Ecological momentary assessment of digital food and beverage marketing exposure and impact in young adults: A feasibility study.

Unhealthy food marketing is contributing to the obesity epidemic, but real-time insights into the mechanisms of this relationship are under-studied. Digital marketing is growing and following food and beverage (F&B) brands on social media is common, but measurement of exposure and impact of such marketing presents novel challenges. Thus, this study aimed to evaluate the feasibility of collecting data on exposure and impact of digital F&B marketing (DFM) using a smartphone-based ecological momentary assessment (EMA) methodology. We hypothesized that DFM-induced food cravings would vary based on whether (or not) participants engaged with F&B brands online. Participants were Singapore residents (n = 95, 21-40 years), recruited via telephone from an existing cohort. Participants were asked to upload screenshots of all sightings of online F&B marketing messages for seven days, and answer in-app contextual questions about sightings including whether any cravings were induced. Participants provided a total of 1310 uploads (median 9 per participant, Q1-Q3: 4-21) of F&B marketing messages, 27% of which were provided on Day 1, significantly more than on other days (P < 0.001). Followers of food/beverage brands on social media encountered 25.6 percentage points (95% CI 11.4, 39.7) more marketing messages that induced cravings than participants who were not followers. University education was also associated with more (18.1 percentage points; 95% CI 3.1, 33.1) encounters with marketing messages that induced cravings. It was practical and acceptable to participants to gather insights into digital F&B marketing exposure and impact using EMA in young adults, although a shorter study period is recommended in future studies. Followers of food and beverage brands on social media appear to be more prone to experience cravings after exposure to digital F&B marketing.

An Exploratory Study of Bone Health Among Native Hawaiian Women in Rural Hawai'i.

INTRODUCTION: The purpose of this study was to obtain baseline data on bone mass density for Native Hawaiian women and to better understand the socio-cultural context for assessing bone health and risk of osteoporosis for this underserved population. METHOD: A sequential mixed-method design guided by Leininger's Culture Care Theory of Diversity and Universality consisted of two phases: (a) an initial exploratory focus group and (b) dual-energy X-ray absorptiometry (DEXA) scans and individual interviews. Data were analyzed using descriptive statistics and thematic analysis. RESULTS: Phase a (n = 12) suggested that Native Hawaiian women have limited knowledge of bone health, but recognize traditional and cultural ways of health. Phase b (n = 50) showed that Native Hawaiian women have healthy bones, according to the T-score results. The interviews suggested that perspectives of bone health are culturally anchored. DISCUSSION: Understanding cultural values and practices are vital for care. Preliminary recommendations for health professionals are included.

Positive association of SARS-CoV-2 RNA concentrations in wastewater and reported COVID-19 cases in Singapore - A study across three populations.

Wastewater testing of SARS-CoV-2 has been adopted globally and has shown to be a useful, non-intrusive surveillance method for monitoring COVID-19 trends. In Singapore, wastewater surveillance has been widely implemented across various sites and has facilitated timely COVID-19 management and response. From April 2020 to February 2022, SARS-CoV-2 RNA concentrations in wastewater monitored across three populations, nationally, in the community, and in High Density Living Environments (HDLEs) were aggregated into indices and compared with reported COVID-19 cases and hospitalisations. Temporal trends and associations of these indices were compared descriptively and quantitatively, using Poisson Generalised Linear Models and Generalised Additive Models. National vaccination rates and vaccine breakthrough infection rates were additionally considered as confounders to shedding. Fitted models quantified the temporal associations between the indices and cases and COVID-related hospitalisations. At the national level, the wastewater index was a leading indicator of COVID-19 cases (p-value <0.001) of one week, and a contemporaneous association with hospitalisations (p-value <0.001) was observed. At finer levels of surveillance, the community index was observed to be contemporaneously associated with COVID-19 cases (p-value <0.001) and had a lagging association of 1-week in HDLEs (p-value <0.001). These temporal differences were attributed to differences in testing routines for different sites during the study period and the timeline of COVID-19 progression in infected persons. Overall, this study demonstrates the utility of wastewater surveillance in understanding underlying COVID-19 transmission and shedding levels, particularly for areas with falling or low case ascertainment. In such settings, wastewater surveillance showed to be a lead indicator of COVID-19 cases. The findings also underscore the potential of wastewater surveillance for monitoring other infectious diseases threats.

Assessing the efficacy of male Wolbachia-infected mosquito deployments to reduce dengue incidence in Singapore: study protocol for a cluster-randomized controlled trial.

BACKGROUND: Dengue is a severe environmental public health challenge in tropical and subtropical regions. In Singapore, decreasing seroprevalence and herd immunity due to successful vector control has paradoxically led to increased transmission potential of the dengue virus. We have previously demonstrated that incompatible insect technique coupled with sterile insect technique (IIT-SIT), which involves the release of X-ray-irradiated male Wolbachia-infected mosquitoes, reduced the Aedes aegypti population by 98% and dengue incidence by 88%. This novel vector control tool is expected to be able to complement current vector control to mitigate the increasing threat of dengue on a larger scale. We propose a multi-site protocol to study the efficacy of IIT-SIT at reducing dengue incidence. METHODS/DESIGN: The study is designed as a parallel, two-arm, non-blinded cluster-randomized (CR) controlled trial to be conducted in high-rise public housing estates in Singapore, an equatorial city-state. The aim is to determine whether large-scale deployment of male Wolbachia-infected Ae. aegypti mosquitoes can significantly reduce dengue incidence in intervention clusters. We will use the CR design, with the study area comprising 15 clusters with a total area of 10.9 km2, covering approximately 722,204 residents in 1713 apartment blocks. Eight clusters will be randomly selected to receive the intervention, while the other seven will serve as non-intervention clusters. Intervention efficacy will be estimated through two primary endpoints: (1) odds ratio of Wolbachia exposure distribution (i.e., probability of living in an intervention cluster) among laboratory-confirmed reported dengue cases compared to test-negative controls and (2) laboratory-confirmed reported dengue counts normalized by population size in intervention versus non-intervention clusters. DISCUSSION: This study will provide evidence from a multi-site, randomized controlled trial for the efficacy of IIT-SIT in reducing dengue incidence. The trial will provide valuable information to estimate intervention efficacy for this novel vector control approach and guide plans for integration into national vector control programs in dengue-endemic settings. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT05505682 . Registered on 16 August 2022. Retrospectively registered.

Perfluoroalkyl substances and lipid concentrations in the blood: A systematic review of epidemiological studies.

BACKGROUND: Perfluoroalkyl substances (PFAS) are widely used synthetic aliphatic compounds. This systematic review aims to assess PFAS associations with low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), total cholesterol (TC) and total triglyceride (TG) concentrations in human populations. METHOD: We systematically searched four online databases, PubMed, Scopus, Embase, and Cochrane Library for relevant peer-reviewed English language articles published until July 2021. Additional relevant articles identified were also included in the search results. We categorised populations into adults (≥18 years old) and children. Primary findings were the associations between PFAS concentrations and LDL, HDL, TC, and TG concentrations in the serum, plasma, or whole blood; secondary findings were the associations between PFAS concentrations and the odds of lipid-related health outcomes. Quantitative synthesis was done by vote counting of the effect directions between concentrations of PFAS and lipids/health outcomes, repeated on articles with sample size >1000. Sign tests were performed to assess the statistical significance of the differences between positive and negative associations. Sensitivity analysis was performed by separating out articles with populations having high concentrations of perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS). Quality was assessed with the STROBE checklist and NHBLI Study Quality Assessment Tool. RESULTS: A total of 58 articles were included for review. There was evidence that PFAS exposure is associated with higher concentrations of LDL, HDL, and TC, particularly for PFOA-LDL, PFOA-TC, PFOS-TC, and PFNA-LDL. Associations between PFAS and TG tended to be negative, especially for perfluoroundecanoic acid (PFUnDA). Associations between PFAS concentration and the odds of secondary outcomes generally supported a positive association between PFAS and cholesterol concentrations. CONCLUSION: We found evidence of associations between the concentrations of some PFAS-lipid pairs in human populations. Future research should be conducted on the less well-studied PFAS to explore their effects on human health and in regions where such studies are currently lacking. (300 words).

SHORT-TERM BIOLOGICAL VARIABILITY OF HEMATOLOGY PARAMETERS IN THE BEARDED DRAGON (POGONA VITTICEPS).

Determination of the biological variation of laboratory tests is essential for accurate interpretation during health assessments. Few studies investigate the biological variation of CBC variables in reptiles, and none of these involve squamates. Thus, we investigated the biological variation of hematology parameters in bearded dragons (Pogona vitticeps) to determine if conventional population-based reference intervals are appropriate in evaluating single laboratory samples. Blood was collected from 10 bearded dragons five separate times over 10 wk and placed in lithium heparin (LH) microtainers, and CBC were performed. WBC were evaluated via both a fresh, non-anticoagulated blood smear and a LH anticoagulated blood smear as well as two manual hemocytometer counts with blood stained with either Natt and Herrick's (NH) solution or Leukopet™ (LO) solution. The between-animal coefficient of variation (CVG), within-animal coefficient of variation (CVI), reference change value (RCV), and index of individuality were determined for PCV, total solids (TS), and WBC using all leukocyte quantification methods. The RVC for PCV, TS, and WBC in bearded dragons were 37%, 84%, and >100%, respectively. The calculated index of individuality values all fell between 0.6 and 1.4, suggesting that the use of judiciously applied population-based reference intervals in interpreting the WBC, PCV, and TS in bearded dragons is appropriate.

Preparation and consideration for establishment of an isolation maternity unit in a tertiary hospital during COVID-19 pandemic.

The SARS-CoV-2 pandemic is rapidly evolving and remains a major health challenge worldwide. With an increase in pregnant women with COVID-19 infection, we recognized an urgent need to set up a multidisciplinary taskforce to provide safe and holistic care for this group of women. In this review of practice in a tertiary hospital in Singapore, we discuss the key considerations in setting up an isolation maternity unit and our strategies for peripartum and postpartum care. Through teleconsultation, we involve these women and their families in the discussion of timing and mode of birth, disposition of babies after birth and safety of breastfeeding to enable them to make informed decisions and individualize their care.

Longitudinal Associations of Marital, Parenting, and Employment Transitions with Weight Gain in a Multi-Ethnic Asian Population Aged 21 Years and Above.

Identifying when most weight gain occurs throughout the life course can inform targeted public health interventions. We evaluated the association of childbirth, marriage, and employment changes with weight changes in a multi-ethnic Asian cohort. Singapore Multi-Ethnic Cohort participants ≥21 years (n = 9655) who identified as ethnic Chinese, Malay, or Indian were weighed and interviewed about marital status, employment, and number of children at baseline and after about four years. We used multivariable regression to evaluate life transitions in relation to weight change and major gain (≥5 kg), and adjusted for socio-demographic covariates. Weight gain was 3.55 kg (95% CI 3.17, 3.94) higher in young adults (21-30 years) compared with participants older than 60 years at baseline. Getting married was associated with weight gain in women, but not men (p interaction < 0.01). Women who got married gained 1.63 kg (95% CI 0.88, 2.38) more weight and were more likely to gain ≥5 kg (OR 1.99, 95% CI 1.35, 2.93) than those remaining unmarried. Having children was not associated with weight gain. Only among ethnic Indians, remaining a homemaker was associated with less weight gain than remaining employed. In this multi-ethnic Asian population, obesity prevention efforts should target young adulthood and, in women, the transition into marriage.

Cosmology favoring extra radiation and sub-eV mass sterile neutrinos as an option.

Precision cosmology and big-bang nucleosynthesis mildly favor extra radiation in the Universe beyond photons and ordinary neutrinos, lending support to the existence of low-mass sterile neutrinos. We use the WMAP 7-year data, small-scale cosmic microwave background observations from ACBAR, BICEP, and QuAD, the SDSS 7th data release, and measurement of the Hubble parameter from HST observations to derive credible regions for the assumed common mass scale m{s} and effective number N{s} of thermally excited sterile neutrino states. Our results are compatible with the existence of one or perhaps two sterile neutrinos, as suggested by LSND and MiniBooNE, if m{s} is in the sub-eV range.

The role of temporal synchrony as a binding cue for visual persistence in early visual areas: an fMRI study.

We examined the role of temporal synchrony-the simultaneous appearance of visual features-in the perceptual and neural processes underlying object persistence. When a binding cue (such as color or motion) momentarily exposes an object from a background of similar elements, viewers remain aware of the object for several seconds before it perceptually fades into the background, a phenomenon known as object persistence. We showed that persistence from temporal stimulus synchrony, like that arising from motion and color, is associated with activation in the lateral occipital (LO) area, as measured by functional magnetic resonance imaging. We also compared the distribution of occipital cortex activity related to persistence to that of iconic visual memory. Although activation related to iconic memory was largely confined to LO, activation related to object persistence was present across V1 to LO, peaking in V3 and V4, regardless of the binding cue (temporal synchrony, motion, or color). Although persistence from motion cues was not associated with higher activation in the MT+ motion complex, persistence from color cues was associated with increased activation in V4. Taken together, these results demonstrate that although persistence is a form of visual memory, it relies on neural mechanisms different from those of iconic memory. That is, persistence not only activates LO in a cue-independent manner, it also recruits visual areas that may be necessary to maintain binding between object elements.

Effect of bupropion on sexual dysfunction.

OBJECTIVE: To determine the role of bupropion in treatment of sexual dysfunction. DATA SOURCES: Studies and case reports were identified through MEDLINE (1970-July 2005) using search terms bupropion, antidepressants, sexual function, and sexual dysfunction. DATA SYNTHESIS: Bupropion has been shown to have a favorable effect on sexual dysfunction. Several reports and small, short-term trials have examined bupropion as an adjunct or substitute for other antidepressants in sexually dysfunctional patients. Use of bupropion has also been studied in nondepressed patients. Bupropion may be a promising medication for treating sexual dysfunction. However, specific dosing is unclear. CONCLUSIONS: While the studies reviewed here demonstrated some benefit in using bupropion to treat sexual dysfunction, limitations exist. Future studies should be conducted using larger sample sizes.

Precision grasps of children and young and old adults: individual differences in digit contact strategy, purchase pattern, and digit posture.

The evolutionary origins and variations of the precision grip, in which an object is held between the thumb and other digits, are poorly understood. This is surprising because the neural basis of this grasp pattern, including the motor cortex and pyramidal tract have received extensive study. Most previous work has shown that features of an object to be grasped (external factors) determine grasp patterns. The objective of the present study was to investigate individual differences (central factors) in use of the pincer and other precision grips. The grasping patterns of male and female young adults, older adults and children were examined as they reached (with both left and right hand) for five small beads (3-16 mm diameter). Frame-by-frame analysis of grasping indicated a high degree of variability in digit contact strategies, purchase patterns and digit posture both within and between subjects. (1) The contact strategies consisted of five variations, depending on whether the thumb or the index finger dragged or stabilized the bead for grasping. (2) Purchase patterns consisted of seven different types of precision grips, involving the thumb and various combinations of other digits. (3) There were four variations stemming from the posture of the non-grasping digits. Grip patterns of the left and right hands were correlated in individual subjects, as were strategies used for different bead sizes. Females displayed slightly more variability in grasp patterns than did males, and digit width (obtained from photocopies of the subjects' hands) was weakly correlated with the grasp patterns used. Although it was expected that the pincer would be used for all objects, it was preferentially used for only the smallest object except for older adults who used the pincer grasp on most objects. The variability in digit contact strategies, purchase patterns, and posture of the non-grasping digits indicates that central factors (innate or learning-induced architecture of the left parietal cortex) make important contributions to the selection of a grasping pattern. These individual differences are discussed in relation to the neural control of grasping and its potential contribution to understanding the evolution, development, and pathology of the precision grip.