Maternal capital predicts investment in infant growth and development through lactation

INTRODUCTION: Maternal capital (MC) is a broad term from evolutionary biology, referring to any aspects of maternal phenotype that represent resources available for investment in offspring. We investigated MC in breastfeeding mothers of late preterm and early term infants, examining its relationship with infant and breastfeeding outcomes. We also determined whether MC modified the effect of the relaxation intervention on these outcomes. METHODS: The data was collected as part of a randomized controlled trial investigating breastfeeding relaxation in 72 mothers of late preterm and early term infants. Indicators of MC (socioeconomic, social, somatic, reproductive, psychological, and cognitive) were collected at baseline at 2-3 weeks post-delivery. Principal Component Analysis was conducted for the MC measures and two components were identified: 1."Subjective" maternal capital which included stress and depression scores, and 2."Objective" maternal capital which included height, infant birth weight, and verbal memory. Univariate linear regression was conducted to assess the relationship between objective and subjective MC (predictors) and infant growth, infant behavior, maternal behavior, and infant feeding variables (outcomes) at 6-8 weeks. The interaction of MC and intervention assignment with outcomes was assessed. RESULTS: Higher objective MC was significantly associated with higher infant weight (0.43; 95%CI 0.21,0.66) and length z-scores (0.47; 95%CI 0.19,0.76), shorter duration of crying (-17.5; 95%CI -33.2,-1.9), and lower food (-0.28; 95%CI -0.48,-0.08) and satiety responsiveness (-0.17; 95%CI -0.31,-0.02) at 6-8 weeks. It was also associated with greater maternal responsiveness to infant cues (-0.05, 95%CI -0.09,-0.02 for non-responsiveness). Greater subjective maternal capital was significantly associated with higher breastfeeding frequency (2.3; 95%CI 0.8,3.8) and infant appetite (0.30; 95%CI 0.07,0.54). There was a significant interaction between the intervention assignment and objective MC for infant length, with trends for infant weight and crying, which indicated that the intervention had greater effects among mothers with lower capital. CONCLUSION: Higher MC was associated with better infant growth and shorter crying duration. This was possibly mediated through more frequent breastfeeding and prompt responsiveness to infant cues, reflecting greater maternal investment. The findings also suggest that a relaxation intervention was most effective among those with low MC, suggesting some reduction in social inequalities in health

Interventions to Improve Breastfeeding Outcomes in Late Preterm and Early Term Infants

BACKGROUND: Late preterm infants (LPIs; born at 340/7 to 366/7 gestational weeks) and early term infants (ETIs; 370/7 to 386/7 gestational weeks) are at higher risk of morbidity and mortality compared with more mature infants. Breastfeeding can reduce these risks, but feeding difficulties are common among these infants and breastfeeding rates are low. We conducted a systematic review to identify the interventions available to improve any breastfeeding, exclusive breastfeeding, or breast milk yield. METHODS: A literature search was performed up to February 23, 2022, using MEDLINE, CINAHL, Embase, and Google Scholar, and nine articles were included. Only one article was a randomized controlled trial, and only one included ETIs. The remaining articles were quasi-experimental and included only LPIs. Outcomes included breastfeeding duration, breastfeeding exclusivity, and/or breast milk production (volume) before 6 months actual age. RESULTS: Professional support significantly improved exclusive breastfeeding rates. A breastfeeding education program delivered at the hospital with weekly telephone follow-up postdischarge significantly increased breastfeeding rates. Neither cup feeding nor early discharge (with in-home lactation support) improved breastfeeding rates, whereas rooming-in (versus direct admission to the neonatal intensive care unit) worsened exclusive breastfeeding rates. DISCUSSION: This is the first systematic review to identify interventions available for both LPIs and ETIs. Overall, there are limited studies that investigate interventions promoting breastfeeding in these populations. However, breastfeeding support delivered by health care professionals seems to improve breastfeeding rates. The main limitations are the lack of randomization, blinding, and adjustment for confounding variables. Experimental studies with robust methodological design are needed

Socio-economic impacts of the COVID-19 pandemic on new mothers and associations with psychosocial wellbeing: Findings from the UK COVID-19 New Mum online observational study (May 2020-June 2021)

Studies have reported unequal socio-economic impacts of the COVID-19 pandemic and associated restrictions in the UK, despite support packages. It is unclear how women with young children, a vulnerable group economically and psychosocially, havebeen impacted by income and employment pandemic changes, and how this is associated with psychosocial wellbeing. Using the UK COVID-19 New Mum online survey of women with children = £45,000/yr; p<0.001). Expenses impacts were associated with greater risk of partner business stopped/shut down (RRR:27.6/9.8/14.5 for rent/food/essentials [p<0.001 vs. no impact on employment]) or being made unemployed (RRR:15.2/9.5/13.5 [p<0.001]). A greater expenses impact was associated with higher (unhealthy) maternal psychosocial wellbeing score (coef:0.9/1.4/1.3 for moderate-major impact on rent/food/essentials vs. no impact [p<0.001]). The pandemic increased financial insecurity and associated poorer psychosocial wellbeing in new mothers. This is concerning given their pre-existing greater risk of poorer mental health and the implications for breastfeeding and child health and development. These findings reflect highlight the need for the UK government to assess shortfalls of implemented pandemic support policies and the provision of catch-up and better support for vulnerable groups such as new mothers, to avoid increasing socio-economic inequalities and the burden of poor maternal mental health and subsequent negative impacts on child wellbeing

Bilateral Anophthalmia in Feline

Background: Anophthalmia is a rare, congenital condition, defined as the complete absence of the eye bulb due to inadequate growth of the vesicle or optic dome. The malformation can be primary (in the absence of complete), secondary (in the presence of only residual tissue), or degenerative (in which the eye begins to form, but for some reason, it begins to degenerate). This condition is rare in dogs, cats, cattle, and sheep. Microscopic evaluation of orbital tissue for identification is always recommended. The aim of this study was to report a case of bilateral anophthalmia in a domestic cat.Case: A feline male, healthy, Maine Coon breed with 60 days of life was attended at the one veterinary private clinic. The cat, negative for FIV and FeLV, was born in a commercial cattery, belonging to his mother's third litter, healthy litter with the exception of this feline. He arrived with a complaint of not opening his eyelids, like the rest of the litter. In the clinical examination, it was found the normality of vital signs, absence of other visible anatomical abnormalities, only the ocular region was observed with closed eyelids. The initial suspicions were anophthalmia and microphthalmia. The patient was referred for an ocular ultrasound, which showed the complete absence of the right and left eye bulbs. The right and left orbital cavities had only a volume of soft, amorphous, and predominantly homogeneous tissue. After the ultrasound report, the patient underwent a surgical procedure to remove a fragment of tissue from the eye socket, which was sent for histopathological examination to confirm anophthalmia and discard the differential diagnosis of microphthalmia. Microscopy revealed immature, epithelial, and glandular tissue in the middle of discrete and moderate connective tissue, loosely arranged. In some fragments, cartilaginous tissue was also revealed. Thus, the histological findings are compatible with immature, pseudoformed tissues and without neoplastic characteristics. The diagnosis of secondary anophthalmia was reached with use of ultrasound and histological reports.Discussion: Congenital malformations in domestic cats are less frequent than in dogs, some of which are rare, and little reported. Secondary anophthalmia in the reported patient was confirmed by histological and ultrasound examination. Bilateral secondary anophthalmia is characterized by the absence of the eyeball, but with the presence of adjacent tissue. The animal was submitted to an ocular ultrasound examination and the complete absence of ocular bulbs was found. The differential diagnosis of microphthalmia was ruled out because there was no evidence of the eyeball. Microphthalmia is a common congenital ophthalmic disorder in veterinary medicine. Representative fragments were submitted to histopathological examination, where immature, epithelial tissue was found. In some fragments sent for analysis, cartilaginous tissue was observed. The histological findings are compatible with immature, pseudoformed tissues, thus verifying bilateral congenital anophthalmia in the reported animal. The clinical examination in these cases serves to ensure that the animal does not have any other congenital changes, allowing a favorable prognosis in puppies. Based on the information presented, the animal in this study has bilateral secondary congenital anophthalmia, with a favorable prognosis for the patient to live with certain normality, with quality and well-being

Cutaneous Asthenia in a Domestic Cat (Felis silvestris catus)

Background: Cutaneous asthenia or Ehlers-Danlos syndrome is an inherited and rare disease. This infirmity is from an autosomal mutation that influences the collagen synthesis of the carrier. Thus, its skeleton, formed of fibers, is structurally defective. The disease is characterized by hyperelasticity and skin fragility, leading to lesions throughout the skin. The lesions may manifest in specific places or in a generalized way, being more frequent in the limbs, neck, and back. This disease does not have a specific treatment, only management care to avoid new traumas.Case: A 3-year-old male castrated, no defined race cat, was attended at one veterinary clinic with a history of intense itching. The rapid tests for feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) were negative. On physical examination, infestation by fleas, lesions all over the body, and skin hyperelasticity were observed. Topical treatment for ectoparasites as well as for body wounds was established. After the treatment, he returned without itching, but with the complaints of new lesions that did not heal. The patient underwent a total shearing to facilitate the treatment of the skin, and then he underwent blood tests, biochemistry, hormonal tests, and ultrasound, which showed no suggestive changes for hyperadrenocorticism and diabetes mellitus. His clinical signs, besides not matching with these diseases, also did not indicate skin fragility due to his history of age and balanced diet. The confirmation of the cutaneous asthenia syndrome was acquired through biopsy of skin fragment, in which it was observed disarray of collagen fibers, hypertrophy, and fibroblast hyperplasia, together with the rate of extensibility of the skin where the value reached the mark of 27.5%. Throughout the hospitalization, it was noted the progression of the disease with the appearance of new lesions, where there was no bleeding and they appeared even with the patient wearing padded clothes. Its progression lasted one year until the patient's euthanasia.Discussion: For the disposal of diabetes mellitus and hyperadrenocorticism as causes of the appearance of lesions by the body in the patient, he was submitted to the suppression tests with dexamethasone, in which he presented normality, in the biochemical examination it was dosed with fructosamine and glucose. The fructosamine was in the reference value, but the glucose was slightly altered, this increase may have been a result of stress at the time of blood collection. In addition to the patient not showing specific clinical signs such as polyphagia, polyuria, polydipsia, and weight loss, these are characteristic clinical signs of the disease. For the diagnosis of Ehlers-Danlos syndrome, histological examination, and calculation of the skin extensibility index were used, where the results obtained confirmed the suspicion. This genetic anomaly has no treatment, being progressive, so only environmental management is done to mitigate the appearance of the lesions and provide animal welfare. This case report contributes to aggregating the scientific literature in the area of veterinary medicine since skin asthenia is a rare disease and when its extent is total it becomes even more atypical. The availability of this article will provide a vision of palliative treatment for other cases, demonstrating the progressive nature of the lesions and the methods of diagnosis. Keywords: cat, collagen deficiency, ehlers-danlos syndrome, hyperelastic, skin.

Effects of exclusive breastfeeding promotion interventions on child outcomes: a systematic review and meta-analysis

Introduction: Interventions promoting exclusive breastfeeding (EBF) may benefit infant health outcomes, but evidence is inconsistent. The objective of this review was to assess the effect of interventions promoting EBF on health outcomes in infants and children under 7 years of age. Methods: A literature search was conducted using EMBASE, MEDLINE, CINAHL, Cochrane Central, Cochrane Database of Systematic Reviews, and WHO International Clinical Trials Registry Platform from inception to April 2022. Inclusion criteria were randomized or cluster-randomized controlled trials aiming to increase EBF that reported effects on offspring growth, morbidity and/or mortality up to age 7 years. The primary outcome was infant/child growth. Secondary outcomes were infant morbidity and mortality and exclusive breastfeeding rates. Data were pooled using a random-effects model. Results: 32 studies (40 papers) were identified. No effect on infant/child growth was observed. EBF promotion interventions significantly improved EBF rates up to 6 months (n=25; OR 3.15; 95%CI 2.36,4.19) and significantly reduced the odds of respiratory illness at 0-3 months by 59% (n=2; OR 0.41; 95%CI 0.20,0.84) but not at later time-points. A borderline significant effect was observed for diarrhea (n=12; OR 0.84; 95%CI 0.70,1.00). Effects on hospitalizations or mortality were not significant. Discussion/Conclusion: EBF promotion interventions improve EBF rates and might yield modest reductions in infant morbidity without affecting infant/child growth. Future studies should investigate the cost-effectiveness of these interventions and examine potential benefits on other health outcomes

Population sequencing of two endocannabinoid metabolic genes identifies rare and common regulatory variants associated with extreme obesity and metabolite level

Abstract Background Targeted re-sequencing of candidate genes in individuals at the extremes of a quantitative phenotype distribution is a method of choice to gain information on the contribution of rare variants to disease susceptibility. The endocannabinoid system mediates signaling in the brain and peripheral tissues involved in the regulation of energy balance, is highly active in obese patients, and represents a strong candidate pathway to examine for genetic association with body mass index (BMI). Results We sequenced two intervals (covering 188 kb) encoding the endocannabinoid metabolic enzymes fatty-acid amide hydrolase (FAAH) and monoglyceride lipase (MGLL) in 147 normal controls and 142 extremely obese cases. After applying quality filters, we called 1,393 high quality single nucleotide variants, 55% of which are rare, and 143 indels. Using single marker tests and collapsed marker tests, we identified four intervals associated with BMI: the FAAH promoter, the MGLL promoter, MGLL intron 2, and MGLL intron 3. Two of these intervals are composed of rare variants and the majority of the associated variants are located in promoter sequences or in predicted transcriptional enhancers, suggesting a regulatory role. The set of rare variants in the FAAH promoter associated with BMI is also associated with increased level of FAAH substrate anandamide, further implicating a functional role in obesity. Conclusions Our study, which is one of the first reports of a sequence-based association study using next-generation sequencing of candidate genes, provides insights into study design and analysis approaches and demonstrates the importance of examining regulatory elements rather than exclusively focusing on exon sequences

Imidazol-1-ylethylindazole Voltage-Gated Sodium Channel Ligands Are Neuroprotective during Optic Neuritis in a Mouse Model of Multiple Sclerosis

[Image: see text] A series of imidazol-1-ylethylindazole sodium channel ligands were developed and optimized for sodium channel inhibition and in vitro neuroprotective activity. The molecules exhibited displacement of a radiolabeled sodium channel ligand and selectivity for blockade of the inactivated state of cloned neuronal Na(v) channels. Metabolically stable analogue 6 was able to protect retinal ganglion cells during optic neuritis in a mouse model of multiple sclerosis