Whereas for some model insects nutrition is well‐understood, more research is necessary to unravel the diverse effects of natural and artificial stressors on the nutrition of non‐model insects, such as these dung‐decomposing flies providing important ecosystem services in human‐mediated grasslands. [ABSTRACT FROM AUTHOR]

Background and aim: The burden of orofacial clefts (OFCs) has declined globally except in sub-Saharan Africa, with a great disease burden in North Africa. Children with OFCs have a high risk of malnutrition, and African countries have some of the highest malnutrition rates. This scoping review assessed the status of research on OFCs and nutrition and feeding among children living in African countries. Methods: We followed the Joanna Briggs Institute guidelines for conducting scoping reviews. We searched eleven databases for articles on malnutrition and feeding among children with OFCs living in African countries. No restriction was done by type of study or publication date. Books, book chapters, and reviews were excluded. Only publications in English language were included. We extracted information about the publication year, study design, setting, location, participants' age, data collection methods, international collaboration, and funding. We classified articles into studies assessing (1) the impact of nutritional deficiencies during pregnancy on OFCs, (2) the impact of OFCs on malnutrition, (3) feeding problems in children with OFCs, and (4) the impact of nutritional status on OFCs repair outcomes. We calculated frequencies and used bar charts and a map. Results: Out of 208 search results, 36 were duplicates, and 25 eventually fit the inclusion criteria, with 52% retrieved from Google Scholar. About 80% of the studies were from four countries: Nigeria, South Africa, Ghana, and Uganda; 72% were hospital-based and 52% were cross-sectional. The most frequent data collection method was clinical examination and questionnaires. Most studies focused on feeding problems in children with OFCs (44%) and the impact of OFCs on malnutrition (32%). International collaboration was observed in six studies, with one study showing South-South collaboration. Only two studies were funded. Conclusions: There is a predominance of under-funded descriptive research not indexed by international databases. Minimal research has been directed to population-level OFC preventive programs in primary healthcare settings and assessing interventions supporting children with OFCs. A research agenda is needed to prioritize research needs and secure funds to support South-South collaboration to address the nutrition and feeding-related problems associated with OFCs. [ABSTRACT FROM AUTHOR]

(1) Background: Creutzfeldt–Jakob disease (CJD) is a rare and fatal neurodegenerative disorder caused by the accumulation of an altered prion protein, which usually leads to death within one year after clinical onset. CJD patients usually present with rapid cognitive impairment associated with declines in cerebellar, motor, visual, behavioral, and swallowing functions. Moreover, CJD patients lose their ability to eat and take medications orally very early on in treatment; nevertheless, there are no specific nutritional guidelines for this disease shared worldwide. (2) Methods: This review aims to describe the nutritional outcomes of CJD patients in Western countries to compare them with those described in East Asian countries and then aims to explore the most recent trends in the nutritional management of CJD patients, including some dietary compounds that present neuroprotective effects. (3) Results: In Japan's, Taiwan's, and China's healthcare systems, CJD patients receive intensive life-sustaining treatment that prolongs their survival (i.e., artificial feeding); conversely, in Western countries, intensive life-sustaining treatments like tube feeding are not commonly provided to CJD patients. (4) Conclusions: It is difficult to pinpoint the reasons for these discrepancies around CJD palliative care supply, but it is clear that specific nutritional guidelines may directly improve the nutritional management of CJD patients and thus allow their families and caregivers to ensure the best end-of-life care for these patients. [ABSTRACT FROM AUTHOR]

Many autistic children display feeding difficulties and consume a limited food variety. These feeding difficulties could be conceptualized as change‐resistant behavior because children often exhibit rigid mealtime routines, avoid novel foods, and only consume foods according to specific types, textures, or under specific mealtime conditions. Currently, behavior‐analytic treatments for pediatric feeding disorders have the most empirical support and many studies have demonstrated the effectiveness of extinction‐based treatments. However, there is less research on alternative treatments for increasing consumption of novel or non‐preferred foods among children with autism spectrum disorder (ASD). In the current study, we evaluated simultaneous presentation and differential reinforcement to increase consumption of novel, target foods for two participants with ASD and change‐resistant feeding behavior. [ABSTRACT FROM AUTHOR]

Background/Objectives: Complementary feeding (CF), is defined as the process of providing foods in addition to milk when breast milk or milk formula alone are no longer adequate to meet nutritional requirements. CF affects not only growth but also the subsequent development of the child's dietary preferences. The Mediterranean diet (MedDiet) is one of the most studied dietary patterns worldwide. The main purpose of this article is to provide practical guidance for CF to caregivers introducing the Greek MedDiet, summarizing the current different approaches. The evidence-based information provided could be used by developers to create a reliable digital app for CF based on Mediterranean foods and traditional dishes. Methods: An in-depth literature review of the existing guidelines and recently published research data on CF using PubMed, national recommendations, and grey literature were undertaken. Results: Practical, simple, evidence-based, comprehensive tables are presented. The tables serve as a guide to simplify the process of introducing Mediterranean foods in CF. Τhe tables consist of a total of more than 90 foods and day-to-day guidance for the first 13 weeks of CF. Furthermore, specific dietary guidance and suggestions regarding the order and content of meals during CF are given. Discussion: The tables are based on updated recommendations, summarizing the optimal feeding practices in a MedDiet-based perspective. Conclusions: Conclusively, there are significant contradictions among different organizations that present practical issues and cause confusion among caregivers. An effort was carried out to provide practical evidence-based guidance for caregivers introducing MedDiet during CF. [ABSTRACT FROM AUTHOR]

ChatGPT uses a so called Large Language Model (LLM) to provide textual output of analyzed data. Those LLMs are one example for Generative Artificial Intelligence (AI), which focuses on creating new content, e.g., text, images, or music, based on learned patterns. Recently, applications in the food industry and agriculture started to apply Generative AI. This mini review provides an overview about applications of Generative AI in the agri-food supply chain and discusses open research challenges, also in combination with digital twins. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, many dairy sheep farms opt for milk replacers after birth. Weaning lambs from milk replacers is expected to be a stressful situation. Methods: With the aim of researching this practice on the animal behavior, body weight yields, and sanitary status of Lacaune lambs, 60 healthy animals from the same lambing house were employed. Lambs were housed in a pen and had ad libitum access to forage, compound feed, and milk replacers. During a 4  days preexperimental period in which all the animals were fed with milk replacers, behavior, hematologic parameters, body weight and seric and fecal stress indicators were recorded. Later, an experimental period took place in which 20  lambs remained in the same conditions. Another 20  lambs were kept in a separate pen in the same barn under the same conditions, but the artificial milk feeding was interrupted (weaning). The third 20  lambs were weaned and also rehoused in fattening pens. After 4  days, the variables previously recorded in the three groups during the pre-experimental period were recorded again. Results: Results showed that change of location and change of feed can have different and synergic effects on the behavior of the lambs. Change of feed had not specifically different effect on body weight than change of location. In the other hand, weaning had no significative effects on hematologic parameters and seric and fecal stress indicators. Discussion: Weaning from artificial milk had significative effects on lambs weight and behavior. More research is needed to improve this ethical aspect in ovine production. [ABSTRACT FROM AUTHOR]

Parenteral artificial nutrition (PAN) is a lifesaving medical treatment for many patients worldwide. Administration of the wrong PAN drug can lead to severe consequences on patients' health, including death in the worst cases. Thus, their correct identification, just before injection, is of crucial importance. Since most of these drugs appear as turbid liquids, they cannot be easily discriminated simply by means of basic optical analyses. To overcome this limitation, in this work, we demonstrate that the combination of speckle pattern (SP) imaging and artificial intelligence can provide precise classifications of commercial pharmaceutical suspensions for PAN. Towards this aim, we acquired SP images of each sample and extracted several statistical parameters from them. By training two machine learning algorithms (a Random Forest and a Multi-Layer Perceptron Network), we were able to identify the drugs with accurate performances. The novelty of this work lies in the smart combination of SP imaging and machine learning for realizing an optical sensing platform. For the first time, to our knowledge, this approach is exploited to identify PAN drugs. [ABSTRACT FROM AUTHOR]

Background: Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. Purpose: The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. Methods: This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. Findings: The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups (P < 0.05), and we also found an interaction effect between grouping and time factors (P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group (P < 0.05). Conclusion: PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium. [ABSTRACT FROM AUTHOR]

Maternal perceptions, about the nutritional status of their children, may have implications for timely health care seeking and feeding behaviour. Shreds of evidence are limited in this area that assessed maternal perception about the nutritional status of the children in the context of Bangladesh. The objective of this study is to assess the differences in mothers' perceptions about their children's nutritional status who are less than 5 years of age and their associated factors in the context of urban slum areas. A cross‐sectional study (Quantitative approach) was conducted in two of the largest urban slums of Dhaka city. A total of 437 mother–children dyads were included in the final analysis. The outcome of interest was the mother's 'varied perceptions' regarding the nutritional status of their children under five. 'Varied perception' refers to the difference between a mother's subjective assessment of her child's nutritional condition and the anthropometrically measured nutritional status. The prevalence of mother's varied perceptions was around 46%, and among them, 37% of mothers underestimated and 9% overestimated their child's nutritional status. 'The child doesn't want to eat' (AOR = 3.69; 95% CI: 2.34–5.85; p < 0.001) and 'Feels light when carried' (AOR = 3.39; 95% CI: 1.69–6.81; p = 0.001) were the significant reasons behind the mother's perception about the nutritional status of their under‐five children. About one in two mothers' perceptions about their children varied from the anthropometry‐derived status. Various research findings indicate that providing health education on proper feeding practices for children, along with anthropometric measurements, can assist mothers in enhancing their understanding and assessing their child's nutritional status with greater accuracy. Further qualitative research may be instrumental in getting deeper insights into maternal perception to develop context‐specific interventions. Key messages: The importance of mothers' awareness of their children's nutritional status cannot be overstated when it comes to both providing appropriate nourishment and promptly seeking health care for their children.Around half of the mothers misperceived their children's nutritional status, and among them, 37% underestimated their children's nutritional status.Children's feeding behaviour and weight of the child while carrying were the significant reasons behind their perceptionInitiatives directed towards prevention should take into account the significance of enhancing parental awareness regarding potential risks. This serves as an initial step in mitigating health hazards for children associated with malnutrition. [ABSTRACT FROM AUTHOR]

This study aimed to investigate if the duration of breastfeeding and the method at initiation of complementary feeding affect eating behaviour in children aged 3−6 years. This is a cross‐sectional analysis from the Childhood Obesity Risk Assessment Longitudinal Study project, an ongoing longitudinal cohort study that aims to identify childhood obesity risk factors in Spanish children. A total of 1215 children aged 3−6 years were included. Breastfeeding duration and the method of initiation of complementary feeding [baby‐led weaning (BLW), traditional/spoon or mixed method] were evaluated. Eating behaviour at 3−6 years was assessed with the Child Eating Behaviour Questionnaire. Generalized linear models were fitted to assess the association between the aforementioned exposures and eating behaviour. Children breastfed for ≥4 months were less likely to be fussy eaters at 3−6 years compared to those breastfed for <1 month (OR: 0.86 95% CI: 0.76−0.98; p = 0.031). Compared to those children using the traditional/spoon‐feeding method, those initiating complementary feeding through BLW or through a mixed approach were more likely to have higher scores on the enjoyment of food (EF) (OR, 95% CI: 1.33, 1.13−1.57; p = 0.001 and 1.17, 1.05−1.30; p = 0.002, respectively) and lower scores on food fussiness (FF) at 3−6 years (0.76, 0.62−0.91; p = 0.004 and 0.87, 0.78−0.98; p = 0.033, respectively). Breastfeeding for ≥4 months and initiation of complementary feeding with the BLW and a mixed approach were associated with greater EF and lower FF, which should endure practice. Key messages: Infants breastfed for ≥4 months have higher enjoyment of food at 3−6 years of age than those breastfed for <1 month.Introducingsolids with hand‐held food pieces, either fully of partially, confers greater ejoyment of food and less food fussiness at 3−6 years of age than traditional/spoon‐feeding.Early feeding practices influence future eating behaviour, particularly during preschool years. [ABSTRACT FROM AUTHOR]

This Commentary discusses the findings of Dang et al.'s systematic review and metanalysis on the "Other Specified Feeding or Eating Disorder" (OSFED) category in the context of current conceptualizations and main international diagnostic schemes of classification, the DSM‐5 and the ICD‐11. The aim to reduce less specified eating disorder categories in these classifications has not been completely achieved and OSFED cases remain prevalent. Different definitions of OSFED contribute to difficulties in study selection and limitation of data aggregation in metanalysis, highlighting the need for improving methodologies for studying OSFED subtypes. Although use of either the DSM‐5 or ICD‐11 scheme concurs with Dang et al.'s main finding that OSFED comprises categories of similar clinical significance to the recognized eating disorders, the ICD‐11 includes more people with anorexia nervosa, bulimia nervosa, or binge‐eating disorder who would receive a DSM‐5 OSFED diagnosis. This may have impacts for epidemiological studies of distribution as well as for identification and treatment of the individual. We support that before creating new eating disorder categories, consideration be given to also broadening current DSM‐5 criteria. This approach may result in fewer OSFED subtypes needing elevation to distinct categories, potentially limiting these to just purging disorder and night eating syndrome. [ABSTRACT FROM AUTHOR]

Background: According to some medical ethicists and professional guidelines, there is no ethical difference between withholding and withdrawing life-sustaining treatment. However, medical professionals do not always agree with this notion. Patients and their families may also not regard these decisions as equivalent. Perspectives on life-sustaining treatment potentially differ between cultures and countries. This study compares Japanese physicians' and citizens' attitudes toward hypothetical cases of withholding and withdrawing life-sustaining treatment. Methods: Ten vignette cases were developed. A web-based questionnaire was administered to 457 citizens and 284 physicians to determine whether they supported withholding or withdrawing treatment. Results: In a case where a patient had an advance directive refusing ventilation, 77% of the physicians and 68% of the citizens chose to withhold treatment. In a case where there was an advance directive but the patient's family requested treatment, 55% of the physicians and 45% of the citizens chose to withhold the ventilator. When a family requested withdrawal of the ventilator but patient wishes were unknown, 19% of the physicians and 48% of the citizens chose to withdraw the ventilator. However, when the patient had also indicated their wishes in writing, 49% of the physicians and 66% of the citizens chose to withdraw treatment. More physicians were prepared to withdraw dialysis (84%) and artificial nutrition (81%) at a patient's request than mechanical ventilation (49%). Conclusions: A significant proportion of Japanese physicians and citizens were reluctant to withhold or withdraw life-sustaining treatment, even in cases where the patient had indicated their wishes in writing. They were more likely to withhold than withdraw treatment, and more likely to withdraw artificial nutrition than mechanical ventilation. Japanese physicians gave significant weight to family views about treatment but were less likely to agree to withdraw treatment than citizens, indicating a potential source of conflict in clinical settings. [ABSTRACT FROM AUTHOR]

Objective We sought to identify clinical and demographic factors associated with gastrostomy tube (g-tube) placement in periviable infants. Study Design We conducted a single-center retrospective cohort study of live-born infants between 22 and 25 weeks' gestation. Infants not actively resuscitated and those with congenital anomalies were excluded from analysis. Results Of the 243 infants included, 158 survived until discharge. Of those that survived to discharge, 35 required g-tube prior to discharge. Maternal race/ethnicity (p = 0.006), intraventricular hemorrhage (p = 0.013), periventricular leukomalacia (p = 0.003), bronchopulmonary dysplasia (BPD; p ≤ 0.001), and singleton gestation (p = 0.009) were associated with need for gastrostomy. In a multivariable logistic regression, maternal Black race (Odds Ratio [OR] = 2.88; 95% confidence interval [CI]: 1.11–7.47; p = 0.029), singleton gestation (OR = 3.99; 95% CI: 1.28–12.4; p = 0.017) and BPD (zero g-tube placement in the no BPD arm; p ≤ 0.001) were associated with need for g-tube. Conclusion A high percentage of periviable infants surviving until discharge require g-tube at our institution. In this single-center retrospective study, we noted that maternal Black race, singleton gestation, and BPD were associated with increased risk for g-tube placement in infants born between 22 and 25 weeks' gestation. The finding of increased risk with maternal Black race is consistent with previous reports of racial/ethnic disparities in preterm morbidities. Additional studies examining factors associated with successful achievement of oral feedings in preterm infants are necessary and will inform future efforts to advance equity in newborn health. Key Points BPD, singleton birth, and Black race are associated with need for g-tube in periviable infants. Severe intraventricular hemorrhage is associated with increased mortality or g-tube placement in periviable infants. Further investigation into the relationship between maternal race and g-tube placement is warranted. [ABSTRACT FROM AUTHOR]

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Data supporting the safety and clinical efficacy of early oral feeding (EOF) after total gastrectomy are limited. The aim of this prospective randomized controlled study was to explore the safety and clinical efficacy of two early enteral nutrition approaches for gastric cancer patients after radical total gastrectomy. The EOF group had faster postoperative recovery of intestinal function than the enteral tube feeding (ETF) group. The times to first flatus and first defecation were shorter in the EOF group (p < 0.05). In addition, the EOF protocol effectively avoided abdominal distension (p < 0.05). The hospitalization cost of the EOF group was lower than that of the ETF group (p < 0.05). Moreover, oral nutrition satisfied the physiological need for oral intake. People were more satisfied with EOF (p < 0.01). Furthermore, it is worth noting that compared with ETF, EOF did not increase the risk of anastomotic complications such as leakage and bleeding. Most obviously, EOF not only avoided the risk of complications during tube insertion, but also avoided the discomfort experience of nasal feeding tube. In summary, compared with ETF, EOF promotes early bowel recovery effectively without increasing the risk of postoperative complications. It is safe and comfortable for gastric cancer patients undergoing radical total gastrectomy. [ABSTRACT FROM AUTHOR]

Objective: To describe long-term outcomes and complications following mandibular distraction osteogenesis (MDO) in a diverse patient cohort Design: Cross-sectional study Setting: Single tertiary-care pediatric center Patients: Forty-eight patients previously undergoing MDO with minimum 4-year follow-up Main Outcome Measures: Respiratory outcomes, feeding patterns, dental development, motor/sensory nerve function, temporo-mandibular joint function, and postsurgical scarring Results: Forty-six patients with a median age of 7 years were evaluated. Of 20 nonsyndromic patients, none required additional airway procedures, none required continuous positive airway pressure (CPAP) during sleep, and 19 (95%) fed exclusively by mouth. Among 26 syndromic patients, 7 (27%) required CPAP and 8 (31%) were tube fed. Permanent first molar differences were seen in the majority of subjects; patterns of damage interfering with function were more common in syndromic (13/28, 46%) compared to nonsyndromic (5/24, 21%; P =.014) subjects. MDO prior to age two was associated with more frequent and worse dental damage (P =.001). Inferior alveolar nerve and marginal mandibular nerve function were fully intact in 37 (80%) and 39 (85%) of patients, respectively. Three patients (6%), all with associated genetic syndromes, demonstrated severe nerve impairment. By the Vancouver scar scale, ≥ 80% of surgical scars were rated in the most favorable category for each quality assessed. Temporomandibular joint dysfunction was rare. Conclusions: MDO shows highly favorable long-term respiratory, feeding, nerve, and scar outcomes in nonsyndromic patients, although permanent molar changes not precluding tooth viability are commonly seen. Patients with associated syndromes demonstrate respiratory and feeding benefits, but higher rates of dental and nerve abnormalities. [ABSTRACT FROM AUTHOR]

Simple Summary: With the development of technology and science, automated farming methods have gradually begun to replace traditional manual feeding methods, offering advantages such as precise feeding and reduced labor costs. However, there is still a lack of extensive research on the effects of different feeding methods on the reproductive performance of pigs and the diversity of their intestinal microbiota. This study analyzed the reproductive performance of Yorkshire pigs fed the same diet under different feeding methods, and further explored the diversity of their intestinal microbiota, aiming to elucidate the interactions between feeding methods, intestinal microbiota, and reproductive phenotypes, in order to understand the impact of the interaction between feeding methods and intestinal microbiota on host reproductive performance. This study aims to provide a certain theoretical and experimental basis for the promotion of automated feeding modes. The feeding mode is an important factor affecting the reproductive performance of pigs. The composition and expression of the intestinal microbiota are closely related to the physiological and biochemical indicators of animals. Therefore, to explore the impact of different feeding patterns on the reproductive performance of pigs, this study collected reproductive performance data from 1607 Yorkshire pigs raised under different feeding patterns and conducted a fixed-effect variance analysis. Among them, 731 were in the artificial feeding (AM) group and 876 were in the feeding station feeding (SM) group. Additionally, 40 Yorkshire sows in the late gestation period were randomly selected from each feeding mode for intestinal microbiota analysis. The results of the analysis showed that, in the AM group, both the number of birth deformities (NBD) and the number of stillbirths (NSB) were significantly greater than they were in the SM group (p < 0.05). Additionally, the total number born (TNB) in the AM group was significantly lower than that in the SM group (p < 0.05). The results of the intestinal microbiota analysis revealed that at the phylum level, there were significant differences in nine bacterial taxa between the AM and SM groups (p < 0.05). At the genus level, the abundance of a variety of beneficial bacteria related to reproductive performance in the SM group was significantly greater than that in the AM group. Finally, fecal metabolomic analysis revealed that the contents of butyric acid, isovaleric acid, valeric acid, and isobutyric acid, which are associated with reproductive performance, in the feces of sows in the SM group were significantly higher than those in the AM group (p < 0.05). These results indicate that different feeding methods can affect the gut microbiota composition of Yorkshire pigs and further influence the reproductive performance of pigs through the gut microbiota–metabolic product pathway. The results of this study provide valuable insights for further exploring the relationships between feeding modes, intestinal microbial composition, and host phenotypes. [ABSTRACT FROM AUTHOR]

Background: Breastfeeding provides vital nutrients and fosters maternal–infant bonding, benefiting both mother and child. However, breastfeeding duration is influenced by various factors, especially in women of high-risk pregnancy. This study aims to identify predictors of breastfeeding duration among women of high-risk and low-risk pregnancy, focusing on exclusive and mixed feeding practices. Methods: Conducted at a public hospital in Attica, Greece, this 20-month prospective cohort study (May 2020–January 2022) included 380 pregnant women, divided into high-risk and low-risk groups. The final sample of 157 women, after excluding non-breastfeeding participants, was assessed across five phases from prenatal to six months postpartum using interviews, calls, and surveys. Multiple linear regression identified key predictors, with statistical methods applied. Results: Results revealed birth weight as a consistent significant predictor of breastfeeding duration. For women with high-risk pregnancy, additional factors like infant gender, jaundice, and early introduction of solid foods influenced breastfeeding duration. The mixed breastfeeding model for women with high-risk pregnancy explained 72.9% of the variance. Exclusive and mixed breastfeeding models for women with low-risk pregnancy also highlighted birth weight's influence. Conclusion: The findings highlight the important role of birth weight and other specific factors in determining breastfeeding duration among women of high-risk and low-risk pregnancy. Further research is needed to validate these findings across diverse populations. [ABSTRACT FROM AUTHOR]

Research on medicinal plants is essential for their conservation, propagation, resistance to environmental stress, and domestication. The use of organic nutrition has been demonstrated to improve soil fertility and plant quality. It is also important to study the effects of the Basic Cation Saturation Ratio (BCSR) approach, which is a topic where there is currently controversy and limited scientific information. Evaluating the growth and yields of Agastache mexicana subsp. mexicana (Amm) in different environments is crucial for developing effective propagation and domestication strategies. This includes examining warm and subhumid environments with rain in summer in comparison to mild environments with summer rain. Significant differences were observed in the effects of cold, waterlogging, and heat stresses on the plant's biomass yield and the morphometric-quantitative modeling by means of isolines. The biomass yield was 56% higher in environment one compared to environment two, 19% higher in environment one with organic nutrition, and 48% higher in environment two with organic nutrition compared to using only BCSR nutrition. In the second harvesting cycle, the plants in environment one did not survive, while the plants in environment two managed to survive without needing additional nutrition. Statistical and mathematical analyses provided information about the population or sample. Additionally, further analysis using isolines as a new approach revealed new insights into understanding phenology and growth issues. [ABSTRACT FROM AUTHOR]

Introduction: This review identified and appraised Australian open‐access online resources relating to feeding and nutrition during the first 5 years of life. Methods: Eligible resources were identified by hand searching plus a targeted search of pertinent source websites (government, hospitals and health services, peak bodies, and nutrition organisations) published in English with/without translations to other languages between 2012 and 2022. Search terms relating to the population (children) AND topic (nutrition OR feeding) were entered into Google and Bing. Critical appraisal of each resource was conducted using a modified version of the Centres for Disease Control and Prevention Clear Communication Index. Results: The search identified 1327 nutrition resources, of which 1067 were appraised. Forty‐five percent were paper‐based resources, 47% were online content only, and 8% audio‐visual resources. Almost half of the resources (45%) broadly addressed the 0–5 years age range, and 24% provided information on breast or formula feeding. Limited resources were found specifically addressing growth and development (5%) and introducing solids (8%). Only 10% of resources were culturally tailored and only 3% were translated into a language other than English. Appraisal showed the majority included visual cues and appropriate language, but less included images to support the main message of the resource. Discussion: Although there were a large volume of evidence‐based nutrition resources available in Australia for feeding children under 5 years, they were highly dispersed and of varying quality. Collating and presenting these resources in an open‐access resource hub would empower families and education and health professionals in the nutritional care of young children. [ABSTRACT FROM AUTHOR]

Aim: In Taiwan, over 90% of dementia patients received home care. Severe dementia‐linked food refusal significantly affects nutrition, thereby straining caregivers. Family caregivers can reduce their burden by learning feeding and dementia nutrition online, thus preserving patient oral feeding. The study aim for family caregivers learn online Hand‐Under‐Hand (UH) techniques to ease feeding in severe dementia, enhancing nutrition and reducing their burden. Methods: In this quasi‐experimental study, participants in the experimental group received 2‐h UH courses online, while the control group received their usual care. The primary outcome indicators were abnormal eating behavior, nutritional status, and caregiver burden, with outcomes tracked at 0, 1, and 3 months. At the neurology outpatient clinic of a medical center in Taipei, 65 dyads—comprising patients with severe dementia and their caregivers—were randomly assigned to groups. Results: The study participants comprised 36 female and 29 male caregivers, with an average age of 58.09 years. The patient group included 43 females and 22 males, with a mean age of 83.32 years. Patients in the experimental group exhibited reduced abnormal eating behavior, and caregiver burden was reduced at 1 and 3 months, patients demonstrated improved nutritional status by month 3. Conclusions: The accessibility and convenience of online courses enabled family caregivers to use UH feeding techniques to effectively improve the nutritional status and correct the abnormal eating behavior of patients with dementia, while also decreasing caregiver burden. Geriatr Gerontol Int 2024; 24: 867–873. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to scrutinize how online occupational therapy group training for mothers influenced their attitudes and stress levels relating to feeding their children and the eating behaviours of the children. The secondary purpose of the study is to evaluate the satisfaction of the participants of this program. Twenty‐nine mothers of children aged 3–6 years, experiencing feeding issues, were randomly allocated to either an intervention or control group. Background: Feeding problems including selective eating, loss of appetite, and mealtime behaviour problems are prevalent during childhood. Parents play a fundamental role in acquiring knowledge about feeding. Problems in the feeding process may lead to parental stress, feelings of despair, and incorrect attitudes. Results: The mothers in the research group participated in the 4‐week training. Results indicated positive effects on both maternal attitudes and their children's eating behaviours (p < 0.05). No significant change was found in mothers' state and trait anxiety levels (p > 0.05). Participants were asked to score their satisfaction level with the program between 1 and 10, and the average of the scores was 9.78 ± 0.42. Conclusion: This study shows that online group education for mothers can support existing treatments and guide clinicians working with children with feeding problems. [ABSTRACT FROM AUTHOR]

Family-based treatment (FBT) is a first-line treatment for adolescents with eating disorders (ED's) for which weight gain early in treatment and caregiver empowerment are predictive of success. A variety of dietary interventions are used in practice, but little is known about their effectiveness. We compared clinical outcomes of patients (N = 100) undergoing eating disorder treatment, and user experience across two virtually delivered interventions: (1) Daily calorie target and (2) Plate-by-Plate™ approach. The calorie group gained more weight on average, though the difference was small (β = 1.62 [−0.02, 3.26]). Participants in both groups improve their eating disorder symptoms at roughly the same rate (β = 0.09 [−0.83, 1.04]). Caregivers in the Plate-by-Plate group increased confidence at a slower rate (β = 0.05 [−0.002, 0.09]). Caregivers rated the daily calorie target as more effective (β = 2.18 [0.94, 3.6]), and rated the two approaches equally for ease of use (β = -0.73 [−1.92, 0.48]). The daily calorie target approach was rated as more effective and was preferred overall by caregivers and dietitians. Findings challenge long-standing assumptions underlying FBT and suggest that clinicians should consider using a calorie framework with caregivers to guide renourishment efforts. [ABSTRACT FROM AUTHOR]

Context Increasing numbers of patients and caregivers are requesting transition to blenderized tube feeding. There is a lack of systematic reviews addressing the outcomes of blenderized tube feeding. Objective The aim was to evaluate the association of blenderized tube feeding on feeding tolerance in enterally fed pediatric patients. Data Sources A literature search for articles from 2012–2022 using PubMed, Medline, Embase, and CINAHL yielded 78 articles. Data Extraction A description and evaluation of the study's sample, purpose, and results were summarized for 9 studies using the Academy of Nutrition and Dietetics Evidence Analysis Library Worksheet. Data Analysis Nine studies were evaluated using the Evidence Analysis Library Quality Criteria checklist. Conclusions Studies demonstrated an improvement in vomiting (n = 7), gagging/retching and heartburn (n = 6), abdominal pain/upset and distension (n = 3), and diarrhea (n = 6) with blenderized tube feeding. The outcomes of blenderized tube feeding on gas (n = 5) and constipation (n = 9) are variable and remain unclear. Systematic Review Registration PROSPERO registration no. CRD42022369247. [ABSTRACT FROM AUTHOR]

Natural nutrition is a factor determining normal physiological development and good neuropsychological health in early childhood. In recent years, the topic has become increasingly relevant and continues to be a challenge for both pediatricians and other health care professionals. The benefits of natural nutrition; therisks due to artificial nutrition, awareness and whether it matters for the number of hospitalizations. Natural nutrition is not only a way to take in nutrients, but also a psychosomatic relationship between mother and child. [ABSTRACT FROM AUTHOR]

Importance: Self-feeding independence is often the first goal in acute stroke rehabilitation. Attention deficits appear frequently after stroke, but neuropsychological tests may be difficult to perform in the acute phase, and the effect on self-feeding activities may be difficult to detect. Therefore, we aimed to clarify behavioral problems with self-feeding using the Moss Attention Rating Scale (MARS), a behavioral observational rating scale of attentional function, for a better understanding of the effects of self-feeding. Objective: To identify behavioral problems caused by attention deficits among patients with acute stroke who need assistance in self-feeding, using the MARS. Design: Cross-sectional single-center study. Setting: St. Marianna University Yokohama Seibu Hospital, Kanagawa, Japan. Participants: A total of 96 patients (42 women and 54 men) were admitted to the hospital for stroke treatment. Patients' median age was 75.0 yr. The date of evaluation was a median of 3.0 days from admission. Outcome and Measures: The primary outcome was the FIM® eating subscore. The secondary outcome was the MARS score. Results: Significant differences were noted in the total raw MARS, logit, and three-factor scores for self-feeding independence (p <.01). The effect size of the consistent or sustained factor on independence was large (r =.83). Conclusions and Relevance: Behavioral problems related to self-feeding dependence include the inability for sustained attention. Our results suggest that sustained concentration during self-feeding is necessary for eating independence. Rehabilitation focused on sustained attention is important for independent self-feeding. Plain-Language Summary: A patient's self-feeding independence is often the first goal in acute stroke rehabilitation. Patients frequently experience attention deficits after a stroke, but neuropsychological tests may be difficult to perform in the acute phase of rehabilitation, and the effect of attention deficits on self-feeding may be difficult to identify. To have a better understanding of the effects on self-feeding, this study aimed to identify behavioral problems using the Moss Attention Rating Scale (MARS). The study found that the MARS can be used to identify behavioral problems related to self-feeding independence, which can help occupational therapists to develop rehabilitation programs for their clients who have experienced a stroke. The Moss Attention Rating Scale can be used to identify behavioral problems related to self-feeding independence, which can help occupational therapists to develop rehabilitation programs for their clients who have experienced a stroke. [ABSTRACT FROM AUTHOR]

Childhood obesity is a major medical and public health issue of global interest, which is influenced by a diverse array of factors and carries significant medical and psychosocial implications. Despite the extensive studies that have been conducted to explore the specific issue, the impact of several factors that influence, generate, worsen, and make chronic the phenomenon needs further exploration. This study aimed to construct a grounded theory that includes and connects the psychological, social, parental, and biological factors affecting childhood obesity. Key psychological factors include mental health issues such as depression and emotional eating, while social factors encompass socioeconomic status and cultural influences. Parental factors involve parenting styles and feeding practices, and biological factors relate to genetic predispositions and prenatal conditions. These factors interact in complex ways, highlighting the multifactorial nature of childhood obesity. The study employed a qualitative grounded theory approach, using research articles to achieve a thorough understanding. Qualitative analysis of the articles was conducted using Atlas.ti 24.0 software. Twenty-five research articles were required to reach theoretical saturation. The analysis resulted in 336 codes that were grouped into seven broad categories and twenty-four different subcategories. Through the construction of the theoretical framework, it was recognized that obesity in minors is a complex and multifactorial issue and that the network of causes and influencing factors covers a broad spectrum ranging from the individual to the family, and subsequently to society at large, which interact with each other. [ABSTRACT FROM AUTHOR]

Objectives: We performed the current research to describe healthcare providers' perspectives toward withdrawal of life-sustaining treatment (WLST) and advanced directive (AD) of patients with unresponsive wakefulness syndrome (UWS) and to identify influencing factors of their perspectives. Methods: Healthcare providers were recruited during a professional conference on disorders of consciousness (DoC). Participants completed self-administered questionnaires which included demographics, personal perspectives regarding WLST and the perception of ADs. Results: A total of 230 Chinese healthcare providers (female: 69.7%) were included. Only a small proportion reported positive attitudes toward withdrawing artificial nutrition and hydration (35.2%), antibiotics (30.9%), and do-not-resuscitation orders (23.5%) in UWS patients. As for predictors' identification, religion was significantly associated with the positive attitude toward DNR order (p = 0.004). Moreover, although 47.4% of the participants had never heard of ADs before of conference, almost all of them would consider ADs (95.7%) thereafter, especially for non-neurologists (p = 0.033). Conclusion: The propensity to WLST for UWS in China is low and perspective on WLST is significantly associated with individual characteristics. The attitudes of healthcare providers toward integrating ADs in the decisional process are positive. Future research regarding ADs and their predictors should be carried out to improve the quality of end-of-life care of UWS in China. [ABSTRACT FROM AUTHOR]

Rationale Aims and Objectives Method Results and Conclusion The Joint Commission emphasizes the importance of cultural competence and effective communication in quality medical care, particularly during end‐of‐life (EOL), when decisions are influenced by diverse cultural and religious backgrounds. For Orthodox Jewish patients, the philosophical framework used for EOL decision‐making may conflict with that used in traditional Western medical ethics. In this paper, we explore the complexities of EOL decision‐making for devout Jewish patients and highlight how approaches may differ from a Western ethical framework.This paper aims to familiarize clinicians with EOL preferences of Orthodox Jewish patients, organized into an ethical framework called ‘casuistic deontology’. Leading with an open‐minded approach emphasizing cultural humility, we explore ways in which integrating this perspective can allow for culturally appropriate and compassionate EOL care.Using a case study methodology, we focus on a 79‐year‐old Orthodox Jewish male hospitalized with severe injuries. The patient's medical course is analyzed, highlighting how the decisions made by his family in consultation with their Rabbi may differ from the decisions made with a philosophy of a Western ethical framework.This case illustrates the ethical tensions that may arise when Western medical practices intersect with Orthodox Jewish beliefs, particularly regarding brain death, resuscitation, and artificial nutrition. We underscore the need for cultural sensitivity when approaching EOL decision‐making, allowing for compassionate and comprehensive care that respects religious perspectives. This paper helps provide a structure for clinicians to navigate the complex EOL care needs for the devout Jewish patient in a manner consistent with their cultural and religious identity. [ABSTRACT FROM AUTHOR]

【Objective】The study is carried out to explore the effect of mulberry leaf feeding on the growth and development of Spodoptera frugiperda, with an aim to provide a theoretical basis and reference for the potential damage of mulberry gardens caused by S. frugiperda.【Method】The populations of S. frugiperda feeding on artificial diet and mulberry leaves were established by two-sex life tables, and the growth & development and reproductive indexes were measured, including the development duration, oviposition amount, pupal weight and pupation rate. And the population parameters were calculated with the two-sex life table software TWOSEX-MS Chart 2024, followed by ANOVA and graphing. Finally, TIMINGMschart was used to predict the future 90 d population dynamics of S. frugiperda feeding on artificial diet and mulberry leaves. 【Result】The total developmental durations of S. frugiperda feeding on mulberry leaves and artificial diet were 44.18 (±0.93) and 32.30 (±0.26) d, the larval survival rates were 41.17 (±5.88)% and 55.56 (±12.73)%, the pupal weight were 174.4 (±34.2) and 225.9 (±23.7) mg per pupa, the oviposition amounts of single female moth were 499.58 (±278.67) and 877.40 (±440.79), and both of the pupation rate were 100%. The intrinsic rates of increase of S. frugiperda feeding on mulberry leaves and artificial diet were 0.10 (±0.01) and 0.14 (±0.01) per day, finite rates of increase were 1.11 (±0.01) and 1.16 (±0.01) per day, net reproduction rates were 128.57 (±36.37) and 250.64 (±77.14) eggs per single female moth, and mean generation times were 47.03 (±1.42) and 37.86 (±0.34) days, respectively.【Conclusion】S. frugiperda feeding on mulberry leaves and artificial diet could complete the generation development, and compared with feeding on artificial diet, the growth and development rate of S. frugiperda feeding on mulberry leaves is slower, and the developmental uniformity, the survival rate, and oviposition amount are all lower. In conclusion, under natural conditions, when the population density is too large or the most suitable host plant is insufficient, it may pose a threat for S. frugiperda larvae to live on mulberry leaves. [ABSTRACT FROM AUTHOR]

Background: Neurological impairment (NI) relates to disorders of the central nervous system. The specific aetiology of NI varies but includes genetic, congenital abnormalities or brain injury. In children with severe NI, feeding impairments can lead to undernutrition, and some children require a feeding tube. Although tube feeding improves overall nutritional status, it has also been associated with excess body fat. Commercially available enteral formulas that are low in energy, hydrolysed and nutritionally adequate for protein and micronutrients are available to mitigate gastrointestinal symptoms and obesity. Methods: This is a retrospective multicentre study of children who attended NI clinics between January 2022 and July 2023. Data were collected before and 1 month after receiving a low‐energy, partially hydrolysed enteral formula (0.6 kcal/mL) on demographic data (age, sex, ethnicity and NI diagnosis), anthropometric measurements (weight, height, weight‐for‐age Z‐score, height‐for‐age Z‐score, body mass index [BMI] Z‐score) and feed regimen (feed volume, total fluids and type of formula/supplements). Results: Dietitians collected data on 28 children, the median age was 7 years (interquartile range [IQR] 3, 8). The most frequently recorded NI was cerebral palsy, in 13 of 28 children (48%). Before the formula switch, the most frequently reported gastrointestinal symptom was constipation, in 13 of 28 children. Within 1 month of switching to a low‐energy, hydrolysed formula, 10 of the 13 (77%) children reported an improvement in constipation. Before the formula switch, all 28 children were experiencing excessive weight gain. After the formula was switched to low‐energy, hydrolysed formula, dietitians reported that 20 of the 28 (76%) children's weight either stabilised or reduced after 1 month. There was no statistically significant difference in weight‐for‐age Z‐score or BMI Z‐scores postswitch of formula (p‐value 0.1 and 0.09, respectively). Fibre intake increased significantly from 3.3 to 8.1 g/day (p‐value < 0.01) after formula switch. The number of children whose feed regimens were simplified after switching to a low‐energy, partially hydrolysed formula was 24 of 28 (91%). Conclusions: Children with an NI who have gastrointestinal symptoms may benefit from a low‐energy, hydrolysed enteral formula to maximise feed tolerance and promote healthy weight gain. In addition, changing to a low‐energy, hydrolysed formula may simplify feed regimens by eliminating the need for additional electrolytes, multivitamins and fluid boluses. Healthcare professionals should be knowledgeable about the effectiveness and availability of a low‐energy, hydrolysed formula. Highlights: A low‐energy, partially hydrolysed enteral formula may promote weight stabilisation and optimise feed tolerance in tube‐fed children with an NI.Switching to a low‐energy, partially hydrolysed enteral formula may simplify overly complicated feed regimens in tube‐fed children with an NI by excluding the need for additional multivitamins or electrolytes.Healthcare professionals should be knowledgeable about the availability of low‐energy, hydrolysed formulas. [ABSTRACT FROM AUTHOR]

Background/aim: Efficient discharge for stroke patients is crucial but challenging. The study aimed to develop early predictive models to explore which patient characteristics and variables significantly influence the discharge planning of patients, based on the data available within 24 h of admission. Design: Prospective observational study. Methods: A prospective cohort was conducted at a university hospital with 523 patients hospitalised for stroke. We built and trained six different machine learning (ML) models, followed by testing and tuning those models to find the best‐suited predictor for discharge disposition, dichotomized into home and non‐home. To evaluate the accuracy, reliability and interpretability of the best‐performing models, we identified and analysed the features that had the greatest impact on the predictions. Results: In total, 523 patients met the inclusion criteria, with a mean age of 61 years. Of the patients with stroke, 30.01% had non‐home discharge. Our model predicting non‐home discharge achieved an area under the receiver operating characteristic curve of 0.95 and a precision of 0.776. After threshold was moved, the model had a recall of 0.809. Top 10 variables by importance were National Institutes of Health Stroke Scale (NIHSS) score, family income, Barthel index (BI) score, FRAIL score, fall risk, pressure injury risk, feeding method, depression, age and dysphagia. Conclusion: The ML model identified higher NIHSS, BI, and FRAIL, family income, higher fall risk, pressure injury risk, older age, tube feeding, depression and dysphagia as the top 10 strongest risk predictors in identifying patients who required non‐home discharge to higher levels of care. Modern ML techniques can support timely and appropriate clinical decision‐making. Relevance to Clinical Practice: This study illustrates the characteristics and risk factors of non‐home discharge in patients with stroke, potentially contributing to the improvement of the discharge process. Reporting Method: STROBE guidelines. [ABSTRACT FROM AUTHOR]

BACKGROUND: Previous studies demonstrate that exclusive breastfeeding has positive long-term health effects on the mother and infant, but research has shown that nearly 50% of mothers do not breastfeed for the recommended amount of time. OBJECTIVE: This article systematizes previous quantitative research on the impact of work on breastfeeding practices to identify the factors that correlate to the cessation of breastfeeding in working mothers. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statements, we performed a systematic review that screened PubMed, CINAHL, PsycINFO, and Academic Search Complete databases for articles relating to maternal employment and breastfeeding. RESULTS: Of the 13,106 articles assessed for eligibility, 21 studies met all requirements and were included in this systematic review. The 21 articles were divided into study type and methods, participant demographics, study outcomes, and additional factors that included stressors and stress levels, factors that increased or decreased rates of breastfeeding, and feeding methods. Articles outside of the United States were excluded due to differences in maternity leave policies of other countries impacting the data. CONCLUSION: Cessation of breastfeeding and breastfeeding outcomes were seen to have a strong association with maternal employment, specifically with the policies and employer support in the workplace. Other factors such as race, level of education, and stress were also shown to relate to breastfeeding outcomes and are important to consider in future public health interventions and workplace policies. [ABSTRACT FROM AUTHOR]

Background: One of the most dangerous complications after endotracheal intubation or tracheostomy is tracheal stenosis. Objectives: This study aimed to determine the personal and clinical characteristics of tracheal stenosis following intubation or tracheostomy in intensive care unit patients. Methods: This is a nested case-control study. Thirty-five patients who suffered from tracheal stenosis from March 2016 to March 2021 and had been intubated and tracheostomized in intensive care units (ICU) were selected for the case group. The control group included 105 patients intubated and tracheostomized in ICU during the same period without tracheal stenosis. A demographic and clinical characteristics questionnaire was used to collect data from the patients' medical records. Results: The mean length of intubation (P < 0.001), endotracheal and tracheostomy tube cuff pressure (P < 0.001), chronic obstructive pulmonary disease (COPD) (P = 0.043), intubation history (P = 0.045), and airway management (P < 0.001) showed significant differences between the case and control groups. The logistic regression model revealed that COPD (OR = 8.519, P = 0.037), intubation history (OR = 3.939, P = 0.013), length of intubation (OR = 1.118, P = 0.003), age (OR = 0.960, P = 0.030), and endotracheal and tracheostomy tube cuff pressure (OR = 1.988, P < 0.001) were associated with tracheal stenosis. The time interval between intubation/tracheostomy ranged from approximately 28 to 938 days. Conclusions: Given the impact of certain care practices during hospitalization on the occurrence of tracheal stenosis, such as the mean length of intubation, endotracheal and tracheostomy tube cuff pressure, and airway management, it is recommended that standardized training on these interventions be prioritized for staff in intensive care departments. Additionally, attention must be given to specific patient characteristics, such as age, COPD, and history of intubation. [ABSTRACT FROM AUTHOR]

Background: Studies on breastfeeding promotion and support interventions suggest some economic benefits. This study assessed the direct and indirect costs of a multicomponent breastfeeding promotion and support intervention during the first two years of the infant's life. Methods: This is a cost-benefit analysis of data generated from a randomized controlled trial that investigated whether provision of a multicomponent breastfeeding promotion and support intervention to Lebanese mothers in the first six months postpartum would improve breastfeeding rates compared to standard obstetric and pediatric care. Data of 339 participants on sociodemographics, mother and infant health, infant nutrition, direct and indirect costs of the intervention were used to assess the benefit-cost ratio (BCR) of the intervention at one, six, 12, and 24 months as primary outcome. Secondary outcomes included overall costs of infant nutrition and infant-mother dyad health costs during the first two years. Multiple linear regression models explored the effect of the intervention on the overall infant nutrition cost and mother-infant health costs. Similar regression models investigated the association between cost variables and infant nutrition types (exclusive breastfeeding, mixed feeding, artificial milk). Intention to treat analyses were conducted using SPSS (version 24). Statistical significance was set at a p-value below 0.05. Results: The prevalence of Exclusive/Predominant breastfeeding among participants declined from 51.6% in the first month to 6.6% at the end of second year. The multicomponent breastfeeding intervention incurred 485 USD more in costs than the control group during the first six months but was cost-efficient at one year (incremental net benefits of 374 USD; BCR = 2.44), and two years (incremental net benefits of 472 USD; BCR = 2.82). In adjusted analyses, the intervention was significantly associated with fewer infant illness visits in the first year (p = 0.045). Stratified analyses by the infant nutrition type revealed that infants who were on Exclusive/Predominant, or Any Breastfeeding had significantly more favorable health outcomes at different time points during the first two years (p<0.05) compared to infants receiving Artificial Milk only, with health benefits being highest in the Exclusive/Predominant breastfeeding group. Moreover, Exclusive/Predominant and Any Breastfeeding had significantly lower costs of infant illness visits, hospitalizations, and infant medications during the two years (p<0.05) but had additional cost for maternal non-routine doctor visits due to breastfeeding (all p values <0.05). Whereas the overall cost (direct and indirect) during the first six months was significantly lower for the Exclusive/Predominant breastfeeding infants (p = 0.001), they were similar in infants on Mixed Feeding or Artificial Milk. Conclusions: Breastfeeding is associated with significant economic and infant health benefits in the first two years. In the context of the current economic crisis in Lebanon, this study provides further evidence to policymakers on the need to invest in national breastfeeding promotion and support interventions. [ABSTRACT FROM AUTHOR]

Usutu virus (USUV) is an emerging flavivirus that is maintained in an enzootic cycle with mosquitoes as vectors and birds as amplifying hosts. In Europe, the virus has caused mass mortality of wild birds, mainly among Common Blackbird (Turdus merula) populations. While mosquitoes are the primary vectors for USUV, Common Blackbirds and other avian species are exposed to other arthropod ectoparasites, such as ticks. It is unknown, however, if ticks can maintain and transmit USUV. We addressed this question using in vitro and in vivo experiments and field collected data. USUV replicated in IRE/CTVM19 Ixodes ricinus tick cells and in injected ticks. Moreover, I. ricinus nymphs acquired the virus via artificial membrane blood-feeding and maintained the virus for at least 70 days. Transstadial transmission of USUV from nymphs to adults was confirmed in 4.9% of the ticks. USUV disseminated from the midgut to the haemocoel, and was transmitted via the saliva of the tick during artificial membrane blood-feeding. We further explored the role of ticks by monitoring USUV in questing ticks and in ticks feeding on wild birds in the Netherlands between 2016 and 2019. In total, 622 wild birds and the Ixodes ticks they carried were tested for USUV RNA. Of these birds, 48 (7.7%) carried USUV-positive ticks. The presence of negative-sense USUV RNA in ticks, as confirmed via small RNA-sequencing, showed active virus replication. In contrast, we did not detect USUV in 15,381 questing ticks collected in 2017 and 2019. We conclude that I. ricinus can be infected with USUV and can transstadially and horizontally transmit USUV. However, in comparison to mosquito-borne transmission, the role of I. ricinus ticks in the epidemiology of USUV is expected to be minor. Author summary: Usutu virus (USUV) is a virus primarily circulating between birds and mosquitoes. Other blood-feeding arthropods, such as ticks, feed on birds. However, it is unknown whether ticks can be infected with USUV and transmit the virus to birds or other animals. Therefore, we infected a tick cell line and ticks collected from the field with USUV. We showed that the virus replicates in tick cells, as well as in field-collected ticks. Moreover, we showed that USUV disseminated through the tick body and was excreted with the saliva of ticks during artificial feeding. We further investigated if ticks are infected with USUV while feeding on wild birds and when searching for a host in the vegetation. We found that 7.7% of tick-infested birds carried USUV positive ticks, while USUV was not detected in questing ticks. Our findings provide evidence that ticks can be infected with USUV and might transmit the virus to another host, but the role of ticks in the transmission of USUV is expected to be minor. [ABSTRACT FROM AUTHOR]

The quality of complementary feeding can have both short‐ and long‐term health impacts by delaying or promoting child growth and establishing taste preferences and feeding behaviours. We aimed to assess the healthy and unhealthy feeding practices of infants and young children in rural Ethiopia. We conducted two rounds of surveys in December 2017/18 in Habru district, North Wello, rural Ethiopia among caregivers of infants and young children (N = 574). We characterised the consumption of infants and young children using non‐quantitative 24 h recall and the World Health Organization infant and young child feeding indicators. Sociodemographic characteristics, anthropometry and haemoglobin concentrations were assessed. Breastfeeding was a norm as 82% and 67% were breastfed in the first and second rounds. Between the two rounds, dietary diversity increased from 5% to 17% (p < 0.05), but more pronounced increases were observed in the consumption of ultra‐processed food (UPFs). Up to one‐in‐five (22%) of the children consumed UFPs. With an average of only three food groups consumed, the consumption of nutrient‐dense foods like animal source foods, fruits and vegetables was very low particularly among younger children. UPFs are an additional risk factor that contributes to poor quality diets. Behavioural Change Communication interventions, including those in rural areas, should explicitly discourage the consumption of UPFs. Future studies should aim to quantify the amount of UPFs consumed and evaluate how this is associated with diet adequacy and nutritional outcomes. Key messages: Complementary diets in rural Ethiopia are extremely low in diversity.Consumption of unhealthy foods is more prevalent than the proportion that meets the minimum dietary diversity.Consumption of ultra‐processed foods was not associated with household wealth score.Indicators of unhealthy feeding practices should be integrated into nutrition programme monitoring. [ABSTRACT FROM AUTHOR]

Barest feeding is the act of feeding breast milk to an infant, it can directly from the mother's breast, or breast milk can be pumped and then fed from a bottle. Breast milk contains calories, vitamins, minerals, and other important nutrients that help an infant grow and develop. It also contains antibodies, which help protect the infant against some infections. Breastfeeding also helps protect the infant and mother against certain diseases or conditions. Exclusive Breastfeeding is defined as an infant receiving only breast milk, it's recommended to exclusively breastfeed infants for the first 6 months of their life as it has positive outcomes on the infant's and mother's health. The aim of the study is to determine role of the knowledge, attitude, perception and practices on breast feeding among female medical students at Umm Al-Qura University in Makkah city, Saudi Arabia. A descriptive Cross-sectional study was conducted, (205) female students included using stratified sampling technique. Data were collected using self-administered questionnaire, factors associated with breastfeeding were measured using appropriate statistical tests with p-values of less than 0.05 were considered as statistically significant. Study clarified that (90.2%) of the medical students who have children practiced breastfeeding. (4.9%) agreed that artificial milk is a healthier than mother milk, while (42.9%) perceived that artificial milk is a healthy alternative. (95.1%) agreed that breastfeeding reduces the risk of breast cancer and ovarian cancer. study discovered that there's no statistically significant relationship between practicing breastfeeding among lactating respondents and their perception about artificial milk as a healthy choice since the p-value (>0.05). Female medical students have a high level of knowledge, good perception and attitudes about importance of breastfeeding, but there no effect on the actual practices among lactating respondents, more efforts is needed to overcome the problem which may affect the health of coming generations. [ABSTRACT FROM AUTHOR]

As dementia advances, it can present with a challenge to those individuals who require aid with feeding. Assessing the efficacy of nasogastric (NG) feeding on improving survival outcomes can be challenging and there is a lack of studies in clinical research. This article aims to highlight the ethical considerations and challenges in NG feeding in patients with dementia. [ABSTRACT FROM AUTHOR]

The article discusses research which examined the perspectives of nursing home staff on the challenges in implementing dementia advance directives related to stopping feeding and drinking. The study surveyed views of physicians, nurse practitioners and physician assistance on the acceptability and implementation of comfort feeding in persons with late stage dementia using the Dartmouth Dementia Directive and the End of Life Choices New York's Advance.

Background. Necrotising enterocolitis (NEC) is life-threatening with a rising incidence due to improved neonatal care. While researchers' focus has shifted to causes, risk factors and preventative clinical strategies, little is known about the exact aetiology of NEC. Risk factors include the relationship between red blood cell transfusions (RBCTs) and the development of transfusion-associated NEC (TANEC) and peri-transfusion feeding, increasing the risk of TANEC. Objectives. Evaluate the relationship between RBCT and peri-transfusion feeding practices and the development of TANEC in very low birthweight (VLBW) neonates over 5 years. Methods. This was a retrospective analytical record review of all VLBW neonates admitted to two tertiary hospitals' neonatal units in Bloemfontein, South Africa (SA), from 1 January 2012 - 31 December 2016. Results. The study population (n=1 426) had a median birthweight of 1 260 g and a median gestation age of 30 weeks. RBCTs were given to 41.9%, and NEC developed in 7.4%, of whom 47.6% had an RBCT (TANEC). Half (47.2%) were kept nil per os (NPO) around the transfusion. No association was found between NPO status and TANEC development (8.9% NPO patients, 7.9% non-NPO patients, p=0.6826). No significant differences regarding Modified Bell's Staging were found between neonates who developed TANEC v. NEC. Conclusion. Optimising the administration of RBCTs and evidence-based feeding protocols is crucial in reducing TANEC's impact on premature neonates. [ABSTRACT FROM AUTHOR]

Determine self-reported parental feeding behavior changes and perspectives on parental feeding intervention at 12-month follow-up. Telephone focus groups using a 2 × 2 design (English/Spanish × in-class or online) with Expanded Food and Nutrition Education Program participants (n = 37) with children 2–8 years and high exposure to the Food, Feeding, and Your Family intervention (7 lessons). Researchers (n = 3) independently identified themes. Parental behavior changes that (1) positively influenced children's diets, (2) involved children in food-related activities, (3) eased stressful situations around food, (4) led to healthier food choices, and (5) saved money when food shopping. Commonly implemented practices included establishing structured mealtime routines, introducing new foods multiple times, and encouraging children's eating competence. Online participants noted materials were easily accessible via text messages. Incorporating parental feeding content (in-class or online) into nutrition education interventions, such as the Expanded Food and Nutrition Education Program , supports developing positive parental feeding behaviors in families with low income. [ABSTRACT FROM AUTHOR]

Summary: Background/Objectives: The infant diet represents one of the main modifiable determinants of early growth. This study aimed to investigate the associations of infant feeding practices with body mass index (BMI) until 7.5 years. Subjects/Methods: Analyses were based on data from the French nationwide ELFE birth cohort. Data on breastfeeding (BF) and complementary feeding (CF) were collected monthly from 2 to 10 months. Infant feeding practices were characterized using principal component analyses (PCA) and hierarchical ascendant classification. BMI z‐score was computed at 1, 2, 3, 5 and 7.5 years, from data collected in the child's health booklet; 7.5‐year overweight was defined according to IOTF references. Associations between infant feeding practices and BMI were investigated by linear regression models adjusted for main confounders. Results: Ever breastfeeding was not associated with BMI up to 7.5 years. Compared to intermediate breastfeeding duration (1 to <3 months), longer breastfeeding duration (≥6 months) was related to lower 1‐year BMI, but not at older ages. Compared to the recommended age at CF introduction (4–6 months), early CF (<4 months) was related to higher BMI up to 5 years with a similar trend at 7.5 years, but not to the risk of overweight. The PCA patterns characterized by early baby cereal introduction and late food pieces introduction or by frequent intake of main food groups were related to a lower BMI up to 7.5 years. Conclusion: Breastfeeding was related with a lower BMI in infancy but not thereafter, whereas an early CF initiation (<4 months) was associated with a higher BMI in childhood. [ABSTRACT FROM AUTHOR]