Financial hardship and dietary adherence during COVID-19 pandemic

The COVID-19 pandemic affected the global economy resulting in financial hardship due to declining wages or job losses. A decreased income influences food expenditure and accessibility affecting dietary adherence to healthy recommendations. Thus, this study aimed to investigate the association between financial hardship and dietary adherence among Malaysian working adults during the pandemic. Individuals aged 18 to 59 years (N=163) who experienced financial hardship during the pandemic participated in this cross-sectional study. The data were collected through an online survey. The reported number of servings consumed by the respondents for nine food groups was compared with the recommendations by the Malaysian Dietary Guidelines 2020 and Malaysian Food Pyramid 2020 using one-sample t-test to measure dietary adherence. The association between the financial hardship categories (≤25%, 26-50%, 51-75%, and 76-100% of monthly household income reduction rate during the pandemic) and dietary adherence status was assessed using the chi-squared test. The respondents consumed significantly lower number of servings of vegetables, fruits, cereals, fish, legumes, milk and milk products, and fat/oils, compared to recommendations (all p<0.001) whereas their sugar intake was significantly higher than recommended (p=0.041). These indicate dietary non-adherence. However, no association between financial hardship and dietary adherence was detected among adults who were financially affected during the COVID-19 pandemic in this study. In conclusion, most Malaysian adults who reportedly experienced financial hardship during the COVID-19 pandemic demonstrated non-adherence to healthy dietary recommendations. However, whether this was influenced by financial difficulties faced during the pandemic is inconclusive and warrants further investigation

Internet of Things: Underwater routing based on user’s health status for smart diving

Technological advancements affect everyday life; they benefited our daily routines, habits, and activities. Underwater diving is one of the most interesting and attractive activities for tourists worldwide but could be risky and challenging. When paths are not clear, diving might take additional time and effort leading to some health problems. Thus, providing divers with proper direction information to surf underwater can be useful and helpful. Also, monitoring diverse health statuses and alerting them in case of any undesirable condition can increase their safety. Smart devices such as mobiles, watches, sensor devices, cellular networks along with the Internet of Things (IoT) can all provide location-based services. Such services can help in providing the best path for the divers and monitor their health status during diving. This paper proposes a new underwater routing approach, called Underwater Routing for Smart Diving “URSD”, which provides divers with routing information to visit underwater cultural or natural resources and monitors their health status during the diving period. The URSD approach was simulated and compared with the shortest path. Results showed that the URSD helped divers to route within paths that have a larger number of nodes, furthermore, it could enhance and improve divers experience and help them mitigate underwater risks

Feasibility Study of Monsoon Effect on Wave Power for Wave Energy Converter in Sabah, Malaysia

This paper presents a research to determine the effects of the Northeast Monsoon (NEM) and the Southwest Monsoon (SWM) on wave power along the coastal area of Mandi Darah Island, Sabah. This study identified the daily data of wave height and wave period for 6 months from June to December 2018. The following period was chosen because it consisted of two monsoon seasons in Sabah. The data obtained from the Acoustic Doppler Current Profiler (ADCP) were thoroughly analyzed to estimate the wave height and the wave period to identify the wave power at Mandi Darah Island. The wave heights ranged from 0.01 m to 0.47 m while the wave periods ranged from 1.0 s to 8.6 s. The wave height range during the NEM was higher by 0.12 m than SWM, while the difference of wave period was significantly higher by 2.17 s during the NEM. The maximum wave power recorded at Mandi Darah Island was 1.57 kW/m throughout the period. During NEM, the wave power was significantly higher than during SWM, by 0.70 kW/m. These findings led to determining the wave energy type converter that suits the wave conditions at the Mandi Darah Island coastal area

Employing CNN ensemble models in classifying dental caries using oral photographs

Dental caries is arguably the most persistent dental condition that affects most people over their lives. Carious lesions are commonly diagnosed by dentists using clinical and visual examination along with oral radiographs. In many circumstances, dental caries is challenging to detect with photography and might be mistaken as shadows for various reasons, including poor photo quality. However, with the introduction of Artificial Intelligence and robotic systems in dentistry, photographs can be a helpful tool in oral epidemiological research for the assessment of dental caries prevalence among the population. It can be used particularly to create a new automated approach to calculate DMF (Decay, Missing, Filled) index score. In this paper, an autonomous diagnostic approach for detecting dental cavities in photos is developed using deep learning algorithms and ensemble methods. The proposed technique employs a set of pretrained models including Xception, VGG16, VGG19, and DenseNet121 to extract essential characteristics from photographs and to classify images as either normal or caries. Then, two ensemble learning methods, E- majority and E-sum, are employed based on majority voting and sum rule to boost the performances of the individual pretrained model. Experiments are conducted on 50 images with data augmentation for normal and caries images, the employed E-majority and E-sum achieved an accuracy score of 96% and 97%, respectively. The obtained results demonstrate the superiority of the proposed ensemble framework in the detection of caries. Furthermore, this framework is a step toward constructing a fully automated, efficient decision support system to be used in the dentistry area

Identification of chrysotile in brake pads and linings from Malaysian vehicles and heavy vehicles by using Polarized Light Microscope (PLM)

Exposure to types of asbestos such as chrysotile and crocidolite increases respiratory disease risks such as lung cancer, mesothelioma, and asbestosis. Nevertheless, asbestos products banning in Malaysia is only limited to crocidolite as per stated in OSHA (Prohibition of Use of Substance) Order 1999, though other types are highly suspected to be found in asbestos-containing materials (ACM) like brake pads and linings. This study ascertains the presence of asbestos fibres, particularly chrysotile, in brake pads and linings used in Malaysia's vehicle and heavy vehicle sector. Seven different brake pads; three from vehicle brands, and four from heavy vehicle brands were collected by bulk sampling approaches from the market and field. Dust fibres were extracted using slow grinding method and analysed under Polarized Light Microscope (PLM). The fibre characteristics such as colour, morphology, pleochroism, extinction, and dispersion staining technique were examined, referring the National Institute for Occupational Safety and Health (NIOSH) Manual of Analytical Methods (NMAM) 9002. Additionally, the observed samples also were verified by an accredited lab to support the authenticity of the outcome. From the analysis and lab results, chrysotile fibres were consistently detected in all brake pad samples, fulfilling the fibre characteristics and positive elongation signs

Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis

Results: We analyzed 1,402 surveys and 15 in-depth interviews. Many (32%) CL participants reported greater difficulty refilling medications and a minority (14%) reported greater difficulty accessing HIV care during the pandemic. Most (99%) Opt4Mamas participants reported no difficulty refilling medications or accessing HIV/pregnancy care. Among the CL participants, older women were less likely (aOR = 0.95, 95% CI: 0.92–0.98) and women with more children were more likely (aOR = 1.13, 95% CI: 1.00–1.28) to report difficulty refilling medications. Only 2% of CL participants reported greater difficulty managing FP and most (95%) reported no change in likelihood of using FP or desire to get pregnant. Qualitative analysis revealed three major themes: (1) adverse organizational/economic implications of the pandemic, (2) increased importance of pregnancy prevention during the pandemic, and (3) fear of contracting COVID-19

Human milk: From complex tailored nutrition to bioactive impact on child cognition and behavior

Human milk is a highly complex liquid food tailor-made to match an infant's needs. Beyond documented positive effects of breastfeeding on infant and maternal health, there is increasing evidence that milk constituents also impact child neurodevelopment. Non-nutrient milk bioactives would contribute to the (long-term) development of child cognition and behavior, a process termed 'Lactocrine Programming'. In this review we discuss the current state of the field on human milk composition and its links with child cognitive and behavioral development. To promote state-of-the-art methodologies and designs that facilitate data pooling and meta-analytic endeavors, we present detailed recommendations and best practices for future studies. Finally, we determine important scientific gaps that need to be filled to advance the field, and discuss innovative directions for future research. Unveiling the mechanisms underlying the links between human milk and child cognition and behavior will deepen our understanding of the broad functions of this complex liquid food, as well as provide necessary information for designing future interventions

Human milk: From complex tailored nutrition to bioactive impact on child cognition and behavior

Human milk is a highly complex liquid food tailor-made to match an infant's needs. Beyond documented positive effects of breastfeeding on infant and maternal health, there is increasing evidence that milk constituents also impact child neurodevelopment. Non-nutrient milk bioactives would contribute to the (long-term) development of child cognition and behavior, a process termed 'Lactocrine Programming'. In this review we discuss the current state of the field on human milk composition and its links with child cognitive and behavioral development. To promote state-of-the-art methodologies and designs that facilitate data pooling and meta-analytic endeavors, we present detailed recommendations and best practices for future studies. Finally, we determine important scientific gaps that need to be filled to advance the field, and discuss innovative directions for future research. Unveiling the mechanisms underlying the links between human milk and child cognition and behavior will deepen our understanding of the broad functions of this complex liquid food, as well as provide necessary information for designing future interventions.All authors participated in the four-day hybrid meeting on ‘Lactational Programming: joining forces to optimize research on how maternal milk composition influences child cognition and behavior’ (Zeist, the Netherlands, 16-19 November 2020), which was financed by an Early Career Partnership 2020 Grant of the Royal Netherlands Academy of Arts and Sciences (awarded to Beijers). Funding sources for individual authors: Netherlands Organization for Scientific Research VICI grant (016.Vici.185.038-to de Weerth), The National Center for Advancing Translational Sciences Clinical Science and Translational Award (UL1TR001863-to Dettmer), NWO Food Cognition and Behaviour (057-14-003-to Korosi), Turku University Foundation, Maire Taponen Foundation and Finnish Psychiatry Foundation (-to Aatsinki), Polish National Science Centre OPUS grant (2015/17/B/NZ8/02436 -to Ziomkiewicz), Canadian Research Chair in Human Nutrition and Metabolism and funding from Natural Science and Engineering Council of Canada NSERC (RGPIN-2017-04746-to Field), The USDA National Institute of Food and Agriculture Hatch Project (1021411-to Slupsky), USDA NRI (2007-35203-18098 and 2013-67016-20523-to Bartol), Spanish Ministry of Science and Innovation grant (PID2019-105606RB-I00-to Rodríguez), UC San Diego Chair of Collaborative Human Milk Research, endowed by the Family Larsson-Rosenquist Foundation, Switzerland (-to Bode), Wellcome Trust (220225/Z/20/Z-to Moore), Tier 2 Canada Research Chair and Fellow in the CIFAR Humans and the Microbiome Program, Canadian Institutes of Health Research (CIHR), Research Manitoba, the Canada Foundation for Innovation, the Bill and Melinda Gates Foundation, the Manitoba Children’s Hospital Foundation, Prolacta Biosciences, Mitacs, CIFAR, and the Garfield G. Weston Foundation (-to Azad), CIHR Vanier Canada Graduate Scholarship (-to Turner), European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (ERC starting grant, no. 639226-to Collado), Netherlands Organization for Scientific Research VENI grant (016.195.197-to Beijers).Peer reviewe

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks