Nudging customers towards healthier food and beverage purchases in a real-life online supermarket: a multi-arm randomized controlled trial

Background Nudging is increasingly used to promote healthy food choices in supermarkets. Ordering groceries online is gaining in popularity and nudging seems efficacious there as well, but is never comprehensively tested in real-life. We evaluated the real-life effectiveness of nudging in an online supermarket on healthy food purchases. Methods We conducted a multi-arm, parallel-group, individually randomized controlled trial in an online supermarket. During 1 month, all customers were randomized to (1) control condition, (2) information nudges, (3) position nudges, and (4) information and position nudges combined. Allocation was concealed and customers were not blinded, but unaware of the intervention. Mean differences between the control condition and the intervention arms in the total percentage of healthy purchases were assessed with a linear mixed model. We tested for effect modification by area-level deprivation. Results Based on sales data from 11,775 shoppers, no overall significant effects were detected. Yet, effects were modified by area-level deprivation (pArm 2 < 0.001). Among shoppers from deprived areas, those allocated to information nudges purchased a 2.4% (95%CI 0.8, 4.0) higher percentage of healthy products compared to controls. No significant differences were observed for position (− 1.3%; 95%CI − 2.8, 0.3) and combined nudges (− 0.1%; 95%CI − 1.7, 1.5). Shoppers from non-deprived areas exposed to information nudges (− 1.6%; 95%CI − 3.2, − 0.1) and the combined nudges (− 2.1%; 95%CI − 3.6, − 0.6), but not position nudges (− 0.9%; 95%CI − 2.4, 0.7), purchased a lower percentage of healthy products. Conclusion Information nudges in an online supermarket can increase healthy product purchases, but only for those living in deprived areas. The adverse effects found on purchasing behaviors for those from non-deprived areas call for further research. Further research should also focus on real-life effects of online healthy food nudging as part of a broader nutrition intervention strategy, and on the equitability of the online nudging intervention within populations. Trial registration Retrospectively registered in the ISRCTN registry at May 21, 2021 (ISRCTN10491616).

Spatially Resolved Operando Synchrotron-Based X-Ray Diffraction Measurements of Ni-Rich Cathodes for Li-Ion Batteries

Understanding the performance of commercially relevant cathode materials for lithium-ion (Li-ion) batteries is vital to realize the potential of high-capacity materials for automotive applications. Of particular interest is the spatial variation of crystallographic behavior across (what can be) highly inhomogeneous electrodes. In this work, a high-resolution X-ray diffraction technique was used to obtain operando transmission measurements of Li-ion pouch cells to measure the spatial variances in the cell during electrochemical cycling. Through spatially resolved investigations of the crystallographic structures, the distribution of states of charge has been elucidated. A larger portion of the charging is accounted for by the central parts, with the edges and corners delithiating to a lesser extent for a given average electrode voltage. The cells were cycled to different upper cutoff voltages (4.2 and 4.3 V vs. graphite) and C-rates (0.5, 1, and 3C) to study the effect on the structure of the NMC811 cathode. By combining this rapid data collection method with a detailed Rietveld refinement of degraded NMC811, the spatial dependence of the degradation caused by long-term cycling (900 cycles) has also been shown. The variance shown in the pristine measurements is exaggerated in the aged cells with the edges and corners offering an even lower percentage of the charge. Measurements collected at the very edge of the cell have also highlighted the importance of electrode alignment, with a misalignment of less than 0.5 mm leading to significantly reduced electrochemical activity in that area.

Plumage Response of Young Turkeys to Diets with Increased Methionine to Lysine Ratios at Three Dietary Arginine Levels

A 2 × 3 factorial experiment was conducted to evaluate the effects of two dietary methionine levels (Met; 30% and 45% of Lys content) and three arginine levels (Arg; 90%, 100%, and 110% of Lys content) on plumage development in 4- and 16-week-old female turkeys. One-day-old turkey poults were assigned to six groups (eight replicate pens per group and 18 birds per pen) and fed experimental diets containing 1.6%, 1.5%, 1.3%, and 1.0% of Lys in four successive four-week periods. After weeks 4 and 16 of feeding, eight turkeys per group were selected for plumage evaluation. Feathers were collected from the outer side of one thigh and from an area of 4 cm2 in the interscapular region. Plumage was evaluated based on an established pattern of five feather development stages in turkeys, from stage I (pinfeathers covered in sheaths) to stage V (mature feathers). An increase in the Met inclusion rate to 45% of Lys content had no significant effect on feather growth in 4-week-old turkeys, but it accelerated the development of feathers in 16-week-old birds. A lower percentage of stage II (p = 0.035), stage III (p = 0.019), and stage IV (p = 0.003) immature feathers, and a higher percentage of stage V (mature) feathers (p = 0.001) were observed. Methionine exerted a greater effect on the development of thigh feathers (p = 0.001) than interscapular feathers (p = 0.074). Unlike Met, different Arg concentrations had no influence on plumage development in turkeys. Overall, the present results indicate that supplemental Met has a potential for accelerating feather development in 16-week-old turkeys via an increased supply of total sulfur amino acids.

Public Perceptions About Covid-19 Prevention Measures in Ganting Parak Gadang Village, Padang Timur District

Background: The dominant factors that influence Covid-19 prevention behavior can be divided into three domains; knowledge, attitude and action. Knowledge is the result of knowing after people have sensed certain objects. Attitude describes whether a person like or dislike towards an object. Action is a response to a stimulus that is active and observable.Methods: This study aims to determine the public's perception towards Covid 19 Prevention in Ganting Parak Gadang Village, East Padang. The type of research used is the Winshield Survey. The sample used 24 families by random sampling at TNI AD Ganting Parak Gadang dormitory, RW: 08 consists of RT 01,02,03,04,05,06.Results: The results of this research showed that the respondents' perceptions of 100% considered the current situation is seriously in dangerous and should not be considered as trivial cases, 62% of handling COVID-19 carried out preventive behaviors such as maintaining immunity, 71% of people's behavior in worshiping choosing to worship at home, as much as 75% did not go to planned events. Knowledge of respondents 84% still doubted and did not know about the symptoms of covid 19 and as much as 23% did not know about OTG covid 19 is 62% knew from social media.Conclusions: The conclusion in this study are attitude and the highest percentage of preventive actions in the good category compared with the lower percentage of prevention knowledge. The suggestion in the study is that the public is expected to maintain health protocols by continuing to follow government recommendations in efforts to prevent Covid-19.

Ticagrelor Versus Clopidogrel in The Treatment of Elderly Chinese Chronic Total Occlusion Patients Undergoing PCI

Background: Taking thrombosis and bleeding risks into consideration, little real world study data is available to dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in elderly Chinese chronic total occlusion (CTO) patients. Methods: We assigned 504 CTO patients aged ≥75 years who successfully underwent PCI from December 2009 to May 2020. The patients were randomized to Clopidogrel and Ticagrelor group and received DAPT for up to 12 months. Efficacy endpoints were evaluated by major adverse cardiac events (MACE) consisting of all-cause death, nonfatal myocardial infarction (MI) and clinically driven revascularization. The safety endpoints were recorded as the incidence of Bleeding Academic Research Consortium (BARC) bleeding. Results: Patients in Clopidogrel group were older, they had a higher percentage of BMI, diastolic blood pressure and HDL-C than those in Ticagrelor group. Clopidogrel group had a lower percentage of hyperlipidemia, prior PCI, glucose, TG and LDL-C. No significant difference was found as to the Angiographic and procedural characteristics (P＞0.05 for all). After 12 months' follow-up, the incidence of MACE (12.19% vs. 11.04%, P=0.763) and bleeding (9.38% vs. 13.64%, P=0.205) had no significant difference. After clinical characteristics balanced matching by IPTWs model, we found that Ticagrelor had an unfavorable effect on reducing the incidence of bleeding with the IPTWs model (IPTW-OR, 1.81, 95% CI: 1.18-2.76, P=0.006). Conclusions: This clinical study demonstrated that Clopidogrel should be recommended to elderly CTO patients after PCI, especially those with a high bleeding risk. Trial registration: The study protocol was approved by the Ethics Committee of Air Force Medical University (KY20172019-1).

Metformin-Incorporated Gelatin/Nano-Hydroxyapatite Scaffolds Promotes Bone Regeneration in Critical Size Rat Alveolar Bone Defect Model

In this study, we fabricated gelatin/nano-hydroxyapatite/metformin scaffold (GHMS) and compared its effectiveness in bone regeneration with extraction-only, Sinbone, and Bio-Oss Collagen® groups in a critical size rat alveolar bone defect model. GHMS was synthesized by co-precipitating calcium hydroxide and orthophosphoric acid within gelatin solution, incorporating metformin, and cross-linked by microbial transglutaminase. The morphology, characterization, and biocompatibility of scaffold were examined. The in vitro effects of GHMS on osteogenic gene and protein expressions were evaluated. In vivo bone formation was assessed in a critical size rat alveolar bone defect model with micro-computed tomography and histological examination by comparing GHMS with extraction-only, Sinbone, and Bio-Oss Collagen®. The synthesized GHMS had a highly interconnected porous structure with a mean pore size of 81.85 ± 13.8 µm. GHMS exhibited good biocompatibility; promoted ALPL, RUNX2, SP7, BGLAP, SPARC and Col1a1 gene expressions; and upregulated the synthesis of osteogenic proteins, including osteonectin, osteocalcin, and collagen type I. In critical size rat alveolar bone defects, GHMS showed superior bone regeneration compared to extraction-only, Sinbone, and Bio-Oss Collagen® groups as manifested by greater alveolar ridge preservation, while more bone formation with a lower percentage of connective tissue and residual scaffold at the defect sites grafted with GHMS in histological staining. The GHMS presented in this study may be used as a potential bone substitute to regenerate alveolar bone. The good biocompatibility, relatively fast degradation, interconnected pores allowing vascularization, and higher bioactivity properties of the components of the GHMS (gelatin, nHA, and metformin) may contribute to direct osteogenesis.

Significance of the neutrophil-to-lymphocyte ratio in predicting the response to neoadjuvant chemotherapy in extremity osteosarcoma: a multicentre retrospective study

Background At present, no predictive factor has been validated for the early efficacy of neoadjuvant chemotherapy (NACT) in osteosarcoma. The purpose of this study was to investigate the significance of the neutrophil-to-lymphocyte ratio (NLR) in predicting the response to NACT in extremity osteosarcoma. Methods Pathological complete response (pCR) was used to assess the efficacy of NACT. Receiver operating characteristic (ROC) curves and the Youden index (sensitivity + specificity-1) were used to determine the optimal cut-off values of the NLR. Univariate and multivariate analyses using logistic regression models were conducted to confirm the independent factors affecting the efficacy of NACT. Results The optimal NLR cut-off value was 2.36 (sensitivity, 80.0%; specificity, 71.3%). Univariate analysis revealed that patients with a smaller tumour volume, lower stage, lower NLR and lower PLR were more likely to achieve pCR. Multivariate analyses confirmed that the NLR before treatment was an independent risk factor for pCR. Compared to patients with a high NLR, those with a low NLR showed a more than 2-fold higher likelihood of achieving pCR (OR 2.82, 95% CI 1.36-5.17, p = 0.02). Conclusion The NLR is a novel and effective predictive factor for the response to NACT in extremity osteosarcoma patients. Patients with a higher NLR showed a lower percentage of pCR after NACT.

Client satisfaction to methadone maintenance treatment program in Myanmar

Background To tackle the long-standing opioid misuse problem, Myanmar introduced the methadone maintenance treatment (MMT) program in 2006, starting with 260 clients. Since then, the program has been expanded across different geographical sites in the country. This study was done in 2017 to explore the treatment satisfaction of the clients towards the MMT program. Method A total of 210 clients with a minimum of six-month treatment history enrolled in five MMT program sites across Myanmar were recruited through stratified random sampling. Administering the Verona Service Satisfaction Scale for Methadone-Treatment (VSSS-MT), this study assessed the satisfactory responses under three categories viz., 1) clinic staff professional skills; 2) basic drug intervention; 3) specific intervention (individual rehabilitation and psychotherapy). Results The majority (89%, n = 186) of the respondents were satisfied with the current MMT program. Specifically, 89.5% (n = 187) were satisfied with the clinic staff professional skills category, 91.9% (n = 192) with the basic program intervention and 74.6% (n = 156) with specific interventions. Among the respondents, treatment satisfaction with the MMT program was higher (p < 0.05) in those (i) with a higher quality of life score in physical, psychological, social and environmental categories, ii) who were satisfied with their current marital and leisure status, and those iii) who consumed alcohol. Results from stepwise binary logistic regression showed alcohol consumption and physical health status had a significant association with MMT treatment satisfaction. Conclusion Treatment satisfaction of the clients, in general is high. However, the lower percentage of satisfied clients (74.6%) for the specific interventions category compared with 89.5 and 91.9% respectively for staff and basic drug management categories highlights the need for improvement in this category for overall enhancement of the MMT program.

Perbedaan pertumbuhan dan produktivitas varietas bayam hijau dan bayam merah

Bayam termasuk salah satu sayuran terpenting di Indonesia karena paling banyak dikonsumsi setelah kangkung. Bayam hijau dan bayam merah merupakan jenis bayam paling banyak ditanam dan dikonsumsi. Penelitian ini bertujuan untuk mengetahui perbedaan pertumbuhan dan produktivitas varietas bayam hijau dan bayam merah. Penelitian dilakukan pada Februari – April 2021 di Kebun Percobaan Leuwikopo, Departemen Agronomi dan Hortikultura, Fakultas Pertanian, IPB University. Sebanyak 9 varietas bayam hijau (Maryland, Richie, Maestro, Benua, Doly, Khanafiah, Manila, Pacific, White Leaf) dan 4 varietas bayam merah (Mira, Baret Merah, Clara, Aurora) ditanam menggunakan rancangan kelompok lengkap teracak dengan tiga ulangan. Hasil penelitian memperlihatkan bahwa varietas bayam hijau memiliki kandungan persentase warna hijau daun lebih banyak namun memiliki persentase warna biru dan merah yang lebih rendah dibandingkan varietas bayam merah. Hasil penelitian juga memperlihatkan bahwa varietas bayam hijau menghasilkan tinggi tanaman dan produktivitas yang lebih baik dibandingkan varietas bayam merah, namun varietas bayam merah menghasilkan luas daun dan jumlah daun per tanaman saat panen yang lebih baik besar dibandingkan varietas bayam hijau. Varietas White Leaf merupakan varietas bayam yang sangat baik karena memiliki persentase warna hijau daun yang tinggi, luas daun yang besar dan produktivitas yang tinggi. Spinach is one of the most important vegetables in Indonesia because it was the second most consumed after kangkung. Green spinach and red spinach are the most widely grown and consumed types of spinach. This study aimed to determine differences in growth and productivity between varieties of green spinach and red spinach. The research was conducted in February – April 2021 at the Leuwikopo Experimental Field, Department of Agronomy and Horticulture, Faculty of Agriculture, IPB University. A total of nine varieties of green spinach and four varieties of red spinach were planted using a completely randomized block design with three replications. The results showed that the green spinach variety contained a higher percentage of green leaf color but had a lower percentage of blue and red leaf color than the red spinach varieties. The results also showed that the green spinach varieties produced better plant height and productivity than the red spinach varieties, but the red spinach produced better leaf area and a number of leaves per plant at harvest than the green spinach. The White Leaf variety is the excellent spinach variety because it has a high percentage of green leaf color, large leaf area, and high productivity.

Factors associated with risk, perception and knowledge of falls in elderly people

ABSTRACT Objective: To verify the factors associated with risk, perception, and knowledge of falls; and pain among older adults. Method: A cross-sectional study carried out in the Emergency Service of a teaching hospital in the city of São Paulo between September 2019 and March 2020. We selected 197 older adults aged 65 and over, who were not disoriented or confused, of both genders. The instruments Awareness Questionnaire on the Risk of Falls, Morse Fall Scale and Numerical Pain Scales were applied. Mann-Whitney and Kruskal-Wallis tests were used. Results: Interviewees with a high risk of falls in older adults (p = 0.0041); those with a support network had a lower perception and knowledge about the risk of falls (p = 0.0025) and lower percentage of severe pain (p = 0.0033). Conclusion: Factors associated with risk, perception and knowledge of falls and pain among older adults were age, family income, number of dependents, caregiver, support network, hypertension, impaired walking, antihypertensive medication, lipid-lowering medication, level of education, comorbidities and religion.