A comparison by milk feeding method of the nutrient intake of a cohort of Australian toddlers

Breastfeeding is recommended beyond 12 months of age, but little is known about the contribution of breastmilk and infant formula to the nutritional intake of toddlers as they transition to a family diet in the second year of life. This study is a cross-sectional analysis of data collected from a birth cohort study in Adelaide, Australia. Dietary intake data were collected when children were approximately 1 year of age by an interviewer-administered multi-pass 24 h recall and a mother-completed 2 days food diary. Children were categorized according to their milk feeding method, i.e., breastmilk, infant formula, combination or other, and their nutrient intakes compared with recommended nutrient reference values. Complete data were available for 832 children, of which 714 had plausible energy intakes. Breastmilk and formula made a substantial contribution to the nutrient intake of those toddlers, contributing 28% and 34% of total energy, and 16% and 26% of protein intake, respectively when not drunk in combination. In general, Australian toddlers transitioning to the family diet consumed nutritionally adequate diets, although almost one quarter of all children and half of breastfed children with plausible intakes had iron intakes below the estimated average requirement, placing them at risk of iron deficiency.Jane Scott, Kristina Davey, Ellen Ahwong, Gemma Devenish, Diep Ha and Loc D

An Empirical Investigation of Debt Contract Design: The Determinants of the Choice of Debt Terms in Eurobond Issues

This paper provides a comprehensive analysis of the determinants for the optimal choice of contract terms on Eurobonds issued by UK companies. We examine predictions of extant theories that associate the choice of debt features namely, maturity, call options, convertible options, and protective covenants to firm and market characteristics. Like in Correia (2003), a simultaneous equations approach is adopted to test the alternative use of contract features for mitigating debt-contracting costs. The evidence provides strong support to the prediction that both callable and short-term debt and convertible and debt with protective covenants are used as alternative control devises to mitigate agency costs. Further evidence suggests, however, that contrary to the fundamentals guiding the choice of maturity and callability structures, the use of conversion options and protective covenants in Eurobond contracts seems to be determined by equity agency costs rather than debt agency costs. Also, some support is found for the risk uncertainty theory underlying the use of convertibles and for liquidity risk arguments regarding the choice to include protective covenants.

Private Insurance Reimbursements for Newborn Hearing Screening in the United States, 2013-2014

The purpose of this study was to describe private insurance reimbursements for newborn hearing screening (NBHS) in the United States. Data from the MarketScan® Commercial Databases were used to estimate reimbursement for privately insured infants born between January 1, 2013–December 31, 2014. Estimates were based on billed claims for hearing-related services during infancy (71,820 infants with inpatient NBHS, 1,104 with outpatient NBHS). Median reimbursement for NBHS performed in a hospital setting was $148.00 (range$113.51–$196.02) when billed as an inpatient service and$136.48 (range $86.08–$220.15) when billed as an outpatient service. Both reimbursement amounts were three times greater than the median reimbursement of $41.60 (range$30.48–$49.25) for NBHS billed in conjunction with an office visit

The Fate of Binaries in the Galactic Center: The Mundane and the Exotic

The Galactic Center (GC) is dominated by the gravity of a super-massive black hole (SMBH), Sagittarius A$^*$, and is suspected to contain a sizable population of binary stars. Such binaries form hierarchical triples with the SMBH, undergoing Eccentric Kozai-Lidov (EKL) evolution, which can lead to high eccentricity excitations for the binary companions' mutual orbit. This effect can lead to stellar collisions or Roche-lobe crossings, as well as orbital shrinking due to tidal dissipation. In this work we investigate the dynamical and stellar evolution of such binary systems, especially with regards to the binaries' post-main-sequence evolution. We find that the majority of binaries (~75%) is eventually separated into single stars, while the remaining binaries (~25%) undergo phases of common-envelope evolution and/or stellar mergers. These objects can produce a number of different exotic outcomes, including rejuvenated stars, G2-like infrared-excess objects, stripped giant stars, Type Ia supernovae (SNe), cataclysmic variables (CVs), symbiotic binaries (SBs), or compact object binaries. We estimate that, within a sphere of 250 Mpc radius, about 7.5 to 15 Type Ia SNe per year should occur in galactic nuclei due to this mechanism, potentially detectable by ZTF and ASAS-SN. Likewise we estimate that, within a sphere of 1 Gpc$^3$ volume, about 10 to 20 compact object binaries form per year that could become gravitational wave sources. Based on results of EKL-driven compact object binary mergers in galactic nuclei by Hoang at al. (2018), this compact object binary formation rate translates to about 15 to 30 events per year detectable by Advanced LIGO.Comment: 8 pages, 3 figures, accepted by Ap

The ‘‘ICE’’ Study: Feasibility of Inexpensive Commercial Coolers on Mobile EMS Units

Introduction: Prehospital postresuscitation induced hypothermia (IH) has been shown to reduce neurological complications in comatose cardiac-arrest survivors. Retrofitting ambulances to include equipment appropriate to initiate hypothermia, such as refrigeration units for cooled saline, is expensive. The objective of this nonhuman subject research study was to determine if inexpensive, commercially available coolers could, in conjunction with five reusable ice packs, keep two 1 L bags of precooled 0.9% normal saline solution (NSS) at or below 48C for an average shift of eight to 12 hours in a real-world environment, on board in-service Emergency Medical Service (EMS) units, over varying weather conditions in all seasons. Methods: The coolers were chosen based on availability and affordability from two nationally available brands: The Igloo MaxxCold (Igloo Products Corp., Katy, Texas USA) and Coleman (The Coleman Company, Wichita, Kansas USA). Both are 8.5 liter (nine-quart) coolers that were chosen because they adequately held two 1 L bags of saline solution, along with the reusable ice packs designated in the study design, and were small enough for ease of placement on ambulances. Initial testing of the coolers was conducted in a controlled environment. Thereafter, each EMS unit was responsible to cool the saline to less than 48C prior to shift. Data were collected by emergency medical technicians, paramedics, and resident physicians working in seven different ambulance squads. Data analysis was performed using repeated measurements recorded over a 12-hour period from 19 individual coolers and were summarized by individual time points using descriptive statistics. Results: Initial testing determined that the coolers maintained temperatures of 48C for 12 hours in a controlled environment. On the ambulances, results based on the repeated measurements over time revealed that the saline solution samples as defined in the protocol, remained consistently below 48C for 12 hours. Utilizing the lower bound of the 2- sided 95% exact binomial confidence intervals, there was less than a five percent chance that saline samples could not be maintained below 48C for 12 hours, even during the summer months. Conclusions: Simple, commercially available coolers can maintain two 1 L bags of 0.9% NSS at 48C for 12 hours in ambulances in varying environmental conditions. This suggests that EMS agencies could inexpensively initiate prehospital IH in appropriate cases

The Impact of Tobacco Smoking on One Year Patient Outcomes at a Family Medicine Residency Clinic

Abstract Objectives: In Appalachia, tobacco smoking rates are significantly higher than the United States average, and many of the comorbidities that exist with tobacco are prominent. The researchers investigated the impact of tobacco smoking on patients for one year of health outcomes at our resident primary care clinic. Methods: The present study examined outpatient clinic charts and hospital records for a calendar year to determine patient self-reported tobacco rates. Patient medical comorbidities were tracked as well as rates of hospital utilization during the calendar year, and those figures were compared for a group of 90 patients who currently smoke and another group of 90 patients who have never smoked. Results: Tobacco smokers in the present study were more likely to have a history of several medical comorbidities including COPD, musculoskeletal problems, psychiatric treatment, and substance abuse issues. Additionally, tobacco smokers were more likely to have visited the emergency department and to have been admitted to the hospital during the year. Conclusions: The problem of tobacco smoking is complex and primary care clinics provide a wealth of information to investigate numerous comorbid concerns. Consistent with prior research, tobacco users in this study were at greater risk for many medical problems. Abstract Word Count: 19

Determinants and sources of iron intakes of australian toddlers: Findings from the SMILE cohort study

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. The first two years of life is a period of rapid growth and development. During this time a lack of key nutrients, including iron, can have long-lasting effects on motor and cognitive performance. The purpose of this cross-sectional study was to determine intake and sources of iron in a cohort of 828 toddlers (mean age; 13.1 mo) participating in the Adelaide-based Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE), and to identify determinants of iron intake. At approximately 12 months of age, 3 non-consecutive days of dietary intake data were collected using a 24-h recall and 2-days food record. The Multiple Source Method was used to combine data from the 24-h recall and each day of the food record to estimate usual iron intake and descriptive statistics were used to report sources of iron. Linear regression was used to identify associations between iron intake and non-dietary determinants (maternal age, education, country of birth, BMI, socioeconomic position, parity, toddler sex) and primary milk feeding method at 12 months. The mean intake of iron was 7.0 (95% CI 6.7–7.2) mg/day and 18.2% of children had usual intakes below the estimated average requirement of 4 mg/day. The main sources of iron included infant and toddler cereals and formulas. Milk feeding method and parity were significantly associated with iron intake. Toddlers with siblings and those who received breast milk as their primary milk feed had significantly lower iron intakes than only children and those who received formula, respectively. The Australian Infant Feeding Guidelines promote the importance of iron-iron-rich complementary foods such as meat and meat alternatives. However, low intakes of this food group suggest that parents do not recognize the importance of these foods or understand the specific foods that toddlers should be eating