Gender differences in adolescent food preferences and their association with parent food preferences: data from the China Health and Nutrition Survey (CHNS).

PURPOSE: Food preference is an important factor that affects one's eating behavior and dietary intake. Parent food preferences and food choices may influence children food preferences. This study is aimed to describe gender differences and time trends of Chinese adolescent food preferences and to explore the association between adolescent and their parent food preferences. METHODS: The data were drawn from four waves of the China Health and Nutrition Survey (CHNS) conducted between 2006 and 2015. Participants were asked to indicate their degree of preferences for five food categories (fast food, salty snack food, fruits, vegetables, and soft/sugary drinks) using a 5-point Likert scale (from "dislike very much" to "like very much"). Logistic regression was performed to determine the association of food preferences between adolescents and their parents. RESULTS: Adolescent preferences for unhealthy foods were significantly higher than those of adults. Adolescent food preferences for fruits and vegetables decreased slightly over nine years, and there were gender differences in healthy food preferences (girls > boys, P < 0.05). Regardless of boys or girls, adolescent food preferences for healthy foods (fruits and vegetables) were significantly associated with both their fathers (OR: 3.64-4.58 for boys and 2.71-4.39 for girls) and mothers (OR: 2.13-4.11 for boys and 3.07-5.66 for girls) food preferences. For fast food and salty snack food preferences, boys appeared to be influenced greater by their fathers than girls, while girls appeared to be influenced greater by their mothers than boys. CONCLUSIONS: The present study reveals a high degree of unhealthy food preferences among Chinese adolescents and a gender-specific association of fast food and salty snack preference between Chinese adolescents and their parents. Our results may be useful for interventions to reduce adolescent unhealthy food preferences and intakes.

GLUT3 transcriptional activation by ZEB1 fuels the Warburg effect and promotes ovarian cancer progression.

Ovarian cancer (OvCa) is characterized by early metastasis and high mortality rates, underscoring the need for deeper understanding of these aspects. This study explores the role of glucose transporter 3 (GLUT3) driven by zinc finger E-box-binding homeobox 1 (ZEB1) in OvCa progression and metastasis. Specifically, this study explored whether ZEB1 promotes glycolysis and assessed the potential involvement of GLUT3 in this process in OvCa cells. Our findings revealed that ZEB1 and GLUT3 were excessively expressed and closely correlated in OvCa. Mechanistically, ZEB1 activates the transcription of GLUT3 by binding to its promoter region. Increased expression of GLUT3 driven by ZEB1 dramatically enhances glycolysis, and thus fuels Warburg Effect to promote OvCa progression and metastasis. Consistently, elevated ZEB1 and GLUT3 expression in clinical OvCa is correlated with poor prognosis, reinforcing the profound contribution of ZEB1-GLUT3 axis to OvCa. These results suggest that activation of GLUT3 expression by ZEB1 is crucial for the proliferation and metastasis of OvCa via fueling glycolysis, shedding new light on OvCa treatment.

Family treatment courts and the COVID-19 pandemic: Barriers and facilitators to program implementation, client engagement, and recovery.

INTRODUCTION: Family Treatment Courts (FTCs) serve child welfare-involved parents with substance use issues who are working toward recovery and reunification with their children. Research has linked FTCs to successful outcomes such as treatment access and completion and family reunification, but there has been less attention to factors that hinder and facilitate program implementation and client engagement. Moreover, little is known about how the shift to virtual services during the COVID-19 pandemic impacted FTC programs and the families they serve. METHODS: This study examined interview data gathered from staff in six FTCs located in different regions of the country to investigate the impact of the pandemic on programs and the clients they serve. Interviews conducted with clients from one FTC in the Midwest reinforce the data. RESULTS: FTC programs and professionals adjusted to the pandemic by attempting to replicate face-to-face services in an online environment. Virtual services were vital for sustaining FTCs and mitigating barriers to client engagement during the pandemic. At the same time, FTCs were compelled to navigate new barriers to online program implementation as well as acute challenges that clients faced such as greater isolation and reduced treatment access. CONCLUSIONS: We discuss implications from these findings with an eye toward maximizing FTC implementation and impact through the intentional use of both in-person programming and online technology after the pandemic.

LINC01936 inhibits the proliferation and metastasis of lung squamous cell carcinoma probably by EMT signaling and immune infiltration.

Purpose: To discover the biological function and potential mechanism of LINC01936 in the development of lung squamous cell carcinoma (LUSC). Methods: Transcriptome data of LUSC from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases were used to analyze the differentially expressed lncRNAs in LUSC and normal tissues by R "DEseq2", "edgeR" and "limma" packages. The subcellular localization of LINC01936 was predicted by lncLocator. Cell proliferation and apoptosis were measured by CCK-8, MTT assay and Hoechst fluorescence staining. The migration and invasion were detected by Transwell assay. The function and pathway enrichment analysis were performed by Gene Ontology (GO) terms, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis and gene set variation analysis (GSVA). The downstream targets of LINC01936 were predicted using RNA-Protein Interaction Prediction (RPISeq) program. The effect of LINC01936 on tumor immune infiltration was analyzed using Pearson Correlation Analysis using R "ggpubr" package. Results: Based on the gene expression data of LUSC from TCGA database, 1,603, 1,702 and 529 upregulated and 536, 436 and 630 downregulated lncRNAs were obtained by DEseq2, edgeR and limma programs, respectively. For GSE88862 dataset, we acquired 341 differentially expressed lncRNAs (206 upregulated and 135 downregulated). Venn plot for the intersection of above differential expressed lncRNAs showed that there were 29 upregulated and 23 downregulated genes. LINC01936 was one of downregulated lncRNAs in LUSC tissues. The biological analysis showed that the overexpression of LINC01936 significantly reduced proliferation, migration and invasion of LUSC cells, and promoted cell apoptosis. The knockdown of LINC01936 promoted cell proliferation and metastasis. Pathway and GSVA analysis indicated that LINC01936 might participated in DNA repair, complement, cell adhesion and EMT, etc. LINC01936 was predicted to interact with TCF21, AOC3, RASL12, MEOX2 or HSPB7, which are involved in EMT and PI3K-AKT-MTOR pathway, etc. The expression of LINC01936 was also positively correlated with the infiltrating immune cells in LUSC. Conclusions: LINC01936 is downregulated in LUSC. LINC01936 affected proliferation, migration and invasion of LUSC cells probably by EMT and immune infiltration, which might serve as a new target for the treatment of LUSC.

Impact of a family treatment court on child permanency and safety.

BACKGROUND: Family Treatment Courts have been linked to promising effects on key child welfare outcomes, though few rigorous program evaluations have been conducted. OBJECTIVE: This study employs a robust quasi-experimental design to evaluate effects associated with Family Treatment Court participation on child permanency and safety. PARTICIPANTS AND SETTING: The sample included 648 eligible adults who were referred to a Family Treatment Court in a Midwest metropolitan area, including 266 program participants and 382 non-participants. METHODS: Propensity score weighting was applied to match program and comparison groups on demographic and case characteristics. Child welfare records yielded safety and permanency outcomes. Participants and non-participants were compared following an intent-to-treat principle, with logistic regressions used to test the odds of reunification and maltreatment recurrence, and Kaplan-Meier analyses used to explore time to reunification and permanency. Moderation tests were performed to analyze differences in program impact across racial/ethnic groups and substance use types. RESULTS: Compared to non-participants, program participants were 81 % more likely to reunify. Group differences in time to reunification and permanency were mixed, and there was no evidence of program impact on maltreatment recurrence. Substance use type and race/ethnicity did not moderate associations between program participation and study outcomes. CONCLUSIONS: Mounting evidence suggests that Family Treatment Courts are more effective than usual services in promoting family reunification, though it is unclear if these interventions hasten reunification or increase safety post-reunification. Rigorous evaluations are needed to explore moderating and mediating processes and identify implementation drivers and local conditions that contribute to heterogeneous results.

Endoplasmic reticulum stress impairs trophoblast syncytialization through upregulation of HtrA4 and causes early-onset preeclampsia.

OBJECTIVE: Syncytiotrophoblasts form via mononuclear cytotrophoblast fusion during placentation and play a critical role in maternal-fetal communication. Impaired syncytialization inevitably leads to pregnancy-associated complications, including preeclampsia. Endoplasmic reticulum stress (ERS) is reportedly linked with preeclampsia, but little is known about its association with syncytialization. High temperature requirement factor A4 (HtrA4), a placental-specific protease, is responsible for protein quality control and placental syncytialization. This study aimed to investigate the relationship among HtrA4, ERS, and trophoblast syncytialization in the development of early-onset preeclampsia (EO-PE). METHODS: HtrA4 expression and ERS in preeclamptic placentas and control placentas were analyzed by Western blotting and qRT-PCR. HtrA4 and ERS localization in placentas was determined by immunohistochemistry and immunofluorescence. BeWo cells were used to stimulate the effects of HtrA4 and ERS on syncytialization. RESULTS: HtrA4 expression was upregulated in EO-PE and positively correlated with ERS. HtrA4 activity was increased in preeclampsia. Under normoxia, HtrA4 overexpression in BeWo cells did not alter the ERS level. In addition, treatment with hypoxia/reoxygenation (H/R) or an ERS inducer increased HtrA4 expression. HtrA4 upregulation suppressed the levels of syncytin-2 and ß-HCG in the presence of forskolin (FSK), and this change was exaggerated after ERS activation. In addition, treatment with an ERS inhibitor markedly suppressed FSK-treated cell fusion in a manner related to downregulation of HtrA4 expression. CONCLUSION: Our results suggest that ERS enables syncytialization of placental development by upregulating HtrA4, but that excessive HtrA4 expression and preexisting ERS impair syncytialization and cause EO-PE.

Corrigendum: The virus made me lose control: the impact of COVID-related work changes on employees' mental health, aggression, and interpersonal conflict.

[This corrects the article DOI: 10.3389/fpubh.2023.1119389.].

Dual Distillation Discriminator Networks for Domain Adaptive Few-Shot Learning.

Domain Adaptive Few-Shot Learning (DA-FSL) aims at accomplishing few-shot classification tasks on a novel domain with the aid of a large number of source-style samples and several target-style samples. It is essential for DA-FSL to transfer task knowledge from the source domain to the target domain and overcome the asymmetry amount of labeled data in both domains. To this end, we propose Dual Distillation Discriminator Networks (D3Net) from the perspective of the lack of labeled target domain style samples in DA-FSL. Specifically, we employ the idea of distillation discrimination to avoid the over-fitting caused by the unequal number of samples in the target and source domains, which trains the student discriminator by the soft labels from the teacher discriminator. Meanwhile, we design the task propagation stage and the mixed domain stage respectively from the level of feature space and instances to generate more target-style samples, which apply the task distributions and the sample diversity of the source domain to enhance the target domain. Our D3Net realizes the distribution alignment between the source domain and the target domain and constraints the FSL task distribution by prototype distributions on the mixed domain. Extensive experiments on three DA-FSL benchmark datasets, i.e., mini-ImageNet, tiered-ImageNet, and DomainNet, demonstrate that our D3Net achieves competitive performance.

Constructing Co-S interface chemical bonds over Co@NC/ZnIn2S4 for an efficient solar-driven photocatalytic H2 evolution.

Developing novel photocatalysts with an intimate interface and sufficient contact is significant for the separation and migration of photogenerated carriers. In this work, a novel Co@NC/ZnIn2S4 heterojunction with a strong Co-S chemical bond was formed at the interface between Co@NC and ZnIn2S4, which accelerated charge separation. Meanwhile, the recombination of the electron-hole pairs was further restricted by the Co@NC/ZnIn2S4 Schottky junction. The Co@NC (5 wt%)/ZnIn2S4 composite exhibited an H2 evolution rate of 33.3 µmol h-1, which is 6.1 times higher than that of the pristine ZnIn2S4, and Co@NC/ZnIn2S4 showed excellent stability in the photocatalytic water splitting reaction. Its apparent quantum yield reached 38% at 420 nm. Furthermore, the Kelvin probe test results showed that the interfacial electric field formed as the driving force for interface charge transfer was oriented from Co@NC to ZnIn2S4. In addition, the Co-S bond as a high-speed channel facilitated the interfacial electron transfer. This work reveals that in situ formed chemical bonds will pave the way for designing high-efficiency heterojunction photocatalysts.

The virus made me lose control: The impact of COVID-related work changes on employees' mental health, aggression, and interpersonal conflict.

Introduction: COVID-related work changes have seriously disrupted employees' familiar routines and hampered their lives and work. Although this topic has drawn rising attention, to our knowledge, limited studies have investigated the impact of COVID-related work changes on employees' mentality and behavior. In this paper, we developed a moderated mediation model based on ego depletion theory to test how and when COVID-related work changes impact employees' mental health, interpersonal conflict, and aggression behavior. Methods: We collected 536 valid participants by conducting a questionnaire survey in a large Chinese manufacturing company, and tested our proposed theoretical model and hypotheses using SPSS 26.0 and Mplus 8.1. Results: The empirical results showed that COVID-related work changes would harm employees' mental health and boost their interpersonal conflict and aggression via increasing their ego depletion. Moreover, trait resilience has an intervention in the relationship between COVID-related work changes and employees' ego depletion, which weakens the indirect impact of COVID-related work changes on mental health, interpersonal conflict, and aggression. Discussion: These findings suggest that although COVID-related work changes were inevitable, managers should take measures to improve the employees' mental status and avoid conflicts promptly while taking steps to keep organizations on track.

Semantic-Aware Dynamic Generation Networks for Few-Shot Human-Object Interaction Recognition.

Recognizing human-object interaction (HOI) aims at inferring various relationships between actions and objects. Although great progress in HOI has been made, the long-tail problem and combinatorial explosion problem are still practical challenges. To this end, we formulate HOI as a few-shot task to tackle both challenges and design a novel dynamic generation method to address this task. The proposed approach is called semantic-aware dynamic generation networks (SADG-Nets). Specifically, SADG-Net first assigns semantic-aware task representations for different batches of data, which further generates dynamic parameters. It obtains the features that highlight intercategory discriminability and intracategory commonality adaptively. In addition, we also design a dual semantic-aware encoder module (DSAE-Module), that is, verb-aware and noun-aware branches, to yield both action and object prototypes of HOI for each task space, which generalizes to novel combinations by transferring similarities among interactions. Extensive experimental results on two benchmark datasets, that is, humans interacting with common objects (HICO)-FS and trento universal HOI (TUHOI)-FS, illustrate that our SADG-Net achieves superior performance over state-of-the-art approaches, which proves its impressive effectiveness on few-shot HOI recognition.

Memorizing Complementation Network for Few-Shot Class-Incremental Learning.

Few-shot Class-Incremental Learning (FSCIL) aims at learning new concepts continually with only a few samples, which is prone to suffer the catastrophic forgetting and overfitting problems. The inaccessibility of old classes and the scarcity of the novel samples make it formidable to realize the trade-off between retaining old knowledge and learning novel concepts. Inspired by that different models memorize different knowledge when learning novel concepts, we propose a Memorizing Complementation Network (MCNet) to ensemble multiple models that complements the different memorized knowledge with each other in novel tasks. Additionally, to update the model with few novel samples, we develop a Prototype Smoothing Hard-mining Triplet (PSHT) loss to push the novel samples away from not only each other in current task but also the old distribution. Extensive experiments on three benchmark datasets, e.g., CIFAR100, miniImageNet and CUB200, have demonstrated the superiority of our proposed method.

Plasmon Au/K-doped defective graphitic carbon nitride for enhanced hydrogen production.

Knowledge of the photocatalytic H2-evolution mechanism is of critical importance for water splitting, and for designing active catalysts for a sustainable energy supply. In this study, we prepared plasmon Au-modified K-doped defective graphitic carbon nitride (Au/KCNx) and then applied it in photocatalytic hydrogen-production tests. The hydrogen-production rate of the Au/KCNx photocatalyst (8.85 mmol g-1 h-1) was found to be almost 104 times higher than that of Au/g-C3N4 (0.085 mmol g-1 h-1), together with an apparent quantum efficiency of 12.8% at 420 nm. It could significantly improve the photocatalytic activities of the Au/KCNx sample, which was attributed to the synergistic effects of the plasmon effect, potassium doping, and nitrogen vacancy. In addition, the Au/KCNx photocatalyst had a large surface area, which was beneficial for photogenerated carrier separation and transfer. The novel strategy proposed here is a potential new method for the development of graphitic carbon nitride photocatalysts with obviously enhanced activities.

Amino-functionalized MIL-125(Ti) for photodenitrification of pyridine in fuels via coordination activation by unsaturated Ti4+ centers.

Due to their explicit structure, metal-organic frameworks (MOFs) have been supposed to be credible platforms to research the micro-mechanism of heterogeneous photocatalysis. In this study, amino-functionalized MOFs (MIL-125(Ti)-NH2 (denoted as MTi), UiO-66(Zr)-NH2 (denoted as UZr) and MIL-68(In)-NH2 (denoted as MIn)) with three different metal centers were synthesized and applied for the denitrification of simulated fuels under visible light irradiation, during which pyridine was used as a typical nitrogen-containing compound. The results showed that MTi had the best activity among the above three MOFs, and the denitrogenation rate increased to 80% after 4 h of visible light irradiation. On the grounds of the theoretical calculation of pyridine adsorption and actual activity experiments, it can be presumed that the unsaturated Ti4+ metal centers should be the key active sites. Meanwhile, the XPS and in situ infrared results verified that the coordinatively unsaturated Ti4+ sites facilitate the activation of pyridine molecules through the surface -N⋯Ti- coordination species. The coordination-photocatalysis synergism promotes the efficiency of photocatalytic performance and the corresponding mechanism is proposed.

AMPK regulates homeostasis of invasion and viability in trophoblasts by redirecting glucose metabolism: Implications for pre-eclampsia.

Pre-eclampsia (PE) is deemed an ischemia-induced metabolic disorder of the placenta due to defective invasion of trophoblasts during placentation; thus, the driving role of metabolism in PE pathogenesis is largely ignored. Since trophoblasts undergo substantial glycolysis, this study aimed to investigate its function and regulatory mechanism by AMPK in PE development. Metabolomics analysis of PE placentas was performed by gas chromatography-mass spectrometry (GC-MS). Trophoblast-specific AMPKα1-deficient mouse placentas were generated to assess morphology. A mouse PE model was established by Reduced Uterine Perfusion Pressure, and placental AMPK was modulated by nanoparticle-delivered A769662. Trophoblast glucose uptake was measured by 2-NBDG and 2-deoxy-d-[3 H] glucose uptake assays. Cellular metabolism was investigated by the Seahorse assay and GC-MS.PE complicated trophoblasts are associated with AMPK hyperactivation due not to energy deficiency. Thereafter, AMPK activation during placentation exacerbated PE manifestations but alleviated cell death in the placenta. AMPK activation in trophoblasts contributed to GLUT3 translocation and subsequent glucose metabolism, which were redirected into gluconeogenesis, resulting in deposition of glycogen and accumulation of phosphoenolpyruvate; the latter enhanced viability but compromised trophoblast invasion. However, ablation of AMPK in the mouse placenta resulted in decreased glycogen deposition and structural malformation. These data reveal a novel homeostasis between invasiveness and viability in trophoblasts, which is mechanistically relevant for switching between the 'go' and 'grow' cellular programs.

Phosphorus doped and defect modified graphitic carbon nitride for boosting photocatalytic hydrogen production.

The enhancement of photogenerated carrier separation efficiency is a significant factor in the improvement of photocatalyst performance in photocatalytic hydrogen evolution. Heteroatom doping and defect construction have been considered valid methods to boost the photocatalytic activity of graphitic carbon nitride. Herein, we report graphitic carbon nitride modified with P doping and N defects (PCNx), and the effects of doping and defects were investigated in photocatalytic H2 evolution. Its hydrogen evolution rate can reach up to about 59.1 µmol h-1, which is more than 123.1 times higher than pristine graphitic carbon nitride under visible light irradiation. Importantly, the apparent quantum efficiency reaches 8.73% at 420 nm. The excellent performance of the PCNx photocatalyst was attributed to the following aspects: (I) the large BET surface area of PCNx affords more active sites for H2 production and (II) the introduction of P and N defects can accelerate the charge carrier separation and transfer efficiency, leading to more efficient photocatalytic hydrogen production. The photocatalyst showed obviously enhanced activities.

The Metabolic Signatures of Surviving Cotwins in Cases of Single Intrauterine Fetal Death During Monochorionic Diamniotic Pregnancy: A Prospective Case-Control Study.

Introduction: Single intrauterine fetal death (sIUFD) in monochorionic diamniotic (MCDA) twin pregnancy may be associated with adverse clinical outcomes and possible metabolic changes in the surviving co-twin. Metabolomic profiling has not been undertaken before in these complex twin pregnancies. Methods: In this prospectively collected case-control study, three cross-cohort comparisons were made between sIUFD MCDA (n = 16), uncomplicated MCDA (n = 16, eight pairs), and uncomplicated singleton pregnancies (n = 8). To identify major sources of variation within the sIUFD MCDA cohort, a secondary comparison was conducted between spontaneous sIUFD (n = 8) and sIUFD in MCDA twins due to selective termination of a single abnormal fetus by radiofrequency ablation (RFA) (n = 8). Metabolomics analysis of placental tissue and umbilical cord plasma was performed using LC-MS profiling. The underlying metabolic networks and pathways were analyzed by web-based platforms. Associations and statistical correlations of all identified differential metabolites with neonatal birthweight and birth length were assessed by multivariable linear regression, adjusted for maternal age and gestation. Results: Across four comparisons, 131 and 111 differential metabolites were identified in placental tissue and cord plasma, respectively, with the highest variation seen between the spontaneous vs. single-induced IUFD in MCDA twins by RFA in the cord plasma. Conversely, the number of viable fetuses and the presence of sIUFD in MCDA twins had the highest impact on metabolite variation in placental tissue. Compounds correlated with fetal growth including placental acylcarnitines and gangliosides, along with specific amino acids (e.g., histidinyl-hydroxyproline), xenobiotics and biliverdin in cord plasma. Conclusion: sIUFD in MCDA twin pregnancy correlates with distinctive metabolic signatures, mostly in fatty acyls and complex lipids, in placental tissue and cord plasma of the surviving cotwin. Some metabolites are also associated with fetal growth.

The Associations between Caregivers' Emotional and Instrumental Feeding, Children's Emotional Eating, and Children's Consumption of Ultra-Processed Foods in China.

High consumption of ultra-processed foods (UPF) increases the risks of non-communicable diseases and all-cause mortality in adulthood, and the risk of early childhood caries. Limited evidence about factors influencing children's consumption of UPF exists. This study was conducted to assess the prevalence of UPF consumption among children less than three years of age, and identify its associations with caregivers' emotional and instrumental feeding, and children's emotional eating. A cross-sectional study was conducted in Shijiazhuang, Hebei Province, China. Caregivers caring for children aged 6-36 months (n = 408) were recruited. Caregivers' emotional and instrumental feeding practices and children's emotional eating were assessed by the Parents' Feeding Practices Scale for Infant and Young Child and Children's Eating Behaviour Questionnaire, respectively. Children's UPF consumption was assessed by a validated Food Frequency Questionnaire. Of the children, 86.8% consumed UPF. The highest percentage of UPF consumed was pastries (63.5%), followed by solid or semi-solid dairy products (58.8%), and reconstituted meat products (56.4%). Caregivers' emotional and instrumental feeding was positively associated with children's consumption of UPF (OR = 1.59, 95%CI: 1.01, 2.49), a higher frequency of UPF consumption weekly (OR = 1.80, 95%CI: 1.35, 2.39), and a larger amount of UPF consumption weekly (OR = 1.85, 95% CI: 1.38, 2.49). Children's higher frequency of emotional undereating was associated with their UPF consumption (OR = 1.61, 95%CI: 1.07, 2.42) and a higher frequency of UPF consumption weekly (OR = 1.33, 95%CI: 1.03, 1.73). Children's emotional undereating significantly mediated the associations between caregivers' emotional and instrumental feeding and children's consumption of reconstituted meat products. Caregivers should be educated to avoid emotional and instrumental feeding practices, and cultivate children's good eating habits to improve children's diet quality.

Recommendations for breastfeeding during Coronavirus Disease 2019 (COVID-19) pandemic.

BACKGROUND: Coronavirus Disease 2019 (COVID-19) has spread worldwide. The safety of breastfeeding of SARS-CoV-2-positive women has not yet reached a consensus among the scientific community, healthcare providers, experts in lactation care, health organizations and governments. This study was conducted to summarize the latest evidence about the safety of breastfeeding among suspected/confirmed infected mothers and to summarize the recommendations on breastfeeding during COVID-19 from different organizations. METHODS: A comprehensive literature review of publications about the safety of breastfeeding among SARS-CoV-2-infected mothers was conducted. Scientific databases were searched up to 26 May 2021. The evidence was summarized into five perspectives according to a framework proposed by van de Perre et al. with certain modifications. Moreover, websites of different health organizations were visited to gather the recommendations for breastfeeding. RESULTS: The current evidence demonstrated that the majority of infants breastfed by infected mothers were negative for SARS-CoV-2. Breast milk samples from suspected/infected mothers mainly demonstrated negative results in SARS-CoV-2 viral tests. There was insufficient evidence proving the infectivity of breast milk from infected mothers. Recent studies found other transmission modalities (e.g., milk containers, skin) associated with breastfeeding. Specific antibodies in the breast milk of infected mothers were also found, implying protective effects for their breastfed children. According to van de Perre's criteria, the breast milk of infected mothers was unlikely to transmit SARS-CoV-2. Owing to the low quality of the current evidence, studies with a more robust design are needed to strengthen the conclusion regarding the safety of breastfeeding. Further studies to follow up the health status of infants who were directly breastfed by their suspected/infected mothers, to collect breast milk samples at multiple time points for viral tests and to examine specific antibodies in breast milk samples are warranted. Current recommendations on breastfeeding during COVID-19 from different organizations are controversial, while direct breastfeeding with contact precautions is generally suggested as the first choice for infected mothers. CONCLUSIONS: This review determined the safety of breastfeeding and identified the focus for further research during the COVID-19 pandemic. Recommendations on breastfeeding are suggested to be updated in a timely manner according to the latest evidence.

Optimization of Cervical Cancer Screening: A Stacking-Integrated Machine Learning Algorithm Based on Demographic, Behavioral, and Clinical Factors.

PURPOSE: The purpose is to accurately identify women at high risk of developing cervical cancer so as to optimize cervical screening strategies and make better use of medical resources. However, the predictive models currently in use require clinical physiological and biochemical indicators, resulting in a smaller scope of application. Stacking-integrated machine learning (SIML) is an advanced machine learning technique that combined multiple learning algorithms to improve predictive performance. This study aimed to develop a stacking-integrated model that can be used to identify women at high risk of developing cervical cancer based on their demographic, behavioral, and historical clinical factors. METHODS: The data of 858 women screened for cervical cancer at a Venezuelan Hospital were used to develop the SIML algorithm. The screening data were randomly split into training data (80%) that were used to develop the algorithm and testing data (20%) that were used to validate the accuracy of the algorithms. The random forest (RF) model and univariate logistic regression were used to identify predictive features for developing cervical cancer. Twelve well-known ML algorithms were selected, and their performances in predicting cervical cancer were compared. A correlation coefficient matrix was used to cluster the models based on their performance. The SIML was then developed using the best-performing techniques. The sensitivity, specificity, and area under the curve (AUC) of all models were calculated. RESULTS: The RF model identified 18 features predictive of developing cervical cancer. The use of hormonal contraceptives was considered as the most important risk factor, followed by the number of pregnancies, years of smoking, and the number of sexual partners. The SIML algorithm had the best overall performance when compared with other methods and reached an AUC, sensitivity, and specificity of 0.877, 81.8%, and 81.9%, respectively. CONCLUSION: This study shows that SIML can be used to accurately identify women at high risk of developing cervical cancer. This model could be used to personalize the screening program by optimizing the screening interval and care plan in high- and low-risk patients based on their demographics, behavioral patterns, and clinical data.