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l, social) as well as their access to dental care in order to support regular dental attendance and potentially, in turn, enhance oral health. © 2020 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.BACKGROUND AND AIM Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) account for a large and growing proportion of liver disease burden globally. The burden of NAFLD/NASH manifests in increasing levels of advanced liver disease and primary liver cancer in Australia. A Markov model was used to forecast NAFLD burden in Australia through 2030. METHODS A model was used to estimate fibrosis progression, primary liver cancer, and liver deaths among the Australian NAFLD population, with changes in incident NAFLD cases based on long-term trends for changes in the prevalence of obesity. Published estimates and surveillance data were applied to build and validate the model projections, including surveillance data for the incidence of liver cancer. RESULTS Prevalent NAFLD cases were projected to increase 25% from the current burden (5 551 000 [4 748 000-6 306 000] cases in 2019) to 7 024 000 [5 838 000-7 886 000] cases in 2030. The projected increase in the number of NASH cases (40%) was greater than that of NAFLD cases. Incident cases of advanced liver disease are projected to increase up to 85% by 2030, and incident NAFLD liver deaths are estimated to increase 85% from 1900 (1100-3300) deaths in 2019 to 3500 (2100-6100) deaths in 2030. CONCLUSIONS Restraining growth of the obese and diabetic populations, along with potential therapeutic options, will be essential for mitigating disease burden. © 2020 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.AIM To evaluate the feasibility of a structured nurse-led supportive intervention and its effects on family caregivers in end-of-life care at home. BACKGROUND Family caregivers are crucial in end-of-life care. They may experience burden due to the responsibilities associated with caregiving. Some family caregivers feel insufficiently prepared for their caregiver role. Nurses have a unique position to provide supportive interventions at home to reduce caregivers' burden and improve preparedness. However, few nurse-led interventions are available to support family caregivers in end-of-life care at home. DESIGN We will perform a cluster randomized controlled trial. The clusters consist of twelve home care services, randomly assigned to the intervention group or the control group. METHODS The study population consists of family caregivers of patients in the last phase of life. In the intervention group, nurses will systematically assess the supportive needs of family caregivers, using an assessment tool and the method of clinical reasoning. Family members of the control group receive care as usual. Primary outcome is burden measured by the Self-Rated Burden Scale. Secondary outcomes are preparedness for caregiving, caregiving reactions and acute (hospital) admissions of the patient. In addition, the feasibility of the intervention will be evaluated. The study was funded in October 2016 and was ethically approved in April 2019. IMPACT Findings from this study will contribute to the scientific and practical knowledge of nursing interventions to support family caregivers in end-of-life care. TRIAL REGISTRATION The Netherlands Trial Register (NL7702). © 2020 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.BACKGROUND Despite increased interest in combining learning and physical activity (PA), the academic and PA benefits of active learning are uncertain. METHODS A systematic search of 5 databases for studies combining learning math with PA in primary/elementary schools was conducted. Academic benefit was evaluated by pre-post intervention math scores compared to a control group. Effect sizes (ES) were extracted/calculated when possible. Due to study heterogeneity, meta-analysis was not conducted. RESULTS Six randomized controlled trials and 5 quasi-experimental studies evaluating 4082 participants (53% girls; mean age 7.5-11.1 years) were eligible. Math scores were significantly better in the intervention group in 6 of 11 studies on at least 1 test (ES 0.42-4.7; p ≤ .03). Other math tests either were not all statistically significant (2 studies) or the benefit varied across grades (1 study). No studies reported a decline in math scores. Of studies measuring PA with accelerometers, 4 of 5 reported significantly greater PA in the intervention group during the intervention (p  less then  .05) or across the school day (p  less then  .01). CONCLUSIONS Undertaking PA while learning was largely equivocal for math scores but showed promising results for increasing daily PA, without detrimental effects on math performance. The need for more rigorous studies with comprehensive assessment of academic performance and PA is highlighted. © 2020, American School Health Association.This paper examines the content and degree of uniformity of meta-stereotypes among women living homeless in Madrid, Spain, and the differences with their male counterparts. The study was conducted utilizing a structured interview with a representative sample of men living homeless (n = 158) and a convenience sample of a similar size (n = 138) of women living homeless. The results show that the meta-stereotypes of women living homeless in Madrid are characterized by mainly negative (e.g., consumers of alcohol, drug users, lazy, criminals) or indulgent (e.g., physically and psychologically worn out, rejected by society, sick) contents, with very limited positive (e.g., courteous, respectful, polite) contents, and a high degree of uniformity. There are no major differences in the content of meta-stereotypes of the female interviewees in terms of their age, academic background, motherhood, or nationality. Compared to men in the same situation, a larger percentage of women living homeless agree with negative and indulgent meta-stereotypes, and a smaller percentage agree with positive meta-stereotypes. © 2020 Wiley Periodicals, Inc.Two methods for designing adaptive multiarm multistage (MAMS) clinical trials, originating from conceptually different group sequential frameworks are presented, and their operating characteristics are compared. In both methods pairwise comparisons are made, stage-by-stage, between each treatment arm and a common control arm with the goal of identifying active treatments and dropping inactive ones. At any stage one may alter the future course of the trial through adaptive changes to the prespecified decision rules for treatment selection and sample size reestimation, and notwithstanding such changes, both methods guarantee strong control of the family-wise error rate. The stage-wise MAMS approach was historically the first to be developed and remains the standard method for designing inferentially seamless phase 2-3 clinical trials. In this approach, at each stage, the data from each treatment comparison are summarized by a single multiplicity adjusted P-value. These stage-wise P-values are combined by a preslished by John Wiley & Sons, Ltd.BACKGROUND Donor human milk (DHM) is used as alternative to maternal milk to feed preterm infants; however, it may provide less long-chain (LC) polyunsaturated fatty acids (PUFAs) and more oxidized lipids, which may be detrimental to preterm infant health and development. Levels have not been reported for DHM in the United Kingdom. METHODS DHM (n = 19) from 2 neonatal units, preterm milk from a neonatal unit (n = 10), and term milk from the community (n = 11) were analyzed for fatty acids, malondialdehyde, 4-hydroxy-2-nonenal, and hexanal. STUDY REGISTRATION NCT03573531. RESULTS DHM had significantly lower absolute LCPUFA content than term (P less then .001) and significantly lower ω-3 PUFAs than preterm milk (P less then .05), although relative LCPUFA composition did not differ. Exclusive DHM feeding leads to significantly lower fat (3.7 vs 6.7 g/d) and LCPUFA (docosahexaenoic acid [DHA] 10.6 vs 16.8 mg/d; arachidonic acid [ARA] 17.4 vs 25.2 mg/d) intake than recommended by the European Society for Pediatric Gastroenterology, Hepatology and Nutrition, and provides 17.3% and 43.1% of the in utero accreted ARA and DHA. DHM had the highest proportion of lipid peroxidation. Etomoxir CONCLUSIONS This study confirms that DHM in the United Kingdom has insufficient LCPUFAs for preterm infants. It demonstrates for the first time that DHM has the highest level of lipid peroxidation, compared with preterm or term milk. This has important implications for preterm infant nutrition, as exclusive DHM feeding might not be suitable long term and may contribute to the development of major preterm neonatal morbidities. © 2020 American Society for Parenteral and Enteral Nutrition.Chlorpyrifos is a poisonous pesticide that is highly toxic to fish and aquatic organisms. However, there are fewer reports about how chlorpyrifos influences the redox balance of immune cells. Herein, the head kidney tissue treated with chlorpyrifos to do transcriptome analysis and TCR γ was screened out. Subsequently, we established TCR γ knockdown and overexpression carp head kidney lymphocyte models, respectively, by using RNA interference and pcDNA3.1. Real-time PCR, fluorescent staining, oxidation and antioxidant kit were used to detect the related factors. We found that TCR γ knockdown significantly increased the mRNA expression of HSP70 and HSP90 and decreased the mRNA expression of SOD and CAT. Meanwhile, TCR γ knockdown reduced the activities of GSH, GSG-PX, T-AOC, CAT and SOD and increased the content of MDA and H2 O2 and activities of iNOS. Adverse results were obtained in TCR γ overexpression group. Additionally, TCR γ knockdown significantly increased the mRNA expression of IFN-γ, IL-1β, IL-8, IL-10, Nrf2 and NF-κB, but relieved TCR γ overexpression, in which the process of inflammation was activated. Our results reported here indicated that chlorpyrifos induces redox imbalance-dependent inflammation in common carp lymphocyte through dysfunction of T-cell receptor γ, and HSPs play potential protective role in entire process. © 2020 John Wiley & Sons Ltd.White spot syndrome virus has been a threat to the global shrimp industry since it was discovered in Taiwan in 1992. Thus, shrimp-producing countries have launched regulations to prevent import of WSSV-infected commodity shrimp from endemic areas. Recently, cooked shrimp that is infected with WSSV tested positive by PCR. However, there is no study to determine the infectivity of WSSV in cooked shrimp that tested positive by PCR. In the present study, WSSV-infected shrimp were cooked at boiling temperature for different times including 0, 1, 3, 5, 10 and 30 min. Upon exposure to boiling temperature, WSSV-infected shrimp were fed to SPF shrimp (Litopenaeus vannamei). The result showed experimentally challenged shrimp from 0-min treatment (positive control) indeed got infected with WSSV. However, experimentally challenged shrimp that were fed tissues boiled at 1, 3, 5, 10 and 30 min were not infected with WSSV. Mortality data showed that only the positive control (0-min) treatment displayed high mortality, whereas no mortality was observed in any other treatment category.
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