Educational videos for practitioners attending Baby Friendly Hospital Initiative workshops supporting breastfeeding positioning, attachment and hand expression skills: Effects on knowledge and confidence

UNICEF Baby Friendly Initiative (BFHI) is the global standard for maternity and community services requiring all practitioners to be trained to support mothers in the essential skills of supporting positioning and attachment, and hand expression. These studies aim to rigorously assess knowledge in nurses, midwives, and doctors in these skills, tested before and after watching short videos demonstrating these skills. Practitioners were attending BFHI education, and the video study was additional. In Phase 1 clinicians in England were randomised to one of two videos (practitioner role play or clinical demonstration). The results showed improvements in knowledge and confidence, and a preference for clinical demonstration by mothers and infants. The clinical demonstration video was evaluated in China in Phase 2 where expert trainers viewed the video after completing the BHFI workshop, and in Phase 3 practitioners viewed the video before the BHFI workshop. Phase 2 with expert trainers only showed improvement in knowledge of hand expression but not positioning and attachment. In Phase 3 clinicians showed improved knowledge for both skills. In all Phases there were statistically significant improvements in confidence in practice in both skills. Viewing short videos increased knowledge, particularly about teaching hand expression, and confidence in both skills

Exploration by Maximizing R\'enyi Entropy for Reward-Free RL Framework

Exploration is essential for reinforcement learning (RL). To face the challenges of exploration, we consider a reward-free RL framework that completely separates exploration from exploitation and brings new challenges for exploration algorithms. In the exploration phase, the agent learns an exploratory policy by interacting with a reward-free environment and collects a dataset of transitions by executing the policy. In the planning phase, the agent computes a good policy for any reward function based on the dataset without further interacting with the environment. This framework is suitable for the meta RL setting where there are many reward functions of interest. In the exploration phase, we propose to maximize the Renyi entropy over the state-action space and justify this objective theoretically. The success of using Renyi entropy as the objective results from its encouragement to explore the hard-to-reach state-actions. We further deduce a policy gradient formulation for this objective and design a practical exploration algorithm that can deal with complex environments. In the planning phase, we solve for good policies given arbitrary reward functions using a batch RL algorithm. Empirically, we show that our exploration algorithm is effective and sample efficient, and results in superior policies for arbitrary reward functions in the planning phase.Comment: Accepted by AAAI-2

The Fungal CYP51s: Their Functions, Structures, Related Drug Resistance, and Inhibitors

CYP51 (Erg11) belongs to the cytochrome P450 monooxygenase (CYP) superfamily and mediates a crucial step of the synthesis of ergosterol, which is a fungal-specific sterol. It is also the target of azole drugs in clinical practice. In recent years, researches on fungal CYP51 have stepped into a new stage attributing to the discovery of crystal structures of the homologs in Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus. This review summarizes the functions, structures of fungal CYP51 proteins, and the inhibitors targeting these homologs. In particular, several drug-resistant mechanisms associated with the fungal CYP51s are introduced. The sequences and crystal structures of CYP51 proteins in different fungal species are also compared. These will provide new insights for the advancement of research on antifungal agents

Novel models for fatigue life prediction under wideband random loads based on machine learning

Machine learning as a data-driven solution has been widely applied in the field of fatigue lifetime prediction. In this paper, three models for wideband fatigue life prediction are built based on three machine learning models, i.e. support vector machine (SVM), Gaussian process regression (GPR) and artificial neural network (ANN). The generalization ability of the models is enhanced by employing numerous power spectra samples with different bandwidth parameters and a variety of material properties related to fatigue life. Sufficient Monte Carlo numerical simulations demonstrate that the newly developed machine learning models are superior to the traditional frequency-domain models in terms of life prediction accuracy and the ANN model has the best overall performance among the three developed machine learning models

Treatment of electric vehicle battery waste in China: A review of existing policies

This paper reviews existing policies for supporting the treatment of electric vehicle (EV) battery waste in China, and identifies some of their major shortcomings that policy makers may like to consider while making policy decisions. The shortcomings of existing policies identified in this paper include: 1) no clear provisions for historical and orphan batteries; 2) no target for battery collection; 3) unclear definition of the scope of authority among various central and local agencies involved in the regulation of waste battery treatment; 4) unclear requirements for data auditing and verification for tracking the entire life cycle of EV batteries; 5) limited consideration of the challenges to ensure stakeholder cooperation; and 6) no explicit specification of the mechanisms for financing waste battery treatment. This paper also makes some practical policy suggestions for overcoming these shortcomings

Body Mass Index and Risks of Incident Ischemic Stroke Subtypes: The Japan Public Health Center-Based Prospective (JPHC) Study

Background: The association of body mass index (BMI) with risks of ischemic stroke subtypes have not been established.Methods: Cumulative average BMI was calculated using self-reported body weight and height obtained from baseline (Cohort I in 1990, and Cohort II from 1993–1994) and 5- and 10-year questionnaire surveys of Japan Public Health Center-based prospective (JPHC) study. A total of 42,343 men and 46,413 women aged 40–69 years were followed-up for the incidence of lacunar, large-artery occlusive, and cardioembolic strokes. A sub-distribution hazard model was used to estimate sub-distribution hazard ratios (SHRs) and the 95% confidence intervals (CIs).Results: During a median of 20.0 years of follow-up, we documented 809 and 481 lacunar, 395 and 218 large-artery occlusive, and 568 and 298 cardioembolic strokes in men and women, respectively. After adjustment for baseline age, updated smoking, alcohol consumption, leisure-time physical activity, and histories of hypertension, dyslipidemia, and diabetes mellitus, cumulative average BMI was positively linearly associated with lacunar (trend P = 0.007), large-artery occlusive (trend P = 0.002), and cardioembolic (trend P < 0.001) strokes in men, and with lacunar (trend P < 0.001) and large-artery occlusive (trend P = 0.003) strokes in women. There were approximately two-fold excess risk of cardioembolic stroke in both sexes and of lacunar and large-artery occlusive strokes in women for cumulative average BMI ≥30 kg/m2 compared to BMI 23–<25 kg/m2.Conclusion: Cumulative average BMI showed a positive linear effect on sub-distribution hazards of lacunar, large-artery occlusive, and cardioembolic strokes in both sexes, except for cardioembolic stroke in women

Variations in Litterfall Dynamics, C:N:P Stoichiometry and Associated Nutrient Return in Pure and Mixed Stands of Camphor Tree and Masson Pine Forests

Litterfall, directly and indirectly, affects the soil physicochemical properties, microbial activity, and diversity of soil fauna and flora by adding organic matter and nutrients to the soil. This study explores litterfall dynamics such as litterfall production, litter decomposition rate, and associated nutrient return in three forest types, that is, camphor tree forest (CTF), Masson pine forest (MPF), and camphor tree and Masson pine mixed forest (CMF), in subtropical China. Results showed that CMF had the highest mean annual litterfall production (4.30 ± 0.22 t ha−1), which was significantly higher than that of MPF (3.41 ± 0.25 t ha−1) and CTF (3.26 ± 0.17 t ha−1). Leaf represented the major fraction of litterfall, constituting over 71% of the total litterfall mass in the three forest types. The contribution of branch litter was 16.3, 8.9, and 16.9%, and miscellaneous litter was 12.6, 18.9, and 11.1% in CTF, MPF, and CMF, respectively. The concentration of macronutrients ranked as N > Ca > K > Mg > P in all litter fractions. The total annual macronutrient return to the soil from the litterfall was in order as CTF (74.2 kg ha−1‧yr−1) > CMF (70.7 kg ha−1‧yr−1) > MPF (33.6 kg ha−1‧yr−1). The decomposition rate was higher in leaf litter than in branch litter throughout the three forests. Among the forest types, the leaf and branch decomposition rates were in a pattern: CTF > CMF > MPF. The ratio of C/N in both leaf and branch litters was significantly higher in MPF than in CTF and CMF, while no significant differences in N/P ratio were found in these litters among the three forests. The high N:P ratios in leaf litter (23/30) and the branch (24/32) litter indicated the high N returning and low nutrient returning to the soil. Our results suggested that the broadleaved forests have faster litter decomposition and higher macronutrient returns than conifer forests. Moreover, the litter decomposition rate was mainly associated with litterfall quality and chemical composition. The introduction of broadleaved trees into monoculture coniferous stands could increase litter production nutrients return, and thus, it had advantages in soil nutrients restoration and sustainable forest management

Research progress of natural silk fibroin and the application for drug delivery in chemotherapies

Silk fibroin has been widely used in biological fields due to its biocompatibility, mechanical properties, biodegradability, and safety. Recently, silk fibroin as a drug carrier was developed rapidly and achieved remarkable progress in cancer treatment. The silk fibroin-based delivery system could effectively kill tumor cells without significant side effects and drug resistance. However, few studies have been reported on silk fibroin delivery systems for antitumor therapy. The advancement of silk fibroin-based drug delivery systems research and its applications in cancer therapy are highlighted in this study. The properties, applications, private opinions, and future prospects of silk fibroin carriers are discussed to understand better the development of anti-cancer drug delivery systems, which may also contribute to advancing silk fibroin innovation

NtMYB4 and NtCHS1 Are Critical Factors in the Regulation of Flavonoid Biosynthesis and Are Involved in Salinity Responsiveness

High levels of salinity induce serious oxidative damage in plants. Flavonoids, as antioxidants, have important roles in reactive oxygen species (ROS) scavenging. In the present study, the tobacco R2R3 MYB type repressor, NtMYB4, was isolated and characterized. The expression of NtMYB4 was suppressed by salinity. Overexpression of NtMYB4 reduced the salt tolerance in transgenic tobacco plants. NtMYB4 repressed the promoter activity of NtCHS1 and negatively regulated its expression. Rutin accumulation was significantly decreased in NtMYB4 overexpressing transgenic plants and NtCHS1 RNAi silenced transgenic plants. Moreover, high H2O2 and O2− contents were detected in both types of rutin-reduced transgenic plants under high salt stress. In addition, exogenous rutin supplementation effectively scavenged ROS (H2O2 and O2−) and improved the salt tolerance of the rutin-reduced transgenic plants. In contrast, NtCHS1 overexpressing plants had increased rutin accumulation, lower H2O2 and O2− contents, and higher tolerance to salinity. These results suggested that tobacco NtMYB4 acts as a salinity response repressor and negatively regulates NtCHS1 expression, which results in the reduced flavonoid accumulation and weakened ROS-scavenging ability under salt stress