Breastfeeding Initiation,Duration, and Exclusivity Among WIC-Eligible Populations

The benefits of breastfeeding are known to impact infant and maternal health outcomes. Healthy People 2020 designates several evidence-based objectives for breastfeeding initiation, duration, and exclusivity. Despite these recommendations, rates of breastfeeding behaviors in the United States (U.S) fall short. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is required to promote and support breastfeeding practices, yet evidence of breastfeeding outcomes among WIC participants are mixed. This study uses nationally representative data to examine the association between breastfeeding initiation, duration, and exclusivity and family WIC participation status. We analyzed data using the combined 2016-2018 National Survey of Children’s Health, administered by HRSA’s MCHB. Outcome measures included breastfeeding initiation, any breastfeeding at 6 months, and exclusive breastfeeding through 6 months. We conducted weighted bivariate analyses to examine prevalence of breastfeeding practices based on family WIC participation and sociodemographic characteristics, and multivariable logistic regression analyses to assess the association between WIC participation and breastfeeding outcomes. Adjusted analyses controlled for several sociodemographic and health status characteristics. The combined 2016-2018 dataset contains completed questionnaires from 19,030 children ages 0-3 years living in the United States. A total of 6,532 were considered to be WIC-eligible, and 3,174 were from families reported to have participated in WIC within the past 12 months. Rates of breastfeeding outcomes among WIC participants were lower than national rates observed among the general U.S. population—72.8% of children were ever breastfed and 50.3% of children were breastfed ≥ 6 months (versus 83% and 58% nationally, respectively). When examining differences in breastfeeding outcomes between WIC-eligible participants and non-participants, we found that participants were less likely to report any breastfeeding ≥ 6 months than WIC-eligible nonparticipants (Average Marginal Effect (AME) = -9.2, P < .05), after adjusting for covariates. When examining breastfeeding outcomes among WIC-eligible participants while adjusting for covariates, families from predominantly non-English-speaking households were more likely to have ever breastfed (AME = 10.7, P < .01), more likely to report any breastfeeding ≥ 6 months (AME = 27.8, P < .001), and more likely to be exclusively breastfeeding ≥ 6 months (AME = 23.3, P < .01), compared with respondents from English-speaking households. In addition, several sociodemographic characteristics were associated with a lower likelihood of breastfeeding outcomes among children, including Hispanic race/ethnicity, having a single mother, and lower household education. WIC participation was significantly associated with a lower likelihood of breastfeeding duration (any breastfeeding at 6 months), yet had no effect on the likelihood of breastfeeding initiation or exclusivity. Our results on subpopulations of WIC participants with lower rates of breastfeeding outcomes are noteworthy and highlight persistent disparities. Our findings inform potential target areas for interventions to improve breastfeeding outcomes among WIC participants. While anticipatory guidance and education are provided to new mothers through WIC to encourage breastfeeding initiation, additional support and outreach (appropriately timed during the postpartum period) may help overcome barriers that mothers face in maintaining breastfeeding duration. Such initiatives, incorporated with existing WIC programming, may contribute to improvements in breastfeeding rates for WIC populations to more closely align with Healthy People 2020 goals.     

Patient-Reported Outcomes Data From REVEAL at the Time of Enrollment (Baseline): A Prospective Observational Study of Patients With Polycythemia Vera in the United States

Background

Patients with polycythemia vera (PV) often experience symptoms that adversely affect their quality of life (QoL). The ongoing, prospective, observational REVEAL (Prospective Observational Study of Patients With Polycythemia Vera in US Clinical Practices) study was designed to collect contemporary data regarding burden of disease, clinical management, patient-reported outcomes (PROs), and health care resource utilization from adult patients with PV in the United States.

Oxytocin influences intuitions about the relationship between belief in free will and moral responsibility

Philosophers have proposed that laypeople can have deterministic or indeterministic intuitions about the relationship between free will and moral responsibility. However, the psychophysiological mechanisms that generate these extreme intuitions are still underexplored. Exogenous oxytocin offers a unique opportunity to gain a deeper understanding of these underlying mechanisms, since this neuropeptide influences a wide range of outcomes related to social cognition and prosociality. This study investigated the effects of intranasal oxytocin on intuitions about the relationship between free will and moral responsibility by applying a randomized, double-blind, placebo-controlled, between-subject design. Healthy male participants rated the moral responsibility of a hypothetical offender, who committed crimes in either a primed deterministic or an indeterministic universe. Under placebo, participants held the offender more morally responsible when acting in an indeterministic compared to a deterministic universe, which could be accredited to recognition of the offender’s freely chosen action to commit the crimes. Under oxytocin, participants rated the offender’s actions with greater leniency and similarly assigned lower moral responsibility in both universes. These findings strengthen the assumption that a person can have different intuitions about the relationship between free will and moral responsibility, which can be presumably dependent on motivational states associated with affiliation.     

Green tea catechins potentiate triclosan binding to enoyl-ACP reductase from Plasmodium falciparum (PfENR)

We have investigated the mechanism of inhibition of enoyl-acyl carrier protein reductase of Plasmodium falciparum (PfENR) by triclosan in the presence of a few important catechins and related plant polyphenols. The examined flavonoids inhibited PfENR reversibly with Ki values in the nanomolar range, EGCG being the best with 79 +/- 2.67 nM. The steady-state kinetics revealed time dependent inhibition of PfENR by triclosan, demonstrating that triclosan exhibited slow tight-binding kinetics with PfENR in the presence of these compounds. Additionally, all of them potentiated the binding of triclosan with PfENR by a two-step mechanism resulting in an overall inhibition constant of triclosan in the low picomolar concentration range. The high affinities of tea catechins and the potentiation of binding of triclosan in their presence are readily explained by molecular modeling studies. The enhancement in the potency of triclosan induced by these compounds holds great promise for the development of effective antimalarial therapy.     

Dissociation of visual C1 and P1 components as a function of attentional load: An event-related potential study

The earliest cortical location at which attention influences visual processing is controversial. To address this issue, the C1 and P1 components of cue-elicited ERPs were examined in a spatially-cued task under high and low levels of attentional load (active vs. passive viewing). Cues were presented either to the left or to the right visual field in separate trials (unilateral presentation), or to both visual fields simultaneously (bilateral presentation). For the unilateral presentation, C1 (peak latency approximately 80 ms) was not modulated by attentional load, whereas P1 (peak latency approximately 120-140 ms) was larger for high-relative to low-load condition. Bilateral presentation of the stimuli enhanced the amplitude of the C1 component relative to unilateral presentation; however, the increase of signal/noise ratio of C1 revealed no attentional load effect on C1. Results show that attentional load modulates visual processing in the P1, but not in the C1 time range, regardless of the increased signal/noise ratio by bilateral presentation. While it remains unclear about the conditions under which a C1 attentional effect is reliably elicited, the present results suggest that the direct manipulation of attentional load under a voluntary attention task seems not crucial for eliciting C1 attentional effect.     

Anti-leukemic activity of Wattakaka volubilis leaf extract against human myeloid leukemia cell lines

Ethnopharmacological relevance

Wattakaka volubilis has been traditionally used in Ayurvedic medicine in India for treatment of several ailments such as bronchial asthma, inflammations, tumors, piles, leucoderma, application to boils, rat bite etc.

Aim of the study

The present study was designed to investigate anti-leukemic activity of the crude aqueous methanolic extract and to identify active compounds from the leaves of Wattakaka volubilis.

Materials and methods

The leaves of Wattakaka volubilis were extracted with aqueous methanol. Liquid–liquid fractionation of the crude methanolic extract with different organic solvents was done and the fractions were screened for in vitro anti-leukemic activity using different leukemic cell lines. The active fractions were then subjected to chromatographic separation for isolation of bioactive compounds. Structure of isolated compound was elucidated by spectroscopic methods. The in vitro anti-leukemic activities of different extracts of the leaves and isolated compound WVP were studied in U-937, HL-60 and K-562 cell-lines by using cell count, MTT [(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide] and DNA laddering assays, flow-cytometric and confocal microscopic techniques.

Results

Kaempferol-3-O-[α-l-rhamnopyranosyl-(1→4)-O-α-l-rhamnopyranosyl-(1→6)-O]-β-d-glucopyranoside (WVP) was isolated from crude leaves extract of Wattakaka volubilis. Both the n-butanolic extract (WVB) of Wattakaka volubilis and its isolate WVP were found to be responsible for in vitro anti-leukemic activity. The IC₅₀ values of WVB were found be 120, 100 and 50 (μg/ml) in U937, K562, and HL-60 cell lines, respectively. Whereas, the pure isolate WVP exhibited anti-leukemic activity with IC₅₀ values of 13.5, 10.8, and 13.2 (μg/ml) in U937, K562, and HL-60 cell lines, respectively. The flow-cytometric analysis confirms that the cell cycle arrest occurs at G1 phase in case of U937 and K562 cell lines and G2/M phase in case of HL60 cell lines. Similarly both confocal microsocopic analysis and DNA laddering assay confirm the apoptosis and cell cycle arrests of leukemic cells.

Conclusion

The overall results provide evidence for the ethnopharmacological relevance for use of the plant Wattakaka volubilis in developing novel agents for the treatment of leukemia.