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  • The unrevealed links: periodontal health, human milk composition, and infant gut microbiome dynamics

  • Rana Badewy, Michael Glogauer, Kristin L. Connor, Michael Sgro, Jim Yuan Lai, Richard P. Bazinet, Howard C. Tenenbaum, Amir Azarpazhooh
  • Journal:
    Primary Health Care Research & Development / Volume 25 / 2024
    Published online by Cambridge University Press:
    14 November 2024, e62
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  • Aim:

    This review aims to identify the mechanistic relationships related to periodontal diseases and its possible association with changes in human milk composition and the composition and function of infants’ gut microbiome.

    Background:

    Maternal health conditions, especially inflammatory, are associated with altered human milk composition. It is not known whether maternal oral inflammatory diseases, including periodontal diseases, deleteriously affect human milk composition.

    Methods:

    A narrative review was conducted according to SANRA, the Scale for the Assessment of Narrative Review Articles, guidelines. PubMed, Google Scholar, and Cochrane database of systematic reviews were searched from September 2019 up to December 2023 using keywords such as breast/human milk, maternal health/infections, and periodontal diseases. Reference lists of relevant articles were also screened. Our primary outcome of interest was human milk composition (i.e., any changes in macronutrients, immunological components, etc.). Secondary outcomes included changes in human milk microbiome and subsequent changes in the infant gut microbiome. Outcomes were synthesized using a narrative approach where the existing evidence and current literature were summarized. No risk of bias assessment of the studies was performed in this review.

    Findings:

    The search yielded no studies investigating the relationship between periodontal diseases in nursing mothers and changes in human milk composition. However, a dose–response relationship exists between the severity of periodontal diseases and the risk of adverse pregnancy outcomes such as preterm birth. Mastitis and diabetes affected milk lipids. Immunoglobulin A (sIgA) was increased in mastitis, whereas reduced concentrations were reported in diabetes. Potential biological pathways through which periodontal diseases can negatively affect human milk composition include the systemic dissemination of inflammatory cytokines like IL-6, PGE2, and tumor necrosis factor (TNF)-β that can be up-regulated by bacterial by-products. This biological plausibility needs to be investigated, given the potentially negative impact on the quality of human milk that could be caused by periodontal inflammation.

  • Alcohol milestones and internalizing, externalizing, and executive function: longitudinal and polygenic score associations

  • Sarah E. Paul, David A.A. Baranger, Emma C. Johnson, Joshua J. Jackson, Aaron J. Gorelik, Alex P. Miller, Alexander S. Hatoum, Wesley K. Thompson, Michael Strube, Danielle M. Dick, Chella Kamarajan, John R. Kramer, Martin H. Plawecki, Grace Chan, Andrey P. Anokhin, David B. Chorlian, Sivan Kinreich, Jacquelyn L. Meyers, Bernice Porjesz, Howard J. Edenberg, Arpana Agrawal, Kathleen K. Bucholz, Ryan Bogdan
  • Journal:
    Psychological Medicine / Volume 54 / Issue 10 / July 2024
    Published online by Cambridge University Press:
    09 May 2024, pp. 2644-2657
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  • Background

    Although the link between alcohol involvement and behavioral phenotypes (e.g. impulsivity, negative affect, executive function [EF]) is well-established, the directionality of these associations, specificity to stages of alcohol involvement, and extent of shared genetic liability remain unclear. We estimate longitudinal associations between transitions among alcohol milestones, behavioral phenotypes, and indices of genetic risk.

    Methods

    Data came from the Collaborative Study on the Genetics of Alcoholism (n = 3681; ages 11–36). Alcohol transitions (first: drink, intoxication, alcohol use disorder [AUD] symptom, AUD diagnosis), internalizing, and externalizing phenotypes came from the Semi-Structured Assessment for the Genetics of Alcoholism. EF was measured with the Tower of London and Visual Span Tasks. Polygenic scores (PGS) were computed for alcohol-related and behavioral phenotypes. Cox models estimated associations among PGS, behavior, and alcohol milestones.

    Results

    Externalizing phenotypes (e.g. conduct disorder symptoms) were associated with future initiation and drinking problems (hazard ratio (HR)⩾1.16). Internalizing (e.g. social anxiety) was associated with hazards for progression from first drink to severe AUD (HR⩾1.55). Initiation and AUD were associated with increased hazards for later depressive symptoms and suicidal ideation (HR⩾1.38), and initiation was associated with increased hazards for future conduct symptoms (HR = 1.60). EF was not associated with alcohol transitions. Drinks per week PGS was linked with increased hazards for alcohol transitions (HR⩾1.06). Problematic alcohol use PGS increased hazards for suicidal ideation (HR = 1.20).

    Conclusions

    Behavioral markers of addiction vulnerability precede and follow alcohol transitions, highlighting dynamic, bidirectional relationships between behavior and emerging addiction.

  • Motion of a disk embedded in a nearly inviscid Langmuir film. Part 1. Translation

  • Ehud Yariv, Rodolfo Brandão, Michael Siegel, Howard A. Stone
  • Journal:
    Journal of Fluid Mechanics / Volume 977 / 25 December 2023
    Published online by Cambridge University Press:
    18 December 2023, A30
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  • The motion of a disk in a Langmuir film bounding a liquid substrate is a classical hydrodynamic problem, dating back to Saffman (J. Fluid Mech., vol. 73, 1976, p. 593) who focused upon the singular problem of translation at large Boussinesq number, ${\textit {Bq}}\gg 1$. A semianalytic solution of the dual integral equations governing the flow at arbitrary ${\textit {Bq}}$ was devised by Hughes et al. (J. Fluid Mech., vol. 110, 1981, p. 349). When degenerated to the inviscid-film limit ${\textit {Bq}}\to 0$, it produces the value $8$ for the dimensionless translational drag, which is $50\,\%$ larger than the classical $16/3$-value corresponding to a free surface. While that enhancement has been attributed to surface incompressibility, the mathematical reasoning underlying the anomaly has never been fully elucidated. Here we address the inviscid limit ${\textit {Bq}}\to 0$ from the outset, revealing a singular mechanism where half of the drag is contributed by the surface pressure. We proceed beyond that limit, considering a nearly inviscid film. A naïve attempt to calculate the drag correction using the reciprocal theorem fails due to an edge singularity of the leading-order flow. We identify the formation of a boundary layer about the edge of the disk, where the flow is primarily in the azimuthal direction with surface and substrate stresses being asymptotically comparable. Utilising the reciprocal theorem in a fluid domain tailored to the asymptotic topology of the problem produces the drag correction $(8\,{\textit {Bq}}/{\rm \pi} ) [ \ln (2/{\textit {Bq}}) + \gamma _E+1]$, $\gamma _E$ being the Euler–Mascheroni constant.

Letters of Gerald Finzi and Howard Ferguson

  • Chapter 10 - Ricardo and Marx

  • Edited by J. E. King, La Trobe University, Victoria
  • Book:
    The Anthem Companion to David Ricardo
    Published by:
    Anthem Press
    Published online:
    17 October 2023
    Print publication:
    10 January 2023, pp 181-194

  • Summary

    The Place of Ricardo's Economics in Marx's Theory

    Marx had great respect for Ricardo, both regarding his analytic abilities and his intellectual integrity, and Ricardo's influence on Marx's economics was greater than that of any other individual economist. Nonetheless, it is also the case that Marx was severely critical of Ricardo's propositions on value and on growth, as well as those pertaining to the coordination of economic activities under capitalist relations of production and exchange. Moreover, the most impressive parts of Marx's economics lay in areas untouched by Ricardo, and all of Ricardo's economics were interpreted within Marx's own conceptual framework, which was very different from that of Ricardo's own classical liberalism. This conceptual framework is explained in Section 2, and Marx's treatment of Ricardo's economics is elucidated in Section 3. Section 4 follows with an outline of those parts of Marx's economics which owed no debt to Ricardo and which were analytically much stronger than those which did. They are thus relevant for the overall assessment of both Marx and Ricardo as economists. Finally, in Section 5, the claims that it is possible to resurrect a so-called classical-Marxian approach to economic theorization based on the work of Piero Sraffa is assessed as it clearly relates to understanding the intellectual relationship of Ricardo and Marx (Sraffa 1960).

    The Principal Influences in the Formation of Marxism

    Marx's thought has often been described as combining German philosophy, French socialism and British political economy (see, e.g., Lenin 1913). The latter included the work of Ricardo, but the first two intellectual influences had the more profound effects, and these significantly affected Marx's evaluation of British political economy, including Ricardo's ideas. They determined how Marx interpreted Ricardo's economics and how he transformed some of Ricardo's propositions to suit his own purposes. Moreover, they help explain why Marx's most important contributions to economic theory occurred independently of the influence of Ricardo as they follow from Marx's historical perspective and his analysis of the mechanisms of change that are indebted to the first two influences on his thought. By contrast, Ricardo saw all of history as more or less imperfectly capitalist3 and the other British economists that Marx studied were either similarly ahistorical or, like Adam Smith, anticipated strands of the historical materialism Marx developed from his understanding of German philosophy (see Meek 1977).

  • Foodborne illness outbreaks linked to unpasteurised milk and relationship to changes in state laws – United States, 1998–2018

  • Lia Koski, Hannah Kisselburgh, Lisa Landsman, Rachel Hulkower, Mara Howard-Williams, Zainab Salah, Sunkyung Kim, Beau B. Bruce, Michael C. Bazaco, Michael B. Batz, Cary Chen Parker, Cynthia L. Leonard, Atin R. Datta, Elizabeth N. Williams, G. Sean Stapleton, Matthew Penn, Hilary K. Whitham, Megin Nichols
  • Journal:
    Epidemiology & Infection / Volume 150 / 2022
    Published online by Cambridge University Press:
    25 October 2022, e183
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  • Consumption of unpasteurised milk in the United States has presented a public health challenge for decades because of the increased risk of pathogen transmission causing illness outbreaks. We analysed Foodborne Disease Outbreak Surveillance System data to characterise unpasteurised milk outbreaks. Using Poisson and negative binomial regression, we compared the number of outbreaks and outbreak-associated illnesses between jurisdictions grouped by legal status of unpasteurised milk sale based on a May 2019 survey of state laws. During 2013–2018, 75 outbreaks with 675 illnesses occurred that were linked to unpasteurised milk; of these, 325 illnesses (48%) were among people aged 0–19 years. Of 74 single-state outbreaks, 58 (78%) occurred in states where the sale of unpasteurised milk was expressly allowed. Compared with jurisdictions where retail sales were prohibited (n = 24), those where sales were expressly allowed (n = 27) were estimated to have 3.2 (95% CI 1.4–7.6) times greater number of outbreaks; of these, jurisdictions where sale was allowed in retail stores (n = 14) had 3.6 (95% CI 1.3–9.6) times greater number of outbreaks compared with those where sale was allowed on-farm only (n = 13). This study supports findings of previously published reports indicating that state laws resulting in increased availability of unpasteurised milk are associated with more outbreak-associated illnesses and outbreaks.

  • 5 - Airway and Ventilator Management of the Neurologically Critically Ill Patient

  • Edited by Andrew M. Naidech, Northwestern University, Illinois
  • Book:
    Neurocritical Care
    Published online:
    19 May 2022
    Print publication:
    09 June 2022, pp 90-110

  • Summary

    Airway and ventilator management of the neurologically critically ill population poses several specific challenges for providers. These include the prevention of further injury due to hemodynamic instability or hypoxia; understanding the indications for tracheal intubation such as the need for invasive mechanical ventilation, upper airway obstruction, bronchial hygiene, and inability to protect airway; and securing airway in a rapid fashion to prevent aspiration. These patients typically do not have issues with lung mechanics, rather they have issues with airway protection and management of bronchial secretions. Depending on the neurologic pathology, these patients may require tracheostomy.

  • Taking dyads seriously

  • Shahryar Minhas, Cassy Dorff, Max B. Gallop, Margaret Foster, Howard Liu, Juan Tellez, Michael D. Ward
  • Journal:
    Political Science Research and Methods / Volume 10 / Issue 4 / October 2022
    Published online by Cambridge University Press:
    15 November 2021, pp. 703-721

  • International relations scholarship concerns dyads, yet standard modeling approaches fail to adequately capture the data generating process behind dyadic events and processes. As a result, they suffer from biased coefficients and poorly calibrated standard errors. We show how a regression-based approach, the Additive and Multiplicative Effects (AME) model, can be used to account for the inherent dependencies in dyadic data and glean substantive insights in the interrelations between actors. First, we conduct a simulation to highlight how the model captures dependencies and show that accounting for these processes improves our ability to conduct inference on dyadic data. Second, we compare the AME model to approaches used in three prominent studies from recent international relations scholarship. For each study, we find that compared to AME, the modeling approach used performs notably worse at capturing the data generating process. Further, conventional methods misstate the effect of key variables and the uncertainty in these effects. Finally, AME outperforms standard approaches in terms of out-of-sample fit. In sum, our work shows the consequences of failing to take the dependencies inherent to dyadic data seriously. Most importantly, by better modeling the data generating process underlying political phenomena, the AME framework improves scholars’ ability to conduct inferential analyses on dyadic data.

  • Neonatal Exposure to Staphylococcus aureus in the Neonatal Intensive Care Unit: Identifying Reservoirs Among Colonized Healthcare Workers and Parents

  • Jennifer Lee, Annie Voskertchian, Danielle Koontz, Karen Carroll, Tracy Howard, Elizabeth Colantuoni, Aaron Michael Milstone
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 41 / Issue S1 / October 2020
    Published online by Cambridge University Press:
    02 November 2020, pp. s490-s491
    Print publication:
    October 2020
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  • Background: Staphylococcus aureus (S. aureus) is the second most common cause of healthcare-acquired infections in neonates. S. aureus colonization is a known risk factor for invasive disease. Aside from healthcare workers (HCWs), recent data suggest that parents are important reservoirs of S. aureus in the neonatal intensive care unit (NICU). S. aureus typically colonizes the nares, but it can also colonize other anatomic locations such as the throat. Objective: Our objectives were to identify and compare S. aureus colonization among HCWs and parents and to identify and compare different sites of S. aureus colonization. Methods: Between April 2015 and July 2016, we performed 4 point-prevalence surveys and collected nares and throat swabs from HCWs (nurses, respiratory therapists, nurse practitioners, and physicians) at a quaternary-care NICU. During an overlapping period, we screened parents of neonates in the NICU for S. aureus colonization using nares, throat, groin, and perianal cultures as a part of an ongoing randomized control trial. Cultures from both studies were collected using standardized methods. ESwabs were used to collect samples, which were inoculated into broth for enrichment and subsequently cultured onto chromogenic agar to differentiate between MSSA and MRSA. Results: The prevalence of methicillin susceptible S. aureus (MSSA) colonization was 46% (105/226) in HCWs and 28% (239/842) in parents. The prevalence of methicillin resistant S. aureus (MRSA) colonization was 2.2% (5/226) in HCWs and 2.2% (19/842) in parents. Of those who were colonized with S. aureus, 35% (79/226) of HCWs and 46.5% (160/344) of parents had nares and throat colonization while 11.5% (26/226) of HCWs and 12.2% (42/344) of parents had only throat colonization but not nares colonization. Of those who were MRSA colonized, 1.3% (3/226) of HCWs and 1.8% (15/842) of parents had a positive nares and throat culture as compared to 0.9% (2/226) of HCWs and 0.2% (2/842) of parents had only positive throat cultures. Additionally, 68% (175/257) were colonized with S. aureus at any swabbed site including nares, throat, groin, or perinanal areas. However, only 30% (77/257) of parents had only nares colonization as compared to 58.8% (151/257) had throat and nares colonization, 38.1% (98/257) had nares and groin colonization, and 37.4% (96/257) had nares and perianal colonization. Conclusions: HCWs had greater prevalence of S. aureus colonization compared to parents. As expected, the nares was the most common site of MSSA and MRSA, but a large proportion of S. aureus colonized HCWs and parents had only throat colonization. Given the prevalence of S. aureus in non-nares sites of HCWs and parents in the NICU, further studies should examine the role of non-nares carriers in the transmission of S. aureus in this population.

    Funding: None

    Disclosures: Aaron Milstone reports consultancy with Becton Dickinson.

  • 1 - Policy Consultancy in Comparative Perspective

  • Caspar van den Berg, Rijksuniversiteit Groningen, The Netherlands, Michael Howlett, Simon Fraser University, British Columbia, Andrea Migone, Michael Howard, University of Newcastle, New South Wales, Frida Pemer, Stockholm School of Economics, Helen M. Gunter, University of Manchester
  • Book:
    Policy Consultancy in Comparative Perspective
    Published online:
    09 December 2019
    Print publication:
    19 December 2019, pp 1-19

  • Summary

    While the role of consultants in the policy process has long been a concern for scholars of public administration, public management and political science, empirical studies of policy-related consulting are scarce, with little quantitative data. The country-level case studies in this book shed light for the first time on a number of important but as yet under-researched questions. The first is the actual extent of the use of government consulting in a number of countries, and what have been cross-time developments: to what extent has the use of consultants grown over time, and what are the (political, fiscal-economic, society, policy-related) factors that explain greater or lesser growth in a particular country or sector? The second is the question of what role(s) consultants play in the public sector and how large is the share of these consultants in policy work (policy analysis, policy advice, implementation and evaluation).

  • 2 - Consultancy in the UK Government: Modernizing Privatism

  • Caspar van den Berg, Rijksuniversiteit Groningen, The Netherlands, Michael Howlett, Simon Fraser University, British Columbia, Andrea Migone, Michael Howard, University of Newcastle, New South Wales, Frida Pemer, Stockholm School of Economics, Helen M. Gunter, University of Manchester
  • Book:
    Policy Consultancy in Comparative Perspective
    Published online:
    09 December 2019
    Print publication:
    19 December 2019, pp 20-51

  • Summary

    Demands made by the UK government for external policy support are big business, where the highest spend on consultants has been calculated at £2 billion in 2003–2004 (NAO 2006), and currently major consultancy firms are active in bidding for six months of Brexit work with a price tag of £1.5 million (Martin 2017). At the same time, the focus has been on review and retrenchment, with a fall in spending to £1.8b in 2005–2006 (NAO 2006), whereby ‘the government is determined to make every taxpayer penny count’ and the ‘Cabinet Office is working to help departments reduce reliance on everything from expensive consultants to print cartridges’ (Gov.uk ). Thus, it seems there is recognition of a contribution to public policy that is beyond ‘in-house’ capacity: ‘when used correctly and in the appropriate circumstances … [they] … can provide great benefit to clients – achieving things that clients do not have the capacity or capability to do themselves’ (NAO 2006: 4).

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