scholarly journals Total Water-Soluble Choline Concentration Does Not Differ in Milk from Vegan, Vegetarian, and Nonvegetarian Lactating Women

2019 ◽  
Vol 150 (3) ◽  
pp. 512-517
Author(s):  
Maryanne T Perrin ◽  
Roman Pawlak ◽  
Lindsay H Allen ◽  
Daniela Hampel
Keyword(s):  
Breast Milk ◽  
Maternal Diet ◽  
The United States ◽  
Water Soluble ◽  
Total Water ◽  
Maternal Plant ◽  
Lactating Women ◽  
Wide Range ◽  
Significant Difference ◽  
The Impact

ABSTRACT Background Choline is an essential nutrient for brain growth and other processes in the developing neonate. The impact of a maternal plant-based diet on the choline composition of breast milk is unknown. Objective We assessed the water-soluble choline content of milk from lactating women in the United States following 3 dietary patterns: vegan, vegetarian, and nonvegetarian. Methods We conducted a cross-sectional study of 74 healthy lactating women who provided a single breast-milk sample using a standardized collection protocol. Participants completed a food-frequency screener and were classified as follows: nonvegetarians (NONVEG) consumed meat; vegetarians (VEGT) consumed milk, dairy, and/or fish; and vegans (VEGAN) consumed animal products less than monthly. Primary outcomes measured were the concentration (in milligrams per liter) and distribution (percentage) of choline from the following water-soluble forms: free choline, phosphocholine (PCho), and glycerophosphocholine (GPC). Differences between diet groups were evaluated with ANOVA. Results There was a wide range in breast-milk total water-soluble choline (4–301 mg/L), with no significant difference (P > 0.05) by maternal diet pattern. There were differences in choline forms, with VEGAN having a greater mean ± SD concentration and distribution of choline derived from GPC (62.7 ± 25.3 mg/L) than VEGT (47.7 ± 21.2 mg/L) and NONVEG (42.4 ± 14.9 mg/L) (P = 0.0052). There was a lower mean ± SD percentage of choline from PCho (P = 0.0106) in VEGAN (32.5% ± 18.3%) than in VEGT (46.1% ± 18.3%) and NONVEG (44.8% ± 15.7%). Lactation stage and maternal BMI were significantly associated with some choline forms. Conclusions There was a wide range of water-soluble choline concentrations in the milk of healthy lactating women following vegan, vegetarian, and nonvegetarian diets, with no observed difference in total water-soluble choline concentration by maternal diet. This suggests that maternal plant-based diet by itself is not a risk factor for low breast-milk choline.

scholarly journals Vitamin B-12 content in breast milk of vegan, vegetarian, and nonvegetarian lactating women in the United States

2018 ◽  
Vol 108 (3) ◽  
pp. 525-531 ◽  
Author(s):  
Roman Pawlak ◽  
Paul Vos ◽  
Setareh Shahab-Ferdows ◽  
Daniela Hampel ◽  
Lindsay H Allen ◽  
...  
Keyword(s):  
Breast Milk ◽  
Maternal Diet ◽  
Linear Regression Analysis ◽  
The United States ◽  
Diet Group ◽  
Vitamin B ◽  
Supplement Use ◽  
Diet Pattern ◽  
Vitamin B 12 ◽  
The Impact

ABSTRACT Background The nutritional profile of human milk varies significantly between women, and the impact of maternal diet on these variations is not well understood. Objective We analyzed breast-milk vitamin B-12 concentration and vitamin B-12 supplement use pattern among women who adhered to different dietary patterns: vegan, vegetarian, and nonvegetarian. Design A total of 74 milk samples, 29 from vegan, 19 from vegetarian, and 26 from nonvegetarian breastfeeding mothers, were analyzed. Results The prevalences of low vitamin B-12 (<310 pmol/L) were 19.2% for vegans, 18.2% for vegetarians, and 15.4% for nonvegetarians, which was not significant by diet group (P = 1.00). The median (quartile 1, quartile 3) vitamin B-12 values were 558 pmol/L (331, 759 pmol/L) for vegans, 509 pmol/L (368, 765 pmol/L) for vegetarians, and 444 pmol/L (355, 777 pmol/L) for nonvegetarians (P = 0.890). The use of individual vitamin B-12 supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and nonvegetarians (3.9%) (P = 0.001). In linear regression analysis, the use of individual vitamin B-12 supplements was a significant positive predictor of milk vitamin B-12 concentration (β ± SE: 172.9 ± 75.2; standardized β = 0.263; P = 0.024; R2 = 0.069), the use of a multivitamin had a significant negative relation with milk vitamin B-12 concentrations (β ± SE −222.0 ± 98.7; standardized β = −0.258; P = 0.028, R2 = 0.067;), whereas the use of a B-complex vitamin and prenatal vitamin were not predictive of vitamin B-12 milk concentration (P > 0.05). Conclusions Almost 20% of our study participants were classified as having low breast-milk vitamin B-12 concentrations (<310 pmol/L), independent of maternal diet pattern. Approximately 85% of participants categorized as having low vitamin B-12 were taking vitamin B-12 supplements at doses in excess of the Recommended Dietary Allowance, which suggests that more research is needed to determine breast-milk adequacy values.

Abstract 257: Urban Teaching and Non-Teaching Hospitals Outcomes: Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Priscilla O Okunji ◽  
Johnnie Daniel
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Income Group ◽  
The United States ◽  
Teaching Hospitals ◽  
Age Difference ◽  
Age Group ◽  
Urban Teaching ◽  
Significant Difference ◽  
The Impact

Background: Patients with myocardial infarction reportedly have different outcomes on discharge according to hospital characteristics. In the present study, we evaluated the differences between urban teaching hospitals (UTH) and non-teaching hospitals (NTH), discharged in 2012. We also investigated on the outcomes. Methods: Sample of 117,808 subjects diagnosed with myocardial infarction were extracted from a nationwide inpatient stay dataset using the International Classification Data, ICD 9 code 41000 in the United States, according to hospital location, size, and teaching status. Results: The analysis of the data showed that more whites were admitted to both teaching and non teaching hospitals with more males (~24%) admitted than their female counterparts. However, blacks were admitted more (~15%) in urban teaching hospitals than medium urban non teaching hospitals. Age difference was noted as well, while age group (60-79 years) were admitted more in UTH, inversely urban non-teaching hospitals admitted more older (80 years or older) age group. A significant difference (~28%) was observed in both hospital categories with UTH admitting more patients of $1.00 - $38,999.00 income group than other income categories. In addition, it was observed that patients with MI stayed more (~5%) for 14 or more days, and charged more especially for income group of $80,000 or above in UTH than NTH. No significant difference was found in the mortality rate for both hospital categories. Conclusion: The overall outcomes showed that the mortality rate between urban teaching and non-teaching hospitals were non significant, though the inpatients MI stayed longer and were charged more in UTH than NTH. The authors call for the study to be replicated with a higher level of statistical measures to ascertain the impact of the variables on the outcomes for a more validated result.

Evolving oncology provider perspectives on care delivery during the COVID-19 pandemic.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18609-e18609
Author(s):  
Divya Ahuja Parikh ◽  
Meera Vimala Ragavan ◽  
Sandy Srinivas ◽  
Sarah Garrigues ◽  
Eben Lloyd Rosenthal ◽  
...  
Keyword(s):  
Cancer Care ◽  
Care Delivery ◽  
The United States ◽  
Advanced Practice ◽  
Curative Surgery ◽  
Time Points ◽  
Patients With Cancer ◽  
Provider Perspectives ◽  
Significant Difference ◽  
The Impact

e18609 Background: The COVID-19 pandemic prompted rapid changes in cancer care delivery. We sought to examine oncology provider perspectives on clinical decisions and care delivery during the pandemic and to compare provider views early versus late in the pandemic. Methods: We invited oncology providers, including attendings, trainees and advanced practice providers, to complete a cross-sectional online survey using a variety of outreach methods including social media (Twitter), email contacts, word of mouth and provider list-serves. We surveyed providers at two time points during the pandemic when the number of COVID-19 cases was rising in the United States, early (March 2020) and late (January 2021). The survey responses were analyzed using descriptive statistics and Chi-squared tests to evaluate differences in early versus late provider responses. Results: A total of 132 providers completed the survey and most were white (n = 73/132, 55%) and younger than 49 years (n = 88/132, 67%). Respondents were attendings in medical, surgical or radiation oncology (n = 61/132, 46%), advanced practice providers (n = 48/132, 36%) and oncology fellows (n = 16/132, 12%) who predominantly practiced in an academic medical center (n = 120/132, 91%). The majority of providers agreed patients with cancer are at higher risk than other patients to be affected by COVID-19 (n = 121/132, 92%). However, there was a significant difference in the proportion of early versus late providers who thought delays in cancer care were needed. Early in the pandemic, providers were more likely to recommend delays in curative surgery or radiation for early-stage cancer (p < 0.001), delays in adjuvant chemotherapy after curative surgery (p = 0.002), or delays in surveillance imaging for metastatic cancer (p < 0.001). The majority of providers early in the pandemic responded that “reducing risk of a complication from a COVID-19 infection to patients with cancer” was the primary reason for recommending delays in care (n = 52/76, 68%). Late in the pandemic, however, providers were more likely to agree that “any practice change would have a negative impact on patient outcomes” (p = 0.003). At both time points, the majority of providers agreed with the need for other care delivery changes, including screening patients for infectious symptoms (n = 128/132, 98%) and the use of telemedicine (n = 114/132, 86%) during the pandemic. Conclusions: We found significant differences in provider perspectives of delays in cancer care early versus late in the pandemic which reflects the swiftly evolving oncology practice during the COVID-19 pandemic. Future studies are needed to determine the impact of changes in treatment and care delivery on outcomes for patients with cancer.

A New World Economic order formation

2021 ◽  
pp. 932-950
Author(s):  
Vladislav Vyacheslavovich Emelyanov
Keyword(s):  
Oil And Gas ◽  
World Order ◽  
The United States ◽  
New Order ◽  
The West ◽  
Wide Range ◽  
The World ◽  
The Usa ◽  
World Economic Order ◽  
The Impact

Every few decades, the world order changes due to various geopolitical, economic and other circumstances. For example, as a result of globalization, the world order has undergone significant changes in the last forty years. Globalization has led to the destruction of the postwar world order, as well as to world leadership by the United States and the West. However, in recent decades, as a result of globalization, the U.S. and the West began to cede their leadership to developing countries, so there is now a change in the economic structure of relations in the world system. Today the center of economic growth is in the East, namely in Asia. There are no new superpowers in the world at the moment, but the unipolar world will cease to exist due to the weakening of the U. S. leadership, which will lead to a change in the world order. A new leader, which may replace the U. S., will not have as wide range of advantages as the USA has. Most likely, the essence of the new order will be to unite the largest countries and alliances into blocks, for example, the USA together with the Trans-Pacific Partnership, the EU, etc. The article outlines forecasts of GDP growth rates as well as the global energy outlook; analyzes the LNG market as well as the impact of the pandemic on the global oil and gas market; and lists the characteristics of U. S. geopolitics.

scholarly journals Quebec’s Economic and Commercial Linkages with the United States, 1994–2017

2017 ◽  
Author(s):  
Earl H. Fry
Keyword(s):  
United States ◽  
Trade Agreement ◽  
The United States ◽  
The North ◽  
Nation States ◽  
Wide Range ◽  
The Us ◽  
Us Government ◽  
Big Picture ◽  
The Impact

This article examines the ebb and flow of the Quebec government’s economic and commercial relations with the United States in the period 1994–2017. The topic demonstrates the impact of three major forces on Quebec’s economic and commercial ties with the US: (1) the North American Free Trade Agreement (NAFTA) which became operational in 1994 and was fully implemented over a 15-year period; (2) the onerous security policies put in place by the US government in the decade following the horrific events of 11 September 2001; and (3) changing economic circumstances in the United States ranging from robust growth to the worst recession since the Great Depression of the 1930s. The article also indicates that the Quebec government continues to sponsor a wide range of activities in the United States, often more elaborate and extensive than comparable activities pursued by many nation-states with representation in the US. 1 1 Stéphane Paquin, ‘Quebec-U.S. Relations: The Big Picture’, American Review of Canadian Studies 46, no. 2 (2016): 149–61.

P5280The impact of background phase offset errors in cardiovascular magnetic resonance phase contrast imaging: a multi-scanner study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S C S Minderhoud ◽  
N Van Der Velde ◽  
J J Wentzel ◽  
M Attrach ◽  
P A Wielopolski ◽  
...  
Keyword(s):  
Phase Contrast ◽  
Main Pulmonary Artery ◽  
Flow Quantification ◽  
Flow Measurements ◽  
Total N ◽  
Phase Offset ◽  
Wide Range ◽  
Significant Difference ◽  
Clinically Significant ◽  
The Impact

Abstract Background Phase contrast (PC) CMR flow measurements (FM) are widely used for blood flow assessment, but they suffer from phase offset errors (POE). Stationary phantom correction limits these inaccuracies, however, this adds scan time. Stationary tissue (ST) correction is an alternative method that does not require additional scanning. The aim of this study was to evaluate the impact of POE, to assess interscanner variation, and to evaluate the ST correction usage. Methods We included 166 patients in which both aorta and main pulmonary artery FM were acquired including static gelatin phantom data. Subjects were scanned on three types of 1.5T scanners from the one vendor. Uncorrected and ST corrected FM were compared with phantom corrected FM, our reference value, and corrected for BSA. A difference of >10% in net flow was defined as clinically relevant. Regurgitation fraction was calculated and POE influences were assessed. Regurgitation severity was graded and POE influence on severity grading was assessed. Results Of the 166 cases included, the median age was 27 (5–74) years. Overall, the median difference between no corrected and phantom corrected FM was ≤6%, however, with a wide range of over- and underestimation (−155%–78% change) (figure). ST correction resulted in larger differences compared to no correction (p<0.01). Clinically significant differences were seen in 19% of all FM with no correction and in 30% of with ST correction (p<0.01). Furthermore, there were significant differences between scanners (no correction 10%, p<0.01; ST correction, p<0.01). Regurgitation severity indexing changed in 38 (11%) cases with no correction and in 48 (48%) with ST correction. Magnitude of flow change with and without offset corrections (n=332) Flow (ml/m2) Δ no correction and phantom correction (%) Δ ST correction and phantom correction (%) Clinically significant difference (>10%) Mean ± SD Median IQR Range Median IQR Range No correction, N (%) ST correction , N (%) MRI 1 (n=126) 50±12 3 0 to 6 −8 to 30 5 −3 to 9 −26 to 28 13 (10%) 34 (27%) MRI 2 (n=102) 48±13 −2 −15 to 6 −155 to 78 5 −3 to 11 −74 to 52 50 (49%) 50 (49%) MRI 3 (n=104) 48±12 −1 −1 to 0 −7 to 14 2 −2 to 5 −39 to 29 1 (1%) 16 (15%) Total (n=332) 49±12 0 −2 to 4 −155 to 78 3 −2 to 8 −74 to 52 64 (19%) 100 (30%) Conclusion Background POE have a significant impact on flow quantification and regurgitation severity. Unexpectedly, background correction using ST correction worsens accuracy compared to no correction. POE vary greatly between scanners. Therefore, careful assessment of FM at each scanner is essential to determine if routine phantom scanning is necessary.

scholarly journals Maternal Intake of Cow’s Milk during Lactation Is Associated with Lower Prevalence of Food Allergy in Offspring

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3680
Author(s):  
Mia Stråvik ◽  
Malin Barman ◽  
Bill Hesselmar ◽  
Anna Sandin ◽  
Agnes E. Wold ◽  
...  
Keyword(s):  
Food Allergy ◽  
Breast Milk ◽  
Maternal Diet ◽  
Maternal Blood ◽  
Cow’S Milk ◽  
Lower Prevalence ◽  
Food Frequency ◽  
Lactating Women ◽  
Cow's Milk ◽  
Pregnancy And Lactation

Maternal diet during pregnancy and lactation may affect the propensity of the child to develop an allergy. The aim was to assess and compare the dietary intake of pregnant and lactating women, validate it with biomarkers, and to relate these data to physician-diagnosed allergy in the offspring at 12 months of age. Maternal diet during pregnancy and lactation was assessed by repeated semi-quantitative food frequency questionnaires in a prospective Swedish birth cohort (n = 508). Fatty acid proportions were measured in maternal breast milk and erythrocytes. Allergy was diagnosed at 12 months of age by a pediatrician specialized in allergy. An increased maternal intake of cow’s milk during lactation, confirmed with biomarkers (fatty acids C15:0 and C17:0) in the maternal blood and breast milk, was associated with a lower prevalence of physician-diagnosed food allergy by 12 months of age. Intake of fruit and berries during lactation was associated with a higher prevalence of atopic eczema at 12 months of age. Our results suggest that maternal diet modulates the infant’s immune system, thereby influencing subsequent allergy development.

scholarly journals Living and Teaching Internationally: Teachers Talk about Personal Experiences, Benefits, and Challenges

2020 ◽  
Vol 19 (1) ◽  
pp. 38-53
Author(s):  
Nelly Sierra Ospina ◽  
Sergio Lopera Medina
Keyword(s):  
Classroom Management ◽  
Cultural Awareness ◽  
School Administrators ◽  
The United States ◽  
Structured Interview ◽  
Study Data ◽  
Intercultural Development ◽  
Life Styles ◽  
Wide Range ◽  
The Impact

This study reports on the impact of international visiting faculty’s teaching experiences in the United States on their personal, professional, and intercultural development. It is based on the principles of qualitative research and can be described as a case study. Data collection involved a questionnaire, a written narrative, and a semi-structured interview with each of a number of teachers. Participants included a group of 22 visiting faculty. Three main categories, each of which can be subdivided into benefits and challenges, emerged from the analysis: intercultural matters, professional matters, and personal matters. A wide range of benefits was identified, suggesting that the participants adapted to new life styles, became more mature, obtained a deeper understanding of themselves, reaffirmed their own educational values and philosophies, raised cultural awareness, became more flexible, and developed attitudes that involved tolerance and respect. Conversely, visiting faculty reported that they faced challenges related to language barriers, interaction with native speakers, classroom management, lack of support from school administrators, and separation from family.

Assessment in American Higher Education: The Role of Admissions Tests

2019 ◽  
Vol 683 (1) ◽  
pp. 130-148 ◽  
Author(s):  
Rebecca Zwick
Keyword(s):  
Higher Education ◽  
United States ◽  
The United States ◽  
College Performance ◽  
Admissions Tests ◽  
Higher Education System ◽  
Wide Range ◽  
Test Optional ◽  
The Impact

In this article, I review the role of college admissions tests in the United States and consider the fairness issues surrounding their use. The two main tests are the SAT, first administered in 1926, and the ACT, first given in 1959. Scores on these tests have been shown to contribute to the prediction of college performance, but their role in the admissions process varies widely across colleges. Although test scores are consistently listed as one of the most important admissions factors in national surveys of postsecondary institutions, an increasing number of schools have adopted “test-optional” policies. At these institutions, test score requirements are seen as a barrier to campus diversity because of the large performance gaps among ethnic and socioeconomic groups. Fortunately, the decentralized higher education system in the United States can accommodate a wide range of admissions policies. It is essential, however, that the impact of admissions policy changes be studied and that the resource implications of these changes be thoroughly considered.

scholarly journals A pilot study on the impact of maternal diet and preconception body mass index on breast milk macronutrient composition

2014 ◽  
Vol 72 (S1) ◽  
Author(s):  
Goele Jans ◽  
Rivka Turcksin ◽  
Bart Van der Schueren ◽  
Christophe Matthys ◽  
Roland Devlieger
Keyword(s):  
Body Mass Index ◽  
Pilot Study ◽  
Breast Milk ◽  
Body Mass ◽  
Maternal Diet ◽  
Macronutrient Composition ◽  
The Impact
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