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Bornbusch SL, Power ML, Schulkin J, Drea CM, Maslanka MT, Muletz-Wolz CR. Integrating microbiome science and evolutionary medicine into animal health and conservation. Biol Rev Camb Philos Soc 2024; 99:458-477. [PMID: 37956701 DOI: 10.1111/brv.13030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023]
Abstract
Microbiome science has provided groundbreaking insights into human and animal health. Similarly, evolutionary medicine - the incorporation of eco-evolutionary concepts into primarily human medical theory and practice - is increasingly recognised for its novel perspectives on modern diseases. Studies of host-microbe relationships have been expanded beyond humans to include a wide range of animal taxa, adding new facets to our understanding of animal ecology, evolution, behaviour, and health. In this review, we propose that a broader application of evolutionary medicine, combined with microbiome science, can provide valuable and innovative perspectives on animal care and conservation. First, we draw on classic ecological principles, such as alternative stable states, to propose an eco-evolutionary framework for understanding variation in animal microbiomes and their role in animal health and wellbeing. With a focus on mammalian gut microbiomes, we apply this framework to populations of animals under human care, with particular relevance to the many animal species that suffer diseases linked to gut microbial dysfunction (e.g. gut distress and infection, autoimmune disorders, obesity). We discuss diet and microbial landscapes (i.e. the microbes in the animal's external environment), as two factors that are (i) proposed to represent evolutionary mismatches for captive animals, (ii) linked to gut microbiome structure and function, and (iii) potentially best understood from an evolutionary medicine perspective. Keeping within our evolutionary framework, we highlight the potential benefits - and pitfalls - of modern microbial therapies, such as pre- and probiotics, faecal microbiota transplants, and microbial rewilding. We discuss the limited, yet growing, empirical evidence for the use of microbial therapies to modulate animal gut microbiomes beneficially. Interspersed throughout, we propose 12 actionable steps, grounded in evolutionary medicine, that can be applied to practical animal care and management. We encourage that these actionable steps be paired with integration of eco-evolutionary perspectives into our definitions of appropriate animal care standards. The evolutionary perspectives proposed herein may be best appreciated when applied to the broad diversity of species under human care, rather than when solely focused on humans. We urge animal care professionals, veterinarians, nutritionists, scientists, and others to collaborate on these efforts, allowing for simultaneous care of animal patients and the generation of valuable empirical data.
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Affiliation(s)
- Sally L Bornbusch
- Center for Conservation Genomics, Smithsonian's National Zoo and Conservation Biology Institute, 3001 Connecticut Ave. NW, Washington, DC, 20008, USA
- Department of Nutrition Science, Smithsonian's National Zoo and Conservation Biology Institute, 3001 Connecticut Ave. NW, Washington, DC, 20008, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, 3001 Connecticut Ave. NW, Washington, DC, 20008, USA
| | - Jay Schulkin
- Department of Obstetrics & Gynecology, University of Washington School of Medicine, 1959 NE Pacific St., Box 356460, Seattle, WA, 98195, USA
| | - Christine M Drea
- Department of Evolutionary Anthropology, Duke University, 104 Biological Sciences, Campus Box 90383, Durham, NC, 27708, USA
| | - Michael T Maslanka
- Department of Nutrition Science, Smithsonian's National Zoo and Conservation Biology Institute, 3001 Connecticut Ave. NW, Washington, DC, 20008, USA
| | - Carly R Muletz-Wolz
- Center for Conservation Genomics, Smithsonian's National Zoo and Conservation Biology Institute, 3001 Connecticut Ave. NW, Washington, DC, 20008, USA
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Power ML, Muletz-Wolz CR, Bornbusch SL. Microbiome: Mammalian milk microbiomes: sources of diversity, potential functions, and future research directions. Reprod Fertil 2024; 5:e230056. [PMID: 38513351 PMCID: PMC11046322 DOI: 10.1530/raf-23-0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
Graphical abstract Abstract Milk is an ancient, fundamental mammalian adaptation that provides nutrition and biochemical communication to offspring. Microbiomes have been detected in milk of all species studied to date. In this review, we discuss: (a) routes by which microbes may enter milk; (b) evidence for proposed milk microbiome adaptive functions; (c) variation in milk microbiomes across mammals; and (d) future research directions, including suggestions for how to address outstanding questions on the viability and functionality of milk microbiomes. Milk microbes may be sourced from the maternal gastrointestinal tract, oral, skin, and mammary gland microbiomes and from neonatal oral and skin microbiomes. Given the variety of microbial sources, stochastic processes strongly influence milk microbiome assembly, but milk microbiomes appear to be influenced by maternal evolutionary history, diet, environment, and milk nutrients. Milk microbes have been proposed to colonize the neonatal intestinal tract and produce gene and metabolic products that influence physiology, metabolism, and immune system development. Limited epidemiological data indicate that early-life exposure to milk microbes can result in positive, long-term health outcomes. Milk microbiomes can be modified by dietary changes including providing the mother with probiotics and prebiotics. Milk replacers (i.e. infant formula) may benefit from supplementation with probiotics and prebiotics, but data are lacking on probiotics' usefulness, and supplementation should be evidence based. Overall, milk microbiome literature outside of human and model systems is scarce. We highlight the need for mechanistic studies in model species paired with comparative studies across mammals to further our understanding of mammalian milk microbiome evolution. A broader study of milk microbiomes has the potential to inform animal care with relevance to ex situ endangered species. Lay summary Milk is an ancient adaptation that supports the growth and development of mammalian neonates and infants. Beyond its fundamental nutritional function, milk influences all aspects of neonatal development, especially immune function. All kinds of milks so far studied have contained a milk microbiome. In this review, we focus on what is known about the collection of bacterial members found in milk microbiomes. Milk microbiomes include members sourced from maternal and infant microbiomes and they appear to be influenced by maternal evolutionary history, diet, milk nutrients, and environment, as well as by random chance. Once a neonate begins nursing, microbes from milk colonize their gut and produce byproducts that influence their physiology, metabolism, and immune development. Empirical data on milk microbiomes outside of humans and model systems are sparse. Greater study of milk microbiomes across mammals will expand our understanding of mammalian evolution and improve the health of animals under human care.
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Affiliation(s)
- Michael L Power
- Center for Species Survival, Smithsonian’s National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Carly R Muletz-Wolz
- Center for Conservation Genomics, Smithsonian’s National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Sally L Bornbusch
- Center for Conservation Genomics, Smithsonian’s National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
- Department of Nutrition Science, Smithsonian’s National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
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Glick VJ, Power ML. Macronutrient composition of milk from captive southern pig-tailed macaques (Macaca nemestrina). Am J Primatol 2024; 86:e23570. [PMID: 37876290 DOI: 10.1002/ajp.23570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/12/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023]
Abstract
Milk composition is a fundamental aspect of mammalian reproduction. Differences in milk composition between species may reflect phylogeny, dietary ecology, lactation strategy, and infant growth patterns, but may also vary within a species due to maternal body condition. This study presents the first published data on milk macronutrient composition of southern pig-tailed macaques (Macaca nemestrina) and compares the results with data on two other Cercopithecine species. Milk samples were obtained from five dams at 10- and 14-weeks postparturition. Macronutrient composition was determined at the Smithsonian's National Zoo and Conservation Biology Institute using proven methods developed over 30 years. On average (±SEM), the milk contained 83.9 ± 0.4% water, 6.7 ± 0.4% fat, 7.6 ± 0.1% sugar, 1.8 ± 0.1% protein, and 0.22 ± 0.01% mineral content. The Ca:P ratio was 1.8; concentrations of Ca and protein were correlated. Mean gross energy was 1.02 ± 0.03 kcal/g with most of the energy coming from fat (59.6 ± 1.5%), followed by sugar (29.9 ± 1.4%) and protein (10.5 ± 0.5%). The milks at 14 weeks of infant age were higher in energy than the milks at 10 weeks, with an increase in energy from fat (p = 0.005) and decrease in energy from sugar (p = 0.018). The energy from protein did not change (p = 0.272). Compared to captive rhesus macaque (Macaca mulatta) and olive baboon (Papio anubis) milk assayed by identical methods, captive pig-tailed macaque milk was higher in energy, but after accounting for the higher milk energy there was no difference in the proportions of milk energy from protein, fat, and sugar. The captive pig-tailed dams were significantly heavier than reported values for wild pig-tailed macaques, suggesting high body condition. High body condition in captive Cercopithecines appears to result in milk higher in energy, with more energy coming from fat and less from sugar. However, variation in the proportion of milk energy from protein in captive Cercopithecine milks appears relatively constrained.
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Affiliation(s)
- Virginia J Glick
- Department of Immunology and Infectious Disease, Harvard School of Public Health, Harvard University, Boston, Massachusetts, USA
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
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Gillenwater JA, Rep MA, Troy AB, Power ML, Vigh RS, Mackeen AD. Patient Perception of Telemedicine in Maternal-Fetal Medicine. Telemed J E Health 2024; 30:198-203. [PMID: 37466478 DOI: 10.1089/tmj.2023.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
Background: Maternal-fetal medicine (MFM) is a medical subspecialty that cares for patients with high-risk pregnancies. Methods: An IRB-approved survey was offered to patients in MFM offices of a tertiary health care system from March 2022 to May 2022. Demographics and responses to 15 statements about telemedicine were collected via a 5-point Likert scale. Exploratory factor analysis was performed to identify factors affecting patient perception of the telemedicine experience. We sought to examine perception of telemedicine in MFM, identify factors affecting perception, and identify whether specific demographics were associated with patients who view telemedicine appointments favorably. Results: Surveys were completed by 327 of 347 (94%) patients. A total of 233 (71%) patients felt that the telemedicine experience was equal in quality to in-person appointments, and 257 (79%) were open to telemedicine appointments in the future. Exploratory factor analysis yielded two factors: "physician attentiveness" and "technology comfort." Telemedicine was viewed favorably or neutrally for both factors. Education (lower) and marital status (single) were associated with a favorable perception of physician attentiveness. Ethnicity (Hispanic), employment status (employed), and prior telemedicine experience were associated with a favorable perception of technology comfort. Conclusion: Most patients felt the quality of telemedicine appointments was equal to those completed in person. Physician attentiveness and technology comfort affect telemedicine perception. Specific patient demographic characteristics were associated with differing perceptions of telemedicine in MFM. Our findings suggest that telemedicine is positively viewed for MFM and can be used for improving health care delivery efficiency in MFM.
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Affiliation(s)
- Jordan A Gillenwater
- Division of Maternal-Fetal Medicine, Geisinger Women's and Children's Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - Miranda A Rep
- Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA
| | | | - Michael L Power
- Center for Species Survival, Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Richard S Vigh
- Division of Maternal-Fetal Medicine, Geisinger Women's and Children's Institute, Geisinger Health System, Danville, Pennsylvania, USA
| | - A Dhanya Mackeen
- Division of Maternal-Fetal Medicine, Geisinger Women's and Children's Institute, Geisinger Health System, Danville, Pennsylvania, USA
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Gaur P, Power ML, Schulkin J, Jelin AC. Associations of Preconception Body Weight, Body Mass Index, and Hypertension with Preeclampsia. J Womens Health (Larchmt) 2023. [PMID: 38061044 DOI: 10.1089/jwh.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024] Open
Abstract
Objective: Maximizing preconception health is an important strategy to prevent preeclampsia in pregnancy. Preeclampsia remains a significant cause of maternal and fetal morbidity and mortality. We examined the associations between preconception maternal body weight, body mass index (BMI), and blood pressure with preeclampsia and its related outcomes. Materials and Methods: We performed a retrospective review of 11,214 live births from 6 months preconception during 2009-2018 in the University of Washington medical system. Outcomes were analyzed using chi-square, analysis of variance, and t-tests. Binary logistic regression was performed to examine associations. Results: Of 11,214 births, 1,539 (13.7%) were complicated by preeclampsia. Individuals with preeclampsia weighed more and had higher blood pressure from 6 months preconception to at least 6 months of pregnancy compared with those without preeclampsia (p < 0.001). Persons with prepregnancy systolic blood pressure (SBP) ≥130 mmHg were 3.2 times more likely to develop preeclampsia than those with SBP <130 mmHg (adjusted odds ratio [aOR] = 3.24, 95% confidence interval [CI] = 2.37-4.43). Women with prepregnancy BMI ≥30 kg/m2 were 2.3 times more likely to develop preeclampsia (aOR = 2.31, 95% CI = 1.72-3.10) than those with BMI <30 kg/m2. Mothers with preeclampsia were more likely to deliver preterm (29% vs. 13.8%, p < 0.001) and have neonates with 5-minute Apgar scores <8 (22.1% vs. 12.1%, p = 0.02) and lower preterm birthweights (1,909 g, 95% CI = 1,813-2,004 g vs. 2,057 g, 95% CI = 1,989-2,123 g). Conclusions: Maternal obesity and elevated blood pressure from 6 months preconception to 6 months of pregnancy were associated with preeclampsia, resulting in maternal and fetal complications.
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Affiliation(s)
- Priyanka Gaur
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Jay Schulkin
- Department of Gynecology and Obstetrics, University of Washington School of Medicine, Seattle, Washington, USA
| | - Angie C Jelin
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Keady MM, Jimenez RR, Bragg M, Wagner JCP, Bornbusch SL, Power ML, Muletz-Wolz CR. Ecoevolutionary processes structure milk microbiomes across the mammalian tree of life. Proc Natl Acad Sci U S A 2023; 120:e2218900120. [PMID: 37399384 PMCID: PMC10334807 DOI: 10.1073/pnas.2218900120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/22/2023] [Indexed: 07/05/2023] Open
Abstract
Milk production is an ancient adaptation that unites all mammals. Milk contains a microbiome that can contribute to offspring health and microbial-immunological development. We generated a comprehensive milk microbiome dataset (16S rRNA gene) for the class Mammalia, representing 47 species from all placental superorders, to determine processes structuring milk microbiomes. We show that across Mammalia, milk exposes offspring to maternal bacterial and archaeal symbionts throughout lactation. Deterministic processes of environmental selection accounted for 20% of milk microbiome assembly processes; milk microbiomes were similar from mammals with the same host superorder (Afrotheria, Laurasiathera, Euarchontoglires, and Xenarthra: 6%), environment (marine captive, marine wild, terrestrial captive, and terrestrial wild: 6%), diet (carnivore, omnivore, herbivore, and insectivore: 5%), and milk nutrient content (sugar, fat, and protein: 3%). We found that diet directly and indirectly impacted milk microbiomes, with indirect effects being mediated by milk sugar content. Stochastic processes, such as ecological drift, accounted for 80% of milk microbiome assembly processes, which was high compared to mammalian gut and mammalian skin microbiomes (69% and 45%, respectively). Even amid high stochasticity and indirect effects, our results of direct dietary effects on milk microbiomes provide support for enteromammary trafficking, representing a mechanism by which bacteria are transferred from the mother's gut to mammary gland and then to offspring postnatally. The microbial species present in milk reflect both selective pressures and stochastic processes at the host level, exemplifying various ecological and evolutionary factors acting on milk microbiomes, which, in turn, set the stage for offspring health and development.
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Affiliation(s)
- Mia M. Keady
- Center for Conservation Genomics, Smithsonian National Zoo and Conservation Biology Institute, Washington, DC20008
- Nelson Institute for Environmental Studies, University of Wisconsin-Madison, Madison, WI53706
| | - Randall R. Jimenez
- Center for Conservation Genomics, Smithsonian National Zoo and Conservation Biology Institute, Washington, DC20008
- Science Team, International Union for Conservation of Nature, 11501San José, Costa Rica
| | - Morgan Bragg
- Center for Conservation Genomics, Smithsonian National Zoo and Conservation Biology Institute, Washington, DC20008
- Department of Environmental Science and Policy, George Mason University, Fairfax, VA22030
| | - Jenna C. P. Wagner
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian National Zoo and Conservation Biology Institute, National Zoological Park, Washington, DC20008
| | - Sally L. Bornbusch
- Center for Conservation Genomics, Smithsonian National Zoo and Conservation Biology Institute, Washington, DC20008
- Department of Nutrition Science, Smithsonian National Zoo and Conservation Biology Institute, Washington, DC20008
| | - Michael L. Power
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian National Zoo and Conservation Biology Institute, National Zoological Park, Washington, DC20008
| | - Carly R. Muletz-Wolz
- Center for Conservation Genomics, Smithsonian National Zoo and Conservation Biology Institute, Washington, DC20008
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Mitchell SL, Schulkin J, Power ML. Vaccine hesitancy in pregnant Women: A narrative review. Vaccine 2023:S0264-410X(23)00608-4. [PMID: 37291023 DOI: 10.1016/j.vaccine.2023.05.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 06/10/2023]
Abstract
Pregnant women are often at higher risk for morbidity and mortality due to contracting vaccine-preventable diseases that result in adverse pregnancy outcomes such as spontaneous abortion, preterm births, and congenital fetal defects. For example, health care provider recommendation is correlated with maternal acceptance of influenza vaccination, however, up to 33 % of pregnant women remain unvaccinated irrespective of provider recommendation. Vaccine hesitancy is a multifactorial problem that both the medical and public health systems need to address synergistically. Vaccine education should incorporate balanced perspectives to deliver vaccine education. This narrative review addresses four questions: 1) what are the primary concerns of pregnant women that lead them to be hesitant about receiving vaccinations; 2) to what extent does the source (e.g. provider, friend, family) of vaccine advice and information influence a pregnant person's decision to accept a vaccine; 3) how does the delivery method of vaccine education influence their decision; 4) how can categorizing patients into four distinct groups based on their opinions and behavior regarding vaccines be used to improve provider-patient communication and increase vaccine acceptance. Results from the literature show that the three most common reasons for vaccine hesitancy include: i.) fear of side effects or adverse events; ii.) lack of confidence in vaccine safety; iii.) low perception of being at high risk of infection during pregnancy and/or not having previously received the vaccination when not pregnant. We conclude that vaccine hesitancy is dynamic therefore people do not always hold a static level of vaccine hesitancy. People may move between a continuum of vaccine hesitancy for a multifactorial reasons. A framework, characterized by levels of vaccine hesitancy before and during pregnancy, was constructed to help providers find balance between promoting individual health and public health while providing vaccine education.
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Affiliation(s)
- Stephanie L Mitchell
- Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC, USA.
| | - Jay Schulkin
- Obstetrics & Gynecology, University of Washington School of Medicine, Seattle, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC, USA
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Mitchell SL, Strassberg E, Rhoades C, Jones A, Wagner JCP, Schulkin J, Power ML. Pregnant Women's Concerns Regarding COVID-19 and Their Willingness to Be Vaccinated. J Womens Health (Larchmt) 2023; 32:513-520. [PMID: 36897317 DOI: 10.1089/jwh.2022.0427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Objectives: We investigated coronavirus disease 2019 (COVID-19) opinions, experiences, and willingness to accept COVID-19 vaccination during pregnancy at two prenatal clinics in early 2021 and early 2022. Materials and Methods: Paper questionnaires were distributed to pregnant women at prenatal care facilities in Virginia and Florida between January and April 2021 and January and April 2022. Questions regarding acceptance and opinions of the influenza vaccine served as a baseline to assess COVID-19 vaccine opinions. Associations between demographic parameters and vaccine opinions and acceptance were examined using Chi-square. A COVID-19 concern score was constructed by principal component analysis with differences between groups assessed by analysis of variance (ANOVA) and analysis of covariance (ANCOVA). Results: Many participants (40.6%) reported that the COVID pandemic had affected their pregnancy. Main themes were problems with social networks, increased stress/anxiety, and being more cautious. In 2021, 19.5% reported they would accept a COVID-19 vaccination during their pregnancy, which increased to 45.8% in 2022. Vaccine hesitancy did not vary by race or between sites, but educational attainment was significant (p < 0.001). Women with a higher concern score were more likely to report they would accept a COVID-19 vaccine. Women who would accept COVID vaccination had a positive opinion regarding the influenza vaccine. Main themes for refusing COVID-19 vaccination were concerns about side effects, lack of research/data, and mistrust of vaccines. Conclusions: The proportion of women willing to accept COVID-19 vaccination increased but remained below 50%. Willingness to accept vaccination during pregnancy was associated with higher education, higher concern about COVID-19, and a positive opinion of the influenza vaccine.
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Affiliation(s)
- Stephanie L Mitchell
- Center for Species Survival, Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Emmie Strassberg
- Shenandoah Valley Maternal Fetal Medicine, Valley Health, Winchester, Virginia, USA
| | - Courtney Rhoades
- Department of Obstetrics and Gynecology, University of Florida Health, Jacksonville, Florida, USA
| | - Asia Jones
- Center for Species Survival, Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Jenna C P Wagner
- Center for Species Survival, Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA
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Prince A, Wade J, Power ML, Gunawansa N, Cruz-Bendezú A, Schulkin J, Macri CJ. Postpartum care: Discussions and counseling for the peripartum period. J Neonatal Perinatal Med 2023; 16:657-664. [PMID: 38043027 DOI: 10.3233/npm-230167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Traditionally, postpartum care is confined to inpatient care immediately post birth and one appointment approximately six weeks postpartum. Data supports a continuum of care model as best for the health of mother and baby. Despite most women having significant concerns about the postpartum period, these concerns are frequently incompletely addressed by providers. We surveyed prenatal and postpartum patients to understand their concerns and experiences discussing postpartum care with providers. METHODS Cross sectional surveys were administered between June 2019 and May 2021. Principal component analysis was used to show higher than average (positive) or lower than average (negative) conversations with providers about postpartum care examined by race, education, and parity. Chi squared tests were conducted to examine the significance of specific postpartum concerns. RESULTS 421/450 patient surveys were analyzed, based on completion. Most patients were White (193), had post graduate degrees (188), privately insured (236), married (248), first time pregnant (152), and used doctors as their primary provider (267). Patients with lower education, higher parity and Black patients without postgraduate degrees reported higher than average postpartum counseling. Additionally, most patients expressed significant concerns about postpartum exhaustion (65.8%), breastfeeding (62.3%), pain (61.2%), physical activity (54.9%) and the baby blues (50.4%). CONCLUSIONS Postpartum concerns are incompletely and inconsistently addressed amongst patients based on race, parity, and education. A continuum of care approach, beginning in the third trimester, through the postpartum period, may provide better counseling to address all patients' concerns.
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Affiliation(s)
- A Prince
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - J Wade
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - M L Power
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA
- Pregnancy-Related Care Research Network (PRCRN), Seattle, WA, USA
| | - N Gunawansa
- The George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | - A Cruz-Bendezú
- Department of Urology, George Washington University, Washington, DC, USA
| | - J Schulkin
- Pregnancy-Related Care Research Network (PRCRN), Seattle, WA, USA
| | - C J Macri
- Department of Obstetrics and Gynecology, GWU MFA, Washington, DC, USA
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Cleland TP, Power ML. Variation in Milk Proteins Across Lactation in Pongo pygmaeus and Gorilla gorilla. J Proteome Res 2022; 21:2647-2654. [DOI: 10.1021/acs.jproteome.2c00373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Timothy P. Cleland
- Museum Conservation Institute, Smithsonian Institution, Suitland, Maryland 20746, United States
| | - Michael L. Power
- Center for Species Survival, Nutrition Laboratory, Smithsonian National Zoo and Conservation Biology Institute, District of Columbia 20008, Washington, D.C., United States
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Bornbusch SL, Keady MM, Power ML, Muletz-Wolz CR. Milk microbiomes of three great ape species vary among host species and over time. Sci Rep 2022; 12:11017. [PMID: 35773288 PMCID: PMC9247006 DOI: 10.1038/s41598-022-15091-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 05/17/2022] [Indexed: 12/02/2022] Open
Abstract
In mammalian neonates, milk consumption provides nutrients, growth factors, immune molecules, and microbes. Milk microbiomes are increasingly recognized for their roles in seeding infant gut microbiomes and priming immune development. However, milk microbiome variation within and among individuals remains under investigation. We used 16S rRNA gene sequencing to investigate factors shaping milk microbiomes in three captive great ape species: Gorilla gorilla gorilla (individuals, N = 4; samples, n = 29), Pongo abelii (N = 2; n = 16), and Pongo pygmaeus (N = 1; n = 9). We demonstrate variation among host species, over lactation, and between housing facilities. In phylogenetic community composition, milk microbiomes were distinct among the three ape species. We found only a few shared, abundant bacterial taxa and suggest that they likely serve functional roles. The diversity and community composition of milk microbiomes showed gradual changes over time in gorillas and the Bornean orangutan, which was detectable with our comprehensive sampling over lactation stages (> 300-day span). In gorillas, milk microbiomes differed between housing facilities, but were similar between dams within a facility. These results support the strong influence of evolutionary history in shaping milk microbiomes, but also indicate that more proximate cues from mother, offspring, and the environment affect the distribution of rarer microbial taxa.
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Affiliation(s)
- Sally L Bornbusch
- Center for Conservation Genomics, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA. .,Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA.
| | - Mia M Keady
- Center for Conservation Genomics, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA.,Nelson Institute for Environmental Studies, University of Wisconsin-Madison, Madison, WI, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA
| | - Carly R Muletz-Wolz
- Center for Conservation Genomics, Smithsonian's National Zoo and Conservation Biology Institute, Washington, DC, USA
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Satti MA, Reed EG, Wenker ES, Mitchell SL, Schulkin J, Power ML, Mackeen AD. Factors that shape pregnant women's perceptions regarding the safety of cannabis use during pregnancy. J Cannabis Res 2022; 4:16. [PMID: 35387682 PMCID: PMC8983804 DOI: 10.1186/s42238-022-00128-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 03/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background Cannabis use among pregnant women has increased. We surveyed pregnant women in rural Pennsylvania to examine cannabis use and opinions regarding its safety during pregnancy. We examined associations between challenges of pregnancy (e.g., exhaustion, pain, nausea) and cannabis use. Methods A cross-sectional survey was administered to a convenience sample of English-speaking pregnant women receiving prenatal care at Geisinger, May–June 2019. Principal component analysis (PCA) was used to construct three scores (overwhelmed/exhausted, happy/optimistic, and health worries) based on 10 questions regarding common experiences during pregnancy (e.g., nausea/vomiting, pain, exhaustion, mood). A score based on four questions regarding cannabis safety during pregnancy was also constructed. Results From a maximum of 300 surveys distributed, 284 were completed (95%). Most participants were white (87%), married (49%) or living with a partner (38%), and had private health insurance (62%). Most women indicated it was unsafe to use alcohol and tobacco products during pregnancy (> 90%), but that proportion dropped to 82% and 63% regarding recreational cannabis and medical cannabis, respectively. Only women with prior cannabis use (23% of sample) continued to do so during pregnancy: 57% of women reporting daily cannabis use prior to pregnancy continued to use cannabis during pregnancy with 33% reporting daily use. Two thirds of users during pregnancy indicated they were self-medicating for: nausea (90%), anxiety (70%), insomnia (30%), and pain management (30%). Many (56%) of the women who used cannabis during pregnancy believed it is safe. Younger women and women who were overwhelmed/exhausted or less happy/optimistic were more likely to believe cannabis use is safe. Women valued healthcare provider advice more than advice from family and friends. Study strengths include a high response rate. Weaknesses include self-report and that is was a convenience sample; however, the demographics of the sample were similar to past studies. Conclusion Women with a history of cannabis use, especially daily use, are at risk of continuing during pregnancy and should receive counseling. Younger women and women with greater stressors during pregnancy also are at greater risk. Screening for prior use and for stressors may identify patients that would benefit from enhanced counseling.
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Affiliation(s)
- Mohamed A Satti
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Geisinger, Danville, USA
| | - Eda G Reed
- Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
| | - Elizabeth S Wenker
- Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA
| | - Stephanie L Mitchell
- Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA.,School of Public Health, University of California, Berkeley, Berkeley, USA
| | - Jay Schulkin
- Obstetrics & Gynecology, University of Washington School of Medicine, Seattle, USA
| | - Michael L Power
- Center for Species Survival, Smithsonian National Zoological Park and Conservation Biology Institute, 3001 Connecticut Ave NW, Washington DC, 20008, USA.
| | - A Dhanya Mackeen
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Geisinger, Danville, USA
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Henry BA, Power ML, Maslanka MT, Rencken CA, Nollman JA. Challenges of devising a milk recipe in a hand-reared hippopotamus (Hippopotamus amphibius). Zoo Biol 2022; 41:360-364. [PMID: 35049088 DOI: 10.1002/zoo.21680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 12/03/2021] [Accepted: 01/04/2022] [Indexed: 11/08/2022]
Abstract
In January 2017, a Nile hippopotamus (Hippopotamus amphibious) was born approximately six weeks premature at the Cincinnati Zoo & Botanical Garden. Due to the calf's weakened condition and lack of interest from the dam, management at the zoo made the decision to hand-rear the calf. Limited published information was available on hand-rearing this species of hippopotamus (hippo). To devise a nutritionally appropriate recipe, milk samples were acquired from the dam on Days 1, 3, 8, and 9 postpartum, and assayed for sugar, protein, fat, mineral, and water content using standard methods validated for multiple species of mammals at the Smithsonian National Zoo's Nutrition Science Laboratory. The sugar content stayed relatively constant (mean = 4.5%; range: 4.3%-4.7%). The fat consistently increased from 0.48% to 4.24% (mean = 2%). Excluding Day 9, the protein content gradually decreased from 9.56% to 6.39% (mean = 8%). The dry matter (DM) ranged from 14.38% to 16.72% (i.e., water content of 85.62%-83.28%), with the sum of the solids (sugar, protein, fat, and ash) averaging 98.5% of measured DM. Fat content was lower than expected but within the range of other artiodactyls. Between Days 1 and 8, the trend of decreasing protein and increasing fat was consistent with a change from colostrum to mature milk. The sharp increase in fat and protein with a decrease in sugar on Day 9 may indicate the beginning of the involution of the mammary gland due to lack of nursing stimulus. Utilizing this information, the Cincinnati Zoo was able to formulate a successful milk replacement recipe that allowed the calf to be raised through weaning to maturity.
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Affiliation(s)
| | - Michael L Power
- Smithsonian National Zoological Park and Conservation Biology Institute, Nutrition Laboratory, Center for Species Survival, Washington, District of Columbia, USA
| | - Michael T Maslanka
- Department of Nutrition Science, Smithsonian National Zoological Park and Conservation Biology Institute, Washington, District of Columbia, USA
| | - Camerin A Rencken
- Department of Nutrition Science, Smithsonian National Zoological Park and Conservation Biology Institute, Washington, District of Columbia, USA
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Comizzoli P, Power ML, Bornbusch SL, Muletz-Wolz CR. Interactions between reproductive biology and microbiomes in wild animal species. Anim Microbiome 2021; 3:87. [PMID: 34949226 PMCID: PMC8697499 DOI: 10.1186/s42523-021-00156-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/18/2021] [Indexed: 12/24/2022] Open
Abstract
Many parts of the animal body harbor microbial communities, known as animal-associated microbiomes, that affect the regulation of physiological functions. Studies in human and animal models have demonstrated that the reproductive biology and such microbiomes also interact. However, this concept is poorly studied in wild animal species and little is known about the implications to fertility, parental/offspring health, and survival in natural habitats. The objective of this review is to (1) specify the interactions between animals' reproductive biology, including reproductive signaling, pregnancy, and offspring development, and their microbiomes, with an emphasis on wild species and (2) identify important research gaps as well as areas for further studies. While microbiomes present in the reproductive tract play the most direct role, other bodily microbiomes may also contribute to facilitating reproduction. In fish, amphibians, reptiles, birds, and mammals, endogenous processes related to the host physiology and behavior (visual and olfactory reproductive signals, copulation) can both influence and be influenced by the structure and function of microbial communities. In addition, exposures to maternal microbiomes in mammals (through vagina, skin, and milk) shape the offspring microbiomes, which, in turn, affects health later in life. Importantly, for all wild animal species, host-associated microbiomes are also influenced by environmental variations. There is still limited literature on wild animals compared to the large body of research on model species and humans. However, the few studies in wild species clearly highlight the necessity of increased research in rare and endangered animals to optimize conservation efforts in situ and ex situ. Thus, the link between microbiomes and reproduction is an emerging and critical component in wild animal conservation.
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Affiliation(s)
- Pierre Comizzoli
- Smithsonian Conservation Biology Institute, National Zoological Park, Veterinary Hospital MRC5502, PO Box 37012, Washington, DC 20013 USA
| | - Michael L. Power
- Smithsonian Conservation Biology Institute, National Zoological Park, Veterinary Hospital MRC5502, PO Box 37012, Washington, DC 20013 USA
| | - Sally L. Bornbusch
- Smithsonian Conservation Biology Institute, National Zoological Park, Veterinary Hospital MRC5502, PO Box 37012, Washington, DC 20013 USA
| | - Carly R. Muletz-Wolz
- Smithsonian Conservation Biology Institute, National Zoological Park, Veterinary Hospital MRC5502, PO Box 37012, Washington, DC 20013 USA
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15
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Booker WA, Reed EG, Power ML, Schulkin J, Gyamfi-Bannerman C, Manuck T, Berghella V, Vink J. OBGYN practice patterns regarding combination therapy for prevention of preterm birth: A national survey. Eur J Obstet Gynecol Reprod Biol 2021; 266:23-30. [PMID: 34560330 PMCID: PMC9812028 DOI: 10.1016/j.ejogrb.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Our objective was to examine if US obstetrician-gynecologists (OBGYNs) practice outside of evidenced-based guidelines and use a combination of interventions to prevent spontaneous preterm birth (sPTB). STUDY DESIGN An electronic survey was distributed to members of the Pregnancy-Related Care Research Network (PRCRN), and also to members of the Society of Maternal-Fetal Medicine (SMFM). The survey consisted of questions regarding physician demographics, and the use of interventions to prevent sPTB in women with 1) a prior sPTB, 2) an incidental short cervix (no prior sPTB), and 3) a history of cervical insufficiency. RESULTS The PRCRN response rate was 58.6% (283/483) with an additional 143 responses from SMFM members. Among PRCRN responders, 82.7% were general OBGYNs and 17.3% were Maternal-Fetal Medicine subspecialists. Respondents were from all geographic regions of the country; most practiced in a group private practice (42.6%) or academic institution (31.4%). In women with prior sPTB, 45.2% of respondents would consider combination therapy, most commonly weekly intramuscular progesterone (IM-P) and serial cervical length (CL) measurements. If the patient then develops a short cervix, 33.7% would consider adding an ultrasound-indicated cerclage. In women with an incidental short cervix, 66.8% of respondents were likely to recommend single therapy with daily vaginal progesterone (VP). If a patient developed an incidentally dilated cervix, 40.8% of PRCRN respondents would recommend dual therapy, most commonly cerclage + VP, whereas 64.3% of SMFM respondents were likely to continue with VP only. In women with a history of cervical insufficiency, 47% of PRCRN respondents indicated they would consider a combination of IM-P, history-indicated cerclage and serial CL measurements. CONCLUSION Although not currently supported by evidence-based medicine, combination therapy is commonly being used by U.S. OBGYNs to prevent sPTB in women with risk factors such as prior sPTB, short or dilated cervix or more than one of these risks.
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Affiliation(s)
- Whitney A Booker
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA; The Preterm Birth Prevention Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - Eda G Reed
- Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC, USA; Bloomberg School of Public Health and Carey Business School, Johns Hopkins University, Baltimore, MD, USA
| | - Michael L Power
- Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC, USA; American College of Obstetricians and Gynecologists, Washington, DC, USA
| | - Jay Schulkin
- American College of Obstetricians and Gynecologists, Washington, DC, USA; University of Washington School of Medicine, Seattle, WA, USA
| | - Cynthia Gyamfi-Bannerman
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA; The Preterm Birth Prevention Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Tracy Manuck
- Department of Obstetrics and Gynecology, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - Vincenzo Berghella
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Joy Vink
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA; The Preterm Birth Prevention Center, Columbia University Irving Medical Center, New York, NY, USA
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16
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Glick VJ, Bentley-Condit VK, Power ML. Macronutrient composition of olive baboon (Papio anubis) milk: A comparison to rhesus macaque (Macaca mulatta) milk. Am J Primatol 2021; 83:e23315. [PMID: 34339526 PMCID: PMC9881339 DOI: 10.1002/ajp.23315] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/09/2021] [Accepted: 07/24/2021] [Indexed: 01/31/2023]
Abstract
This study was designed to (1) characterize the macronutrient composition of olive baboon (Papio anubis) milk, (2) compare baboon milk composition to that of rhesus macaques (Macaca mulatta), and (3) evaluate the association between the proportion of milk energy derived from protein and relative growth rate within anthropoid primates. A single milk sample was collected from each of eight lactating olive baboons ranging between 47- and 129-days postparturition and six rhesus macaques from 15- to 92-days living at the same institution under identical management conditions. Macronutrient composition (water, fat, protein sugar, and ash) was determined using standard techniques developed at the Nutrition Laboratory at the Smithsonian National Zoological Park. Baboon milk on average contained 86.0% ± 0.6% water, 4.7% ± 0.5% fat, 1.6% ± 0.04% protein, 7.3% ± 0.07% sugar, and 0.165% ± 0.007% ash. Baboon milk gross energy (GE) averaged 0.81 ± 0.04 kcal/g with 51.9% ± 2.6% from fat, 11.8% ± 0.7% from protein, and 36.2% ± 2.0% from sugar. Baboon milk demonstrated strong similarity to milk composition of the closely phylogenetically related rhesus macaque (86.1% ± 0.3% water, 4.1% ± 0.4% fat, 1.69% ± 0.05% protein, 7.71% ± 0.08% sugar, 0.19% ± 0.01% ash, and 0.78 kcal/g). There was no statistical difference between baboon and macaque milk in the proportions of energy from fat, sugar, and protein. Baboon milk can be described as a high sugar, moderate fat, and low protein milk with moderate energy density, which is consistent with their lactation strategy characterized by frequent, on-demand nursing and relatively slow life history compared to nonprimate mammal taxa. The milk energy from protein of both baboon and macaque (12.8% ± 0.3%) milk was intermediate between the protein milk energy of platyrrhine (19.3%-23.2%) and hominoid (8.9%-12.6%) primates, consistent with their relative growth rates also being intermediate. Compared to these cercopithecid monkeys, platyrrhine primates have both higher relative growth rates and higher milk energy from protein, while apes tend to be lower in both.
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Affiliation(s)
- Virginia J. Glick
- Center for Species Survival, Smithsonian National Zoological Park & Conservation Biology Institute, Washington, District of Columbia, USA
| | | | - Michael L. Power
- Center for Species Survival, Smithsonian National Zoological Park & Conservation Biology Institute, Washington, District of Columbia, USA
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17
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Callahan AG, Coleman-Cowger VH, Schulkin J, Power ML. Racial disparities in influenza immunization during pregnancy in the United States: A narrative review of the evidence for disparities and potential interventions. Vaccine 2021; 39:4938-4948. [PMID: 34312009 DOI: 10.1016/j.vaccine.2021.07.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The objectives of this review were to summarize existing data on racial disparities in maternal immunization for influenza in the U.S. and to review the literature on interventions to improve the uptake of the influenza vaccine among Black pregnant women. DATA SOURCES U.S. survey data on maternal influenza immunization by racial and ethnic group were summarized in narrative form. To review intervention studies, PubMed, CINAHL, EMBASE, and the Cochrane Library databases were searched for English language articles published 2017 to 2021, in addition to studies identified by a previous systematic review. STUDY ELIGIBILITY CRITERIA Peer-reviewed studies conducted in the U.S. and reporting interventions designed to increase the uptake of the influenza vaccine in pregnancy with study populations including at least 20% of participants identifying as Black were included. STUDY APPRAISAL AND SYNTHESIS METHODS Studies were grouped and reviewed in a narrative manner according to whether they were conducted in predominantly Black populations or in more racially diverse populations, and whether they tested multicomponent or single-component interventions. RESULTS A decade of survey data show that Black women in the U.S. consistently have the lowest rate of influenza immunization in pregnancy. Black women report a lower rate of being recommended or offered the vaccine, and provider recommendation is associated with greater vaccine uptake. Intervention studies to increase influenza immunization among Black pregnant women have reported mixed results. Successful interventions include multicomponent practice-based interventions, group prenatal care, and culturally competent patient educational messages. CONCLUSIONS Racial disparities in maternal uptake of the influenza vaccine are long-standing, but not intractable. More research is needed to test interventions to address this disparity, with a focus on increasing provider recommendation and offer of the vaccine, addressing patients' concerns about vaccine safety and efficacy, improving providers' cultural competence, and building trust between providers and patients.
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Affiliation(s)
- Alice G Callahan
- Health Professions Division, Lane Community College, 4000 East 30th Ave., Eugene, OR 97405, USA.
| | | | - Jay Schulkin
- Department of Obstetrics and Gynecology, University of Washington, 1959 NE Pacific Street, Box 356460, Seattle, WA 98195, USA.
| | - Michael L Power
- Center for Species Survival, Smithsonian National Zoological Park & Conservation Biology Institute, P.O. Box 37012, MRC 5503, Washington, DC 20013-7012, USA.
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18
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Himschoot EA, Wenker ES, Reed EG, Sampson J, Power ML. Macronutrient composition of milk from two captive African elephant (Loxodonta africana) cows. Zoo Biol 2021; 40:192-200. [PMID: 33705586 DOI: 10.1002/zoo.21599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 02/09/2021] [Indexed: 11/09/2022]
Abstract
We assayed 31 milk samples collected from two African elephant cows housed at the Indianapolis Zoo across lactation (birth to calf age 973 days) for macronutrient composition (water, fat, protein, sugar, gross energy [GE], ash, calcium, and phosphorus). All assays were performed at the Smithsonian National Zoological Park Nutrition Laboratory, Washington, DC (SNZP) using standard methods developed at SNZP. Milk constituents are expressed on a weight-per-weight basis (%) and as a proportion each constituent contributes to milk energy. Calf weights were recorded, and growth rate calculated. The macronutrient composition of the African elephant milk samples was compared to previously published results for Asian elephants using analysis of covariance. African elephant milk is similar to Asian elephant milk, being moderately high in fat and energy and low in sugar. The mean values across lactation (excluding colostrum; n = 28) are 5.6 ± 0.3% crude protein, 3.1 ± 0.3% sugar, 13.0 ± 1.0% fat, and GE of 1.63 ± 0.10 kcal/g. Milk composition did not differ between cows. Milk composition significantly changed over lactation; fat and protein increased, and sugar decreased with calf age, comparable to previously reported data for African and Asian elephant milk. The proportion of milk energy from fat increased and that from sugar decreased over lactation, but the energy from protein was relatively constant. Protein contributed a higher proportion of energy to African elephant milk compared to Asian elephant milk (20.6% vs. 17.0%, p = .001). Despite this, calf growth rate was similar between the species, with the calves in this study gaining about 0.8 kg/day for the first 6 months.
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Affiliation(s)
- Elizabeth A Himschoot
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, Washington, District of Columbia, USA
| | - Elizabeth S Wenker
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, Washington, District of Columbia, USA
| | - Eda G Reed
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, Washington, District of Columbia, USA
| | | | - Michael L Power
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, Washington, District of Columbia, USA
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19
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Remoroza CA, Liang Y, Mak TD, Mirokhin Y, Sheetlin SL, Yang X, San Andres JV, Power ML, Stein SE. Increasing the Coverage of a Mass Spectral Library of Milk Oligosaccharides Using a Hybrid-Search-Based Bootstrapping Method and Milks from a Wide Variety of Mammals. Anal Chem 2020; 92:10316-10326. [PMID: 32639750 PMCID: PMC10939002 DOI: 10.1021/acs.analchem.0c00342] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
This study significantly expands both the scope and method of identification for construction of a previously reported tandem mass spectral library of 74 human milk oligosaccharides (HMOs) derived from results of combined LC-MS/MS experiments and comprehensive structural analysis of HMOs. In the present work, a hybrid search "bootstrap" identification method was employed that substantially broadens the coverage of milk oligosaccharides and thereby increases utility use of a spectrum library-based method for the rapid tentative identification of all distinguishable glycans in milk. This involved hybrid searching of the previous library, which was itself constructed using the hybrid search of oligosaccharide spectra in the NIST 17 Tandem MS Library. The general approach appears applicable to library construction of other classes of compounds. The coverage of oligosaccharides was significantly extended using milks from a variety of mammals, including bovine, Asian buffalo, African lion, and goat. This new method led to the identification of another 145 oligosaccharides, including an additional 80 HMOs from reanalysis of human milk. The newly identified compounds were added to a freely available mass spectral reference database of 219 milk oligosaccharides. We also provide suggestions to overcome several limitations and pitfalls in the interpretation of spectra of unknown oligosaccharides.
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Affiliation(s)
| | - Yuxue Liang
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, United States
| | - Tytus D Mak
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, United States
| | - Yuri Mirokhin
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, United States
| | - Sergey L Sheetlin
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, United States
| | - Xiaoyu Yang
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, United States
| | - Joice V San Andres
- Department of Animal Science, University of Nebraska-Lincoln, 3490 Fair St., Lincoln, Nebraska 68583-0908, United States
- Department of Animal Science, Central Luzon State University, Maharlika Highway, Nueva Ecija 3120, Philippines
| | - Michael L Power
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, National Zoological Park, 3001 Connecticut Ave. NW, Washington, DC 20008, United States
| | - Stephen E Stein
- National Institute of Standards and Technology, 100 Bureau Drive, Gaithersburg, Maryland 20899, United States
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20
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Goodroe AE, Fitz C, Power ML, Colman RJ, Capuano S, Ziegler TE. Evaluation of vitamin D 3 metabolites in Callithrix jacchus (common marmoset). Am J Primatol 2020; 82:e23131. [PMID: 32270886 DOI: 10.1002/ajp.23131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/15/2020] [Accepted: 03/19/2020] [Indexed: 12/26/2022]
Abstract
Vitamin D3 (cholecalciferol) is endogenously produced in the skin of primates when exposed to the appropriate wavelengths of ultraviolet light (UV-B). Common marmosets (Callithrix jacchus) maintained indoors require dietary provision of vitamin D3 due to lack of sunlight exposure. The minimum dietary vitamin D3 requirement and the maximum amount of vitamin D3 that can be metabolized by marmosets is unknown. Observations of metabolic bone disease and gastrointestinal malabsorption have led to wide variation in dietary vitamin D3 provision amongst research institutions, with resulting variation in circulating 25-hydroxyvitamin D3 (25(OH)D3 ), the accepted marker for vitamin D sufficiency/deficiency. Multiple studies have reported serum 25(OH)D3 in captive marmosets, but 25(OH)D3 is not the final product of vitamin D3 metabolism. In addition to serum 25(OH)D3, we measured the most physiologically active metabolite, 1,25-dihydroxyvitamin D3 (1,25(OH)2 D3 ), and the less well understood metabolite, 24,25-dihydroxyvitamin D3 (24,25(OH)2 D3 ) to characterize the marmoset's ability to metabolize dietary vitamin D3 . We present vitamin D3 metabolite and related serum chemistry value colony reference ranges in marmosets provided diets with 26,367 (Colony A, N = 113) or 8,888 (Colony B, N = 52) international units (IU) of dietary vitamin D3 per kilogram of dry matter. Colony A marmosets had higher serum 25(OH)D3 (426 ng/ml [SD 200] vs. 215 ng/ml [SD 113]) and 24,25(OH)2 D3 (53 ng/ml [SD 35] vs. 7 ng/ml [SD 5]). There was no difference in serum 1,25(OH)2 D3 between the colonies. Serum 1,25(OH)2 D3 increased and 25(OH)D3 decreased with age, but the effect was weak. Marmosets tightly regulate metabolism of dietary vitamin D3 into the active metabolite 1,25(OH)2 D3 ; excess 25(OH)D3 is metabolized into 24,25(OH)2 D3 . This ability explains the tolerance of high levels of dietary vitamin D3 by marmosets, however, our data suggest that these high dietary levels are not required.
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Affiliation(s)
- Anna E Goodroe
- Veterinary Resources, Southwest National Primate Research Center, San Antonio, Texas
| | - Casey Fitz
- Veterinary Services Unit, Wisconsin National Primate Research Center, Madison, Wisconsin
| | - Michael L Power
- Conservation Ecology Center, Smithsonian National Zoological Park and Conservation Biology Institute, Washington, District of Columbia
| | - Ricki J Colman
- Veterinary Services Unit, Wisconsin National Primate Research Center, Madison, Wisconsin.,Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Saverio Capuano
- Veterinary Services Unit, Wisconsin National Primate Research Center, Madison, Wisconsin
| | - Toni E Ziegler
- Veterinary Services Unit, Wisconsin National Primate Research Center, Madison, Wisconsin
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Power ML, Snead C, Reed EG, Schulkin J. Integrating evolution into medical education for women's health care practitioners. Evol Med Public Health 2020; 2020:60-67. [PMID: 32382419 PMCID: PMC7196338 DOI: 10.1093/emph/eoaa009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/27/2020] [Accepted: 03/31/2020] [Indexed: 12/24/2022] Open
Abstract
Evolution is a fundamental principle in biology; however, it has been neglected in medical education. We argue that an evolutionary perspective is especially important for women's health care providers, as selection will act strongly on reproductive parameters, and the biological costs of female reproduction are generally more resource expensive than for men (e.g. due to gestation and lactation) with greater effects on health and wellbeing. An evolutionary perspective is needed to understand antibiotic resistance, disease and health risks associated with mismatches between our evolved adaptations and current conditions, the importance of the microbiome and the maternal role in how infants acquire and develop their early-life microbiome (vaginal birth, lactation), and the importance of breastmilk as a biochemical signal from mothers to their babies. We present data that obstetrician-gynecologists' views regarding the inclusion of evolution within their training is generally positive, but many barriers are perceived. Requiring coursework in evolutionary biology with an emphasis on evolutionary medicine prior to enrollment in medical school may be a solution.
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Affiliation(s)
- Michael L Power
- Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC 20013-7012, USA
- American College of Obstetricians and Gynecologists, Washington, DC 20024-2188, USA
| | - Carrie Snead
- American College of Obstetricians and Gynecologists, Washington, DC 20024-2188, USA
| | - Eda G Reed
- Smithsonian National Zoological Park and Conservation Biology Institute, Washington, DC 20013-7012, USA
- Johns Hopkins University, Baltimore, MD 21205, USA
| | - Jay Schulkin
- Obstetrics & Gynecology, University of Washington School of Medicine, Seattle, WA 98195, USA
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Satti MA, Mackeen AD, Reed EG, Wenker ES, Schulkin J, Power ML. 487: Pregnant women’s knowledge and attitudes about opioid use. Am J Obstet Gynecol 2020. [DOI: 10.1016/j.ajog.2019.11.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Power ML, Gaspar-Oishi M, Gibson K, Kelly EW, Lott ML, Mackeen AD, Overcash RT, Rhoades CP, Turrentine M, Yamamura Y, Schulkin J. A Survey of Women and Their Providers Regarding Gestational Weight Gain. J Womens Health (Larchmt) 2019; 28:1399-1406. [DOI: 10.1089/jwh.2018.7067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Michael L. Power
- Department of Research, American College of Obstetricians and Gynecologists, Washington, District of Columbia
- Smithsonian National Conservation Biology Institute, Washington, District of Columbia
| | - Maria Gaspar-Oishi
- Department of Obstetrics and Gynecology, Kapiolani Medical Center, University of Hawaii, Honolulu, Hawaii
| | - Kelly Gibson
- Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio
| | - Elizabeth W. Kelly
- Department of Obstetrics and Gynecology, Albany Medical Center Obstetrics and Gynecology, Albany, New York
| | | | | | | | - Courtney P. Rhoades
- Department of Obstetrics and Gynecology, Methodist Hospital Dallas, Dallas, Texas
| | - Mark Turrentine
- Department of Obstetrics and Gynecology, Kelsey-Seybold Clinic, Houston, Texas
| | - Yasuko Yamamura
- Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, Minnesota
| | - Jay Schulkin
- Department of Research, American College of Obstetricians and Gynecologists, Washington, District of Columbia
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington
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Wenker ES, Himschoot EA, Henry B, Toddes B, Power ML. Macronutrient composition of longitudinal milk samples from captive aardvarks (
Orycteropus afer
). Zoo Biol 2019; 38:405-413. [DOI: 10.1002/zoo.21505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 04/15/2019] [Accepted: 05/31/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Elizabeth S. Wenker
- Nutrition LaboratorySmithsonian Conservation Biology Institute Washington District of Columbia
| | - Elizabeth A. Himschoot
- Nutrition LaboratorySmithsonian Conservation Biology Institute Washington District of Columbia
| | - Barbara Henry
- Department of NutritionCincinnati Zoo and Botanical Garden Cincinnati Ohio
| | | | - Michael L. Power
- Nutrition LaboratorySmithsonian Conservation Biology Institute Washington District of Columbia
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Muletz-Wolz CR, Kurata NP, Himschoot EA, Wenker ES, Quinn EA, Hinde K, Power ML, Fleischer RC. Diversity and temporal dynamics of primate milk microbiomes. Am J Primatol 2019; 81:e22994. [PMID: 31219214 DOI: 10.1002/ajp.22994] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/28/2019] [Accepted: 05/05/2019] [Indexed: 12/30/2022]
Abstract
Milk is inhabited by a community of bacteria and is one of the first postnatal sources of microbial exposure for mammalian young. Bacteria in breast milk may enhance immune development, improve intestinal health, and stimulate the gut-brain axis for infants. Variation in milk microbiome structure (e.g., operational taxonomic unit [OTU] diversity, community composition) may lead to different infant developmental outcomes. Milk microbiome structure may depend on evolutionary processes acting at the host species level and ecological processes occurring over lactation time, among others. We quantified milk microbiomes using 16S rRNA high-throughput sequencing for nine primate species and for six primate mothers sampled over lactation. Our data set included humans (Homo sapiens, Philippines and USA) and eight nonhuman primate species living in captivity (bonobo [Pan paniscus], chimpanzee [Pan troglodytes], western lowland gorilla [Gorilla gorilla gorilla], Bornean orangutan [Pongo pygmaeus], Sumatran orangutan [Pongo abelii], rhesus macaque [Macaca mulatta], owl monkey [Aotus nancymaae]) and in the wild (mantled howler monkey [Alouatta palliata]). For a subset of the data, we paired microbiome data with nutrient and hormone assay results to quantify the effect of milk chemistry on milk microbiomes. We detected a core primate milk microbiome of seven bacterial OTUs indicating a robust relationship between these bacteria and primate species. Milk microbiomes differed among primate species with rhesus macaques, humans and mantled howler monkeys having notably distinct milk microbiomes. Gross energy in milk from protein and fat explained some of the variations in microbiome composition among species. Microbiome composition changed in a predictable manner for three primate mothers over lactation time, suggesting that different bacterial communities may be selected for as the infant ages. Our results contribute to understanding ecological and evolutionary relationships between bacteria and primate hosts, which can have applied benefits for humans and endangered primates in our care.
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Affiliation(s)
- Carly R Muletz-Wolz
- Center for Conservation Genomics, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia
| | - Naoko P Kurata
- Center for Conservation Genomics, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia
- The Graduate Center, The City University of New York, New York, New York
- Department of Ichthyology, American Museum of Natural History, New York, New York
| | - Elizabeth A Himschoot
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia
| | - Elizabeth S Wenker
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia
| | - Elizabeth A Quinn
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri
| | - Katie Hinde
- School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
- Center for Evolution and Medicine, Arizona State University, Tempe, Arizona
| | - Michael L Power
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia
| | - Robert C Fleischer
- Center for Conservation Genomics, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia
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Power ML, Reed EG. I, Mammal: mammalian evolution and biology through a humorous lens. LiamDrew. Bloomsbury: New York, NY/London2017. Pp. 9–320 (Hardback), ISBN 978‐1‐4729‐2289‐2. Am J Hum Biol 2019. [DOI: 10.1002/ajhb.23249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Michael L. Power
- Conservation Ecology Center, Smithsonian National Zoological Park and Conservation Biology Institute Washington District of Columbia
| | - Eda G. Reed
- Conservation Ecology Center, Smithsonian National Zoological Park and Conservation Biology Institute Washington District of Columbia
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Power ML, Lott ML, Mackeen AD, DiBari JN, Schulkin J. Associations Between Maternal Body Mass Index, Gestational Weight Gain, Maternal Complications, and Birth Outcome in Singleton, Term Births in a Largely Non-Hispanic White, Rural Population. J Womens Health (Larchmt) 2019; 28:1563-1568. [PMID: 31038373 DOI: 10.1089/jwh.2018.7531] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: In 2009, the Institute of Medicine (IOM) published guidance on gestational weight gain (GWG) modified by body mass index (BMI). GWG outside of IOM recommendations negatively affects birth outcomes and child health. This study examined the relationship between BMI, GWG, birth complications, and birth outcomes in a rural, non-Hispanic white population over 10 years. Materials and Methods: We examined maternal BMI, GWG, birth weight, birth complications, and Apgar score in 18,217 term singleton births from medical records at Geisinger, PA from 2006 to 2015. Primary outcomes were GWG, delivery mode, Apgar score, and infant birth weight. Results: A majority of women (74.2%) had GWG outside of recommendations. Prevalence of cesarean delivery was highest for women with GWG above recommendations regardless of BMI. One in five neonates of obese women with GWG above recommendations had Apgar scores below eight. Although most births were normal for gestational age (88%), underweight women who gained below recommendations had the highest percentage of small for gestational age (SGA) births (10.4%) and obese women who gained above recommendations had the highest percentage of large for gestational age (LGA) births (22.2%). Among women with BMIs above 35 kg/m2 and GWG within recommendations, 18.9% of births were LGA. Conclusions: Most pregnant women are not gaining weight within recommendations. GWG outside of IOM recommendations resulted in poorer birth outcomes, particularly in underweight and obese women. Underweight women with GWG below recommendations are at increased risk for SGA neonates. We suggest reducing GWG recommendations for women above 35 kg/m2 to decrease LGA births and pregnancy complications.
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Affiliation(s)
- Michael L Power
- Research Department, American College of Obstetricians and Gynecologists, Washington, District of Columbia.,Smithsonian National Zoo and Conservation Biology Institute, Washington, District of Columbia
| | - Melisa L Lott
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger, Danville, Pennsylvania
| | - A Dhanya Mackeen
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Geisinger, Danville, Pennsylvania
| | - Jessica N DiBari
- Division of Research, Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Rockville, Maryland
| | - Jay Schulkin
- Research Department, American College of Obstetricians and Gynecologists, Washington, District of Columbia.,Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, Washington
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Bentley-Condit VK, Power ML. The nutritional content of Tana River yellow baboon (Papio cynocephalus) foods in a partially forested habitat. PLoS One 2018; 13:e0207186. [PMID: 30439991 PMCID: PMC6237341 DOI: 10.1371/journal.pone.0207186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 10/26/2018] [Indexed: 11/18/2022] Open
Abstract
Here we report the first dietary macronutrient and mineral content information for a little-studied yellow baboon group (i.e., the Mchelelo troop) at the Tana River Primate National Reserve, Kenya. We compare forest to savanna samples for this troop found in a partially forested habitat. Observations conducted between 1988 and 1992 determined our list of foods. Subsequently, flora samples, representing 56 species, were collected between April 2008 and March 2009 with nutrient content determined via standard procedures for fiber, gross energy, ash/minerals, crude protein, and crude fat/lipids. Concentrations of specific minerals (calcium, iron, magnesium, manganese, phosphorus, potassium, zinc) were also measured. We predicted forest items would be higher in gross energy and lipids and savanna items higher in crude protein, fiber, and minerals. Our analyses support only the predicted difference in crude protein for savanna items for the overall dataset. In our examination of the top 15 foods, savanna items had significantly higher crude protein, ash, magnesium, and manganese while forest items had higher gross energy. Right-angled mixture triangles show some clustering by location but with substantial overlap in values. Our data provide further indication of the particularity and purposefulness of dietary choices made by primates. They also contribute to the broader discussions of primate nutritional ecology and are a first step towards an examination of macronutrient balancing for this group. Finally, we discuss the impact heavy reliance upon forest products by a "savanna species" may have upon competitors and forest composition. Ultimately, we show that there is still much to be learned about baboon nutrition.
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Affiliation(s)
| | - Michael L. Power
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, D.C., United States of America
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29
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Camperio Ciani JF, Guerrel J, Baitchman E, Diaz R, Evans M, Ibáñez R, Ross H, Klaphake E, Nissen B, Pessier AP, Power ML, Arlotta C, Snellgrove D, Wilson B, Gratwicke B. The relationship between spindly leg syndrome incidence and water composition, overfeeding, and diet in newly metamorphosed harlequin frogs (Atelopus spp.). PLoS One 2018; 13:e0204314. [PMID: 30325919 PMCID: PMC6191089 DOI: 10.1371/journal.pone.0204314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/05/2018] [Indexed: 11/19/2022] Open
Abstract
Spindly Leg Syndrome (SLS) is a persistent animal welfare issue associated with the rearing of amphibians in captivity. We conducted two experiments to investigate the effects of diet, water composition and overfeeding on prevalence of SLS in newly metamorphosed harlequin frogs (Atelopus spp.). In our first experiment, we offered 400 full-sibling tadpoles of Atelopus certus isocaloric diets in treatments of 31%, 37%, 42% and 48% crude protein respectively. Tadpoles fed higher protein diets metamorphosed faster, but the incidence of SLS exceeded 80% in all treatments leading to the conclusion that variation in dietary protein was not responsible for causing SLS. We used 720 full-sibling Atelopus glyphus tadpoles in a second experiment to examine the effects of diet type, water composition and diet ration on SLS. We found that an overall incidence of 58% spindly leg in tadpoles reared in tap water, but reduced to about 10% in water treated by reverse osmosis and then reconstituted. It is possible that the reverse osmosis treatment removed some factor that caused the SLS, or that the reconstitution may have added a mineral lacking in the original tap water. Within tap water treatments, overfeeding tadpoles in tanks increased the incidence of SLS. We recommend further experimental research into this condition to identify the causative factors in the water. Additional research into the nutritional composition of food available to wild tadpoles would be useful in formulating captive diets, that have to date been solely based on surrogate species.
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Affiliation(s)
| | - Jorge Guerrel
- Smithsonian Tropical Research Institute, Panama Amphibian Rescue and Conservation Project, Panamá
| | - Eric Baitchman
- Zoo New England, 1 Franklin Park Road, Boston, MA, United States of America
| | - Rigoberto Diaz
- Smithsonian Tropical Research Institute, Panama Amphibian Rescue and Conservation Project, Panamá
| | - Matthew Evans
- Smithsonian’s National Zoo and Conservation Biology Institute, Washington, DC, United States of America
| | - Roberto Ibáñez
- Smithsonian Tropical Research Institute, Panama Amphibian Rescue and Conservation Project, Panamá
- Sistema Nacional de Investigación, Secretaría Nacional de Ciencia, Tecnología e Innovación, Panamá
| | - Heidi Ross
- Smithsonian Tropical Research Institute, Panama Amphibian Rescue and Conservation Project, Panamá
| | - Eric Klaphake
- Cheyenne Mountain Zoo, Colorado Springs, CO, United States of America
| | - Bradley Nissen
- Smithsonian Tropical Research Institute, Panama Amphibian Rescue and Conservation Project, Panamá
| | - Allan P. Pessier
- College of Veterinary Medicine, Washington State University, Pullman, WA, United States of America
| | - Michael L. Power
- Smithsonian’s National Zoo and Conservation Biology Institute, Washington, DC, United States of America
| | - Caitlin Arlotta
- Smithsonian’s National Zoo and Conservation Biology Institute, Washington, DC, United States of America
| | - Donna Snellgrove
- Waltham Center for Pet Nutrition, Freeby Lane, Waltham on the Wolds, Leicestershire, United Kingdom
| | - Brad Wilson
- Atlanta Botanical Gardens, Atlanta, GA, United States of America
| | - Brian Gratwicke
- Zoo New England, 1 Franklin Park Road, Boston, MA, United States of America
- * E-mail:
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Power ML, Lott ML, Mackeen AD, DiBari J, Schulkin J. A retrospective study of gestational weight gain in relation to the Institute of Medicine's recommendations by maternal body mass index in rural Pennsylvania from 2006 to 2015. BMC Pregnancy Childbirth 2018; 18:239. [PMID: 29914428 PMCID: PMC6006928 DOI: 10.1186/s12884-018-1883-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 06/04/2018] [Indexed: 11/29/2022] Open
Abstract
Background In 2009, the Institute of Medicine (IOM) published guidance on gestational weight gain (GWG) modified by maternal pre-pregnancy body mass index (BMI). Estimates indicate that less than half of US pregnant women have GWG within recommendations. This study examined GWG from before (2006–2009) and after (2010–2015) the release of the IOM guidance in a rural, non-Hispanic white population to assess the proportion of women with GWG outside of IOM guidance, whether GWG became more likely to be within IOM guidance after 2010, and identify potential maternal factors associated with GWG outside of recommendations. Methods We examined GWG in 18,217 term singleton births between 2006 and 2015 in which maternal pre-pregnancy BMI could be calculated from electronic medical records at Geisinger, PA, and a subset of 12,912 births in which weekly GWG in the third trimester could be calculated. The primary outcome was whether GWG was below, within, or above recommendations based on maternal BMI. The relationships between GWG, maternal BMI, parity, age at conception, gestation length, and maternal blood pressure were examined. Results GWG declined with increasing maternal BMI, however, more than 50% of overweight and obese women gained above IOM recommendations. About one of five women gained below recommendations (21.3%) with underweight women the most likely to gain below recommendations (33.0%). The proportion of births with usable data increased after 2010, driven by a higher probability of recording maternal weight. However, the proportion of women who gained below, within or above recommendations did not change over the ten years. GWG above recommendations was associated with higher maternal BMI, lower parity, and longer gestation. GWG below recommendations was associated with lower maternal BMI, higher parity, shorter gestation, and younger age at conception. Maternal blood pressure was higher for GWG outside recommendations. Conclusions Despite the publication of IOM recommendations in 2009 and an apparent increase in tracking maternal weight after 2010, GWG in this population did not change between 2006 and 2015. A majority of overweight and obese women gained above recommendations. GWG below recommendations continues to occur, and is prevalent among underweight women.
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Affiliation(s)
- Michael L Power
- Research Department, American College of Obstetricians and Gynecologists, PO Box 96920, Washington, DC, 20090-6920, USA. .,Smithsonian National Zoo and Conservation Biology Institute, Washington, DC, USA.
| | - Melisa L Lott
- Geisinger, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Danville, PA, USA
| | - A Dhanya Mackeen
- Geisinger, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Danville, PA, USA
| | - Jessica DiBari
- Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Division of Research, Rockville, MD, USA
| | - Jay Schulkin
- Research Department, American College of Obstetricians and Gynecologists, PO Box 96920, Washington, DC, 20090-6920, USA.,Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
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Affiliation(s)
- Michael L Power
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC, USA
| | - S Michelle Watts
- Division of Sciences and Mathematics, University of the Ozarks, Clarksville, AR, USA
| | - Katie L Murtough
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC, USA
- University of Maryland College Park, College Park, MD, USA
| | - Frank M Knight
- Division of Sciences and Mathematics, University of the Ozarks, Clarksville, AR, USA
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Delgado A, Stark LM, Macri CJ, Power ML, Schulkin J. Provider and Patient Knowledge and Views of Office Practices on Weight Gain and Exercise during Pregnancy. Am J Perinatol 2018; 35:201-208. [PMID: 28902375 DOI: 10.1055/s-0037-1606582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study sought to assess provider and patient knowledge and beliefs on gestational weight gain (GWG) and exercise during pregnancy, outline current clinical practices and the perceived value of educational tools. STUDY DESIGN Providers and patients at the George Washington Medical Faculty Associates Obstetricians and Gynecologists clinic were recruited for a voluntary survey. Descriptive statistics of responses were compared and chi-square analysis tested for significant associations. RESULTS A total of 461 patient and 36 provider questionnaires were analyzed. Providers recommended GWG consistent with the Institute of Medicine guidelines for a "normal" body mass index (82.9%); however, a majority (52.8%) recommended GWG below guidelines for obese women. All providers reported counseling patients on GWG, but only 53.4% of patients reported discussing personal recommendations. About half of providers reported distributing educational materials for GWG (60.0%); however, only 30.6% of patients reported receiving them. African American patients self-reported receiving the highest rates of counseling and educational materials, though a lower rate of recommendations to exercise. Patients perceived educational tools to be more useful than did providers. CONCLUSION Our findings suggest a gap between provider-patient perceptions regarding counseling and provision of informational materials. Future research should study whether implementing various educational tools might increase the efficacy of current practices.
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Affiliation(s)
- Arlin Delgado
- Department of Research, American Congress of Obstetricians and Gynecologists, Washington, District of Columbia
| | - Lauren M Stark
- Department of Research, American Congress of Obstetricians and Gynecologists, Washington, District of Columbia
| | - Charles J Macri
- Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Michael L Power
- Department of Research, American Congress of Obstetricians and Gynecologists, Washington, District of Columbia
| | - Jay Schulkin
- Department of Research, American Congress of Obstetricians and Gynecologists, Washington, District of Columbia
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Mohamed SA, El Andaloussi A, Al-Hendy A, Menon R, Behnia F, Schulkin J, Power ML. Vitamin D and corticotropin-releasing hormone in term and preterm birth: potential contributions to preterm labor and birth outcome. J Matern Fetal Neonatal Med 2017; 31:2911-2917. [DOI: 10.1080/14767058.2017.1359534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sara A. Mohamed
- Department of Obstetrics and Gynecology, Mansoura Medical School, Mansoura, Egypt
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Abdeljabar El Andaloussi
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Ramkumar Menon
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Faranak Behnia
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jay Schulkin
- Harold and Margaret Milliken Hatch Laboratory of Neuroendocrinology, Rockefeller University, New York, NY, USA
| | - Michael L. Power
- Department of Research, American College of Obstetricians and Gynecologists, Washington, DC, USA
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Abstract
Objective: Assess obstetrician–gynecologists' knowledge and counseling practices regarding gestational weight gain (GWG). Materials and Methods: Questionnaire studies were conducted in 2012 and 2014 sent to practicing obstetrician–gynecologists. Results: Response rates were 111/236 (47%) and 206/474 (43.5%). The majority of respondents agreed (50.0%) or strongly agreed (26.6%) that excessive GWG is a major health concern, often or always calculate the body mass index (BMI) of their patients (79.1%), and use BMI to modify their weight gain recommendations (78.5%). The physicians reported that, on average, 7.8% of pregnant patients gained too little weight, 47.3% gained an appropriate amount, and 45.1% gained too much. A greater proportion of patients with private insurance was associated with physician perception of fewer gaining excessive weight (r = −0.205, n = 198, p = 0.004), whereas high proportions with Medicaid or uninsured were positively correlated with a perception of excessive GWG (r = 0.206 and 0.187, n = 198, p = 0.004 and 0.008, respectively). A majority of physicians (55.1%) were not confident in their ability to affect their patients' prenatal weight gain. Confident physicians exhibited more appropriate practice efforts (e.g., use prepregnancy BMI; 83.6% vs. 74.8%, p = 0.009) and were more likely to inform their patients about the increased risk of pregnancy complications (90.8% vs. 69.7%, p = 0.001) and possible harms to their baby (76.9% vs. 61.0%, p = 0.001) from excessive GWG. Conclusions: Study participants perceived excessive GWG to be a significant problem, but had low confidence in their ability to address it.
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Affiliation(s)
- Michael L Power
- Department of Research, American College of Obstetricians and Gynecologists , Washington, District of Colombia
| | - Jay Schulkin
- Department of Research, American College of Obstetricians and Gynecologists , Washington, District of Colombia
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35
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Power ML, Dittus WPJ. Vitamin D status in wild toque macaques (Macaca sinica) in Sri Lanka. Am J Primatol 2017; 79. [PMID: 28346700 DOI: 10.1002/ajp.22655] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 11/12/2022]
Abstract
The vitamin D receptor is found on most cells, including active immune cells, implying that vitamin D has important biological functions beyond calcium metabolism and bone health. Although captive primates should be given a dietary source of vitamin D, under free-living conditions vitamin D is not a required nutrient, but rather is produced in skin when exposed to UV-B light. The circulating level of 25 hydroxyvitamin D (25-OH-D) considered adequate for humans is a topic of current controversy. Levels of circulating 25-OH-D sufficient for good health for macaques and other Old World anthropoids are assumed to be the same as human values, but data from free-living animals are scant. This study reports values for 25-OH-D and the active vitamin D metabolite, 1,25-dihydroxyvitamin D (1,25[OH]2 D) for wild, forest-ranging toque macaques (Macaca sinica) in Sri Lanka. Plasma samples were obtained from eight adult males, seven juvenile males, six young nulliparous females, nine adult females not pregnant or lactating, eleven lactating adult females, and four pregnant females. Mean values for the complete sample were 61.3 ± 4.0 ng/ml for 25-OH-D and 155.6 ± 8.7 pg/ml for 1,25[OH]2 D. There were no significant differences for either metabolite among age and sex classes, nor between lactating and non-reproductive females. Values from the literature for circulating 25-OH-D in captive macaques are three times higher than those found in this wild population, however, 1,25[OH]2 D values in captive animals were similar to the wild values. The data from this study indicate that anthropoid primates exposed to extensive sunlight will have circulating values of 25-OH-D generally above 30 ng/ml, providing some support for the Endocrine Society recommendations for humans. Current dietary vitamin D supplementation of captive macaques likely exceeds requirement. This may affect metabolism and immune function, with possible consequences for macaque health and biomedical research results.
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Affiliation(s)
- Michael L Power
- Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia.,Research Department, American College of Obstetricians and Gynecologists, Washington, District of Columbia
| | - Wolfgang P J Dittus
- Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia.,National Institute of Fundamental Studies, Kandy, Sri Lanka
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Affiliation(s)
- Michael L. Power
- Research Department, American College of Obstetricians and Gynecologists, Washington, DC, USA
- Nutrition Laboratory, Conservation Ecology Center, Smithsonian Conservation Biology Institute, Washington, DC, USA
| | - Caroline Quaglieri
- Research Department, American College of Obstetricians and Gynecologists, Washington, DC, USA
| | - Jay Schulkin
- Research Department, American College of Obstetricians and Gynecologists, Washington, DC, USA
- Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
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Abstract
Differences in macronutrients between human and ape milks appear relatively small, but variation in other components such as immunoglobulins (Ig) may be greater. This study characterized the macronutrient and secretory (sIgA) profiles in milk from gorillas and orangutans throughout lactation. Fifty-three milk samples from four gorillas and three orangutans were collected throughout 48 and 22 months postpartum (MPP), respectively. Samples were grouped in five stages of lactation (0 to 6 months, more than 6 months to 12 months, more than 12 months to 18 months, more than 18 months to 36 months, and more than 36 months to 48 months). Data were analyzed as a complete randomized design. Concentration of sIgA did not change due to species or its interaction with MPP. Crude protein, regardless of MPP, was greater for gorillas compared with orangutans (1.27 vs. 0.85%). Fat, sugar, and gross energy were affected by the interaction of species × MPP. For gorilla milk, concentrations of sIgA were 43 mg/L at 6 MPP increasing to 79 mg/L at 48 MPP. Protein was highest at 48 MPP. Sugar was lowest at 48 MPP. Values for fat and gross energy were the highest 36 MPP. For orangutan milk, concentrations of sIgA were highest at 6 MPP. Sugar decreased with MPP. Protein, dry matter, or fat were unaffected by MPP. Gross energy content was steady during the first 18 MPP but it tended to decrease by 36 MPP. The results indicate that macronutrients are similar between human, published data, and great ape milk, though gorilla milk has higher protein and human milk higher fat (published data). Concentrations of sIgA in ape milk were about 10-fold lower than human values from the literature. Differences between human and ape milk may lie more in bioactive/immune molecules than nutrients. RESEARCH HIGHLIGHTS Milk macronutrients from great apes differed throughout lactation. Milk macronutrients but not IgA from non-human great apes and humans were quite similar. Milk protein was greater in Gorilla compared with Orangutan.
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Affiliation(s)
- Miriam Garcia
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
| | - Michael L Power
- Nutrition Laboratory, Smithsonian National Zoological Park, Washington, District of Columbia
| | - Kasey M Moyes
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
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Dhesi AS, Murtough KL, Lim JK, Schulkin J, McGovern PG, Power ML, Morelli SS. Metabolic screening in patients with polycystic ovary syndrome is largely underutilized among obstetrician-gynecologists. Am J Obstet Gynecol 2016; 215:579.e1-579.e5. [PMID: 27457114 DOI: 10.1016/j.ajog.2016.07.043] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 07/13/2016] [Accepted: 07/15/2016] [Indexed: 11/18/2022]
Abstract
Women with polycystic ovary syndrome have substantially higher rates of insulin resistance, impaired glucose tolerance, type 2 diabetes, dyslipidemia, and metabolic syndrome when compared with women without the disease. Given the high prevalence of these comorbidities, guidelines issued by the American College of Obstetricians and Gynecologists and the Endocrine Society recommend that all women with polycystic ovary syndrome undergo screening for impaired glucose tolerance and dyslipidemia with a 2 hour 75 g oral glucose tolerance test and fasting lipid profile upon diagnosis and also undergo repeat screening every 2-5 years and every 2 years, respectively. Although a hemoglobin A1C and/or fasting glucose are widely used screening tests for diabetes, both the American College of Obstetricians and Gynecologists and the Endocrine Society preferentially recommend the 2 hour oral glucose tolerance test in women with polycystic ovary syndrome as a superior indicator of impaired glucose tolerance/diabetes mellitus. However, we found that gynecologists underutilize current recommendations for metabolic screening in women with polycystic ovary syndrome. In an online survey study targeting American College of Obstetricians and Gynecologists fellows and junior fellows, 22.3% of respondents would not order any screening test at the initial visit for at least 50% of their patients with polycystic ovary syndrome. The most common tests used to screen for impaired glucose tolerance in women with polycystic ovary syndrome were hemoglobin A1C (51.0%) and fasting glucose (42.7%). Whereas 54.1% would order a fasting lipid profile in at least 50% of their polycystic ovary syndrome patients, only 7% of respondents order a 2 hour oral glucose tolerance test. We therefore call for increased efforts to encourage obstetrician-gynecologists to address metabolic abnormalities in their patients with polycystic ovary syndrome. Such efforts should include education of physicians early in their careers, at the medical student and resident level. Efforts should also include implementation of continuing medical education activities, both locally and at the national level, to improve understanding of the metabolic implications of polycystic ovary syndrome. Electronic medical record systems should be utilized to generate prompts for appropriate screening tests in patients with a diagnosis of polycystic ovary syndrome. Because obstetrician-gynecologists may be the only physicians seen by many polycystic ovary syndrome patients, particularly those in their young reproductive years, such interventions could effectively promote optimal preventative health care and early diagnosis of metabolic comorbidities in these at-risk women.
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Affiliation(s)
- Amy S Dhesi
- Rutgers-New Jersey Medical School, Newark, NJ.
| | - Katie L Murtough
- American College of Obstetricians and Gynecologists, Washington, DC
| | | | - Jay Schulkin
- American College of Obstetricians and Gynecologists, Washington, DC
| | | | - Michael L Power
- American College of Obstetricians and Gynecologists, Washington, DC
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Power ML, Schulkin J, Drought H, Milligan LA, Murtough KL, Bernstein RM. Patterns of milk macronutrients and bioactive molecules across lactation in a western lowland gorilla (Gorilla gorilla) and a Sumatran orangutan (Pongo abelii). Am J Primatol 2016; 79:1-11. [DOI: 10.1002/ajp.22609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 09/02/2016] [Accepted: 09/06/2016] [Indexed: 01/08/2023]
Affiliation(s)
- Michael L. Power
- Smithsonian Conservation Biology Institute, Conservation Ecology Center; Nutrition; Laboratory, National Zoological Park; Washington District of Columbia
- Research Department; American College of Obstetricians and Gynecologists; Washington District of Columbia
| | - Jay Schulkin
- Research Department; American College of Obstetricians and Gynecologists; Washington District of Columbia
- Department of Neuroscience; Georgetown University; Washington District of Columbia
| | - Heather Drought
- Department of Anthropology, The George Washington University; Washington District of Columbia
| | - Lauren A. Milligan
- Smithsonian Conservation Biology Institute, Conservation Ecology Center; Nutrition; Laboratory, National Zoological Park; Washington District of Columbia
- Anthropology Department, Mira Costa College; Oceanside California
| | - Katie L. Murtough
- Smithsonian Conservation Biology Institute, Conservation Ecology Center; Nutrition; Laboratory, National Zoological Park; Washington District of Columbia
- College of Computer, Mathematical, and Natural Sciences; University of Maryland; College Park Maryland
| | - Robin M. Bernstein
- Department of Anthropology; University of Colorado Boulder; Boulder Colorado
- Health and Society Program; Institute of Behavioral Science, University of Colorado Boulder; Boulder Colorado
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Asher AJ, Hose G, Power ML. Giardiasis in NSW: Identification of Giardia duodenalis assemblages contributing to human and cattle cases, and an epidemiological assessment of sporadic human giardiasis. Infect Genet Evol 2016; 44:157-161. [PMID: 27370572 DOI: 10.1016/j.meegid.2016.06.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 06/19/2016] [Accepted: 06/27/2016] [Indexed: 11/19/2022]
Abstract
Two genetic assemblages (A and B) of the protozoan parasite species, Giardia duodenalis, infect humans, domestic animals and wildlife. In New South Wales, Australia, over 2000 sporadic human giardiasis cases are reported annually, but parasite sources and links between sporadic cases are unknown. This study describes G. duodenalis assemblages contributing to human and cattle cases in NSW, and examines demographic, spatial, and temporal distributions of NSW human infections and G. duodenalis assemblages. Genotyping by PCR-restriction fragment length polymorphism of the glutamate dehydrogenase (gdh) gene identified G. duodenalis assemblage B as the most common (86%) cause of infection among human cases (n=165). Approximately 37% of cattle DNA samples were PCR positive (18S rRNA, gdh), and G. duodenalis assemblages E (69%) or B (31%) were identified from these samples. Human assemblage A was more common among older age groups, and seasonality in the geographic dispersal of human assemblage A was observed. The results of this study indicate G. duodenalis assemblage B is highly prevalent among humans in NSW, and the potential for cross-species transmission exists between humans and cattle in this region. Spatio-temporal and demographic distributions of human assemblage A and B are highlighted, and risk factors associated with these dispersal patterns warrants further research.
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Affiliation(s)
- A J Asher
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia.
| | - G Hose
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
| | - M L Power
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
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Banton SA, Soltow QA, Liu KH, Uppal K, Promislow DEL, Power ML, Tardif SD, Wachtman LM, Jones DP. Plasma Metabolomics of Common Marmosets (Callithrix jacchus) to Evaluate Diet and Feeding Husbandry. J Am Assoc Lab Anim Sci 2016; 55:137-146. [PMID: 27025803 PMCID: PMC4783630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 04/27/2015] [Accepted: 06/19/2015] [Indexed: 06/05/2023]
Abstract
Common marmosets (Callithrix jacchus) are an important NHP model for the study of human aging and age-related diseases. However, the full potential of marmosets as a research model has not been realized due to a lack of evidence-based, standardized procedures for their captive management, especially regarding diet and feeding husbandry. In the present study, we conducted a high-resolution metabolomics analysis of plasma from marmosets from a 3-mo dietary crossover study to determine whether significant metabolic differences occur with a semisynthetic chemically defined (purified) diet as needed for controlled nutrition research. Marmosets were fed a standard, diverse-ingredient diet, followed by a semisynthetic purified diet, and then were switched back to the standard diet. The standard diet used in this analysis was specific to the animal facility, but it is similar in content to the diets currently used for other marmoset colonies. High-resolution metabolomics of plasma with liquid chromatography-mass spectrometry and bioinformatics was used to measure metabolic differences. The concentration of the essential amino acids methionine, leucine/isoleucine, lysine, and threonine were higher when marmosets were fed the purified diet. In contrast, phenylalanine concentrations were higher during exposure to the standard diet. In addition, metabolic pathway enrichment and analysis revealed differences among metabolites associated with dopamine metabolism and the carnitine shuttle. These results show that diet-associated differences in metabolism occur in marmosets and suggest that additional nutritional studies with detailed physiologic characterization are needed to optimize standard and purified diets for common marmosets.
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Affiliation(s)
- Sophia A Banton
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Clinical Biomarkers Laboratory, Emory University, Atlanta, Georgia, USA
| | - Quinlyn A Soltow
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Clinical Biomarkers Laboratory, Emory University, Atlanta, Georgia, USA; Amplyx Pharmaceuticals, San Diego, California, USA
| | - Ken H Liu
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Clinical Biomarkers Laboratory, Emory University, Atlanta, Georgia, USA
| | - Karan Uppal
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Clinical Biomarkers Laboratory, Emory University, Atlanta, Georgia, USA
| | | | - Michael L Power
- Nutrition Laboratory, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, District of Columbia, USA
| | - Suzette D Tardif
- Southwest National Primate Research Center, San Antonio, Texas, USA
| | - Lynn M Wachtman
- New England Primate Research Center, Harvard University, Southborough, Massachusetts, USA; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Clinical Biomarkers Laboratory, Emory University, Atlanta, Georgia, USA.
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Murtough KL, Power ML, Schulkin J. Knowledge, Attitudes, and Practices of Obstetrician-Gynecologists Regarding Influenza Prevention and Treatment Following the 2009 H1N1 Pandemic. J Womens Health (Larchmt) 2015; 24:849-54. [PMID: 26154997 DOI: 10.1089/jwh.2014.5178] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pregnant women are at increased risk for complications associated with influenza. Influenza vaccination during pregnancy helps protect both pregnant women and infants less than 6 months of age from contracting the flu. This study investigated influenza prevention and treatment practices of obstetrician-gynecologists (ob-gyns) during the influenza season immediately following the 2009-2010 H1N1 season. METHODS In 2011, surveys were sent to two groups of Fellows of the American College of Obstetricians and Gynecologists. Group 1 was 907 ob-gyns who responded to our previous survey on practice and knowledge of influenza vaccination, diagnosis, and treatment during the 2009-2010 H1N1 influenza pandemic. Group 2 was 2,293 new recipients randomly selected from the American College of Obstetricians and Gynecologists database. Data were analyzed in 2013. RESULTS A high proportion of pregnant patients were reported to be vaccinated against influenza (71.7%); however, the data suggest that in general preventative practices decreased between the 2009-2010 H1N1 season and 2010-2011 season. A higher proportion of women eligible for Medicaid in a practice was associated with a lower estimate of vaccination rate. Ob-gyns with more than 20 years of practice were more likely to be concerned about the risks of antivirals and less likely to routinely prescribe them. CONCLUSIONS Ob-gyns may be overestimating the proportion of pregnant women being vaccinated. The gains in vaccination and influenza prevention practices from the H1N1 pandemic have not been completely retained. Discrepancies in the use of anti-virals to treat suspected or confirmed influenza in pregnant patients exist and need to be addressed.
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Affiliation(s)
- Katie L Murtough
- Research Department, American College of Obstetricians and Gynecologists , Washington, DC
| | - Michael L Power
- Research Department, American College of Obstetricians and Gynecologists , Washington, DC
| | - Jay Schulkin
- Research Department, American College of Obstetricians and Gynecologists , Washington, DC
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Jones KM, Power ML, Queenan JT, Schulkin J. Response to Roig-Romero. Breastfeed Med 2015; 10:348. [PMID: 26114212 DOI: 10.1089/bfm.2015.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Katherine M Jones
- 1 Department of Research, American College of Obstetricians and Gynecologists , Washington, D.C.,2 Department of Psychology, American University , Washington, D.C
| | - Michael L Power
- 1 Department of Research, American College of Obstetricians and Gynecologists , Washington, D.C
| | - John T Queenan
- 3 Department of Obstetrics and Gynecology, Georgetown University School of Medicine , Washington, D.C
| | - Jay Schulkin
- 1 Department of Research, American College of Obstetricians and Gynecologists , Washington, D.C
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Abstract
This article's aim is to review the literature on racial and ethnic disparities in breastfeeding rates and practices, address barriers to breastfeeding among minority women, conduct a systematic review of breastfeeding interventions, and provide obstetrician-gynecologists with recommendations on how they can help increase rates among minority women. In order to do so, the literature of racial and ethnic disparities in breastfeeding rates and barriers among minority women was reviewed, and a systematic review of breastfeeding interventions among minority women on PubMed and MEDLINE was conducted. Racial and ethnic minority women continue to have lower breastfeeding rates than white women and are not close to meeting the Healthy People 2020 goals. Minority women report many barriers to breastfeeding. Major efforts are still needed to improve breastfeeding initiation and duration rates among minority women in the United States. Obstetrician-gynecologists have a unique opportunity to promote and support breastfeeding through their clinical practices and public policy, and their efforts can have a meaningful impact on the future health of the mother and child.
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Affiliation(s)
- Katherine M Jones
- 1 Department of Research, American College of Obstetricians and Gynecologists , Washington, D.C
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Lott MJ, Hose GC, Power ML. Parasitic nematode communities of the red kangaroo, Macropus rufus: richness and structuring in captive systems. Parasitol Res 2015; 114:2925-32. [PMID: 25916465 DOI: 10.1007/s00436-015-4494-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 04/20/2015] [Indexed: 11/25/2022]
Abstract
Captive management practices have the potential to drastically alter pre-existing host-parasite relationships. This can have profound implications for the health and productivity of threatened species in captivity, even in the absence of clinical symptoms of disease. Maximising the success of captive breeding programmes requires a detailed knowledge of anthropogenic influences on the structure of parasite assemblages in captive systems. In this study, we employed two high-throughput molecular techniques to characterise the parasitic nematode (suborder Strongylida) communities of the red kangaroo, Macropus rufus, across seven captive sites. The first was terminal restriction fragment length polymorphism (T-RFLP) analysis of a region of rDNA encompassing the internal transcribed spacers 1 (ITS1), the 5.8S rRNA gene and the internal transcribed spacer 2 (ITS2). The second was Illumina MiSeq next-generation sequencing of the ITS2 region. The prevalence, intensity of infection, taxonomic composition and comparative structure of strongylid nematode assemblages was assessed at each location. Prevalence (P = <0.001) and mean infection intensity (df = 6, F = 17.494, P = <0.001) differed significantly between the seven captive sites. Significant levels of parasite community structure were observed (ANOSIM, P = 0.01), with most of the variation being distributed within, rather than between, captive sites. The range of nematode taxa that occurred in captive red kangaroos appeared to differ from that of wild conspecifics, with representatives of the genus Cloacina, a dominant nematode parasite of the macropodid forestomach, being detected at only two of the seven study sites. This study also provides the first evidence for the presence of the genus Trichostrongylus in a macropodid marsupial. Our results demonstrate that contemporary species management practices may exert a profound influence on the structure of parasite communities in captive systems.
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Affiliation(s)
- M J Lott
- Department of Biological Sciences, Macquarie University, Sydney, NSW, 2109, Australia,
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Heinze CR, Freeman LM, Martin CR, Power ML, Fascetti AJ. Comparison of the nutrient composition of commercial dog milk replacers with that of dog milk. J Am Vet Med Assoc 2015; 244:1413-22. [PMID: 24871064 DOI: 10.2460/javma.244.12.1413] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the nutrient composition of commercially available dog milk replacers with that of dog milk. DESIGN Prospective, cross-sectional study. SAMPLE 5 dog milk samples and 15 samples of commercial dog milk replacers. PROCEDURES Dog milk and milk replacers were analyzed for concentrations of total protein, essential amino acids, sugars, total fat, essential fatty acids, calcium, and phosphorus. Energy density was calculated. Results from milk replacers were compared with the range of the concentration of each nutrient in milk samples from mature dogs as well as the National Research Council (NRC) recommendations for puppy growth. RESULTS Milk replacers varied widely in caloric density and concentration of nutrients such as calcium, protein, and fat. Calcium concentration was lower in 14 of 15 milk replacers than in the dog milk samples. Docosahexaenoic acid was undetectable in 12 of 15 milk replacers but present in all dog milk samples. All milk replacers had numerous essential nutrients outside of the range of the dog milk samples, and many had concentrations of amino acids, essential fatty acids, calcium, and phosphorus less than the NRC minimal requirement or recommended allowance. Compared with NRC recommendations, some dog milk samples had concentrations of total protein, linoleic acid, calcium, or phosphorus less than the recommended allowance. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that there was substantial variation in nutrient composition of 15 dog milk replacers and that some products were closer approximations of dog milk than others. Nearly all products would benefit from more appropriate calcium, amino acids, and essential fatty acids concentrations and better feeding directions.
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Affiliation(s)
- Cailin R Heinze
- Department of Clinical Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA 01536
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Lott MJ, Hose GC, Isberg SR, Power ML. Genetics and infection dynamics of Paratrichosoma sp in farmed saltwater crocodiles (Crocodylus porosus). Parasitol Res 2014; 114:727-35. [PMID: 25416333 DOI: 10.1007/s00436-014-4240-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 11/14/2014] [Indexed: 11/26/2022]
Abstract
Paratrichosoma-associated helminthiasis has been identified in saltwater crocodiles under intensive farming conditions. The development of sustainable integrated management practices is dependent on a detailed understanding of Paratrichosoma population genetics and infection dynamics. This study investigated the genetic relationships of Paratrichosoma sp in a population of commercially farmed saltwater crocodiles, Crocodylus porosus, in northern Australia. 18S ribosomal RNA gene sequence data were obtained from Paratrichosoma sp eggs present in the epidermis of infected animals. A high level of genetic diversity was distributed within the Paratrichosoma sp population (241 variable positions in the 1094 bp alignment), indicating an accelerated rate of nucleotide base-pair substitutions in this genus of nematodes. Several possible environmental correlates of the incidence and intensity of helminthiasis, including season, rainfall, and mean monthly temperature, were investigated by visual inspection of crocodile skins. Stepwise logistic regression revealed a significant negative linear relationship (P = 0.011, R (2) = 32.69 %) between mean monthly rainfall and the incidence of monthly Paratrichosoma-associated helminthiasis. Variation in the severity of Paratrichosoma-associated helminthiasis could not be explained by any of the independent environmental variables included within an ordinal regression analysis. The large genetic diversity in these nematodes indicates a high probability of anthelmintic resistant alleles occurring in the population. We discuss how the spread of these alleles may be mitigated by adopting targeted treatment protocols.
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Affiliation(s)
- M J Lott
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales, 2109, Australia,
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Petzinger C, Oftedal OT, Jacobsen K, Murtough KL, Irlbeck NA, Power ML. Proximate composition of milk of the bongo (Tragelaphus eurycerus) in comparison to other African bovids and to hand-rearing formulas. Zoo Biol 2014; 33:305-13. [DOI: 10.1002/zoo.21139] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 04/24/2014] [Accepted: 05/08/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Christina Petzinger
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute; National Zoological Park; Washington District of Columbia
| | - Olav T. Oftedal
- Smithsonian Environmental Research Center; Edgewater Maryland
| | | | - Katie L. Murtough
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute; National Zoological Park; Washington District of Columbia
| | | | - Michael L. Power
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute; National Zoological Park; Washington District of Columbia
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Lott MJ, Hose GC, Power ML. Towards the molecular characterisation of parasitic nematode assemblages: an evaluation of terminal-restriction fragment length polymorphism (T-RFLP) analysis. Exp Parasitol 2014; 144:76-83. [PMID: 24971699 DOI: 10.1016/j.exppara.2014.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 05/21/2014] [Accepted: 06/12/2014] [Indexed: 11/27/2022]
Abstract
Identifying factors which regulate temporal and regional structuring within parasite assemblages requires the development of non-invasive techniques which facilitate both the rapid discrimination of individual parasites and the capacity to monitor entire parasite communities across time and space. To this end, we have developed and evaluated a rapid fluorescence-based method, terminal restriction fragment length polymorphism (T-RFLP) analysis, for the characterisation of parasitic nematode assemblages in macropodid marsupials. The accuracy with which T-RFLP was capable of distinguishing between the constituent taxa of a parasite community was assessed by comparing sequence data from two loci (the ITS+ region of nuclear ribosomal DNA and the mitochondrial CO1) across ∼20 species of nematodes (suborder Strongylida). Our results demonstrate that with fluorescent labelling of the forward and reverse terminal restriction fragments (T-RFs) of the ITS+ region, the restriction enzyme Hinf1 was capable of generating species specific T-RFLP profiles. A notable exception was within the genus Cloacina, in which closely related species often shared identical T-RFs. This may be a consequence of the group's comparatively recent evolutionary radiation. While the CO1 displayed higher sequence diversity than the ITS+, the subsequent T-RFLP profiles were taxonomically inconsistent and could not be used to further differentiate species within Cloacina. Additionally, several of the ITS+ derived T-RFLP profiles exhibited unexpected secondary peaks, possibly as a consequence of the restriction enzymes inability to cleave partially single stranded amplicons. These data suggest that the question of T-RFLPs utility in monitoring parasite communities cannot be addressed without considering the ecology and unique evolutionary history of the constituent taxa.
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Affiliation(s)
- M J Lott
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia.
| | - G C Hose
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
| | - M L Power
- Department of Biological Sciences, Macquarie University, Sydney, New South Wales 2109, Australia
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O'Malley RC, Power ML. The energetic and nutritional yields from insectivory for Kasekela chimpanzees. J Hum Evol 2014; 71:46-58. [PMID: 24698197 DOI: 10.1016/j.jhevol.2013.09.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2012] [Revised: 09/03/2013] [Accepted: 09/18/2013] [Indexed: 10/25/2022]
Abstract
Insectivory is hypothesized to be an important source of macronutrients, minerals, and vitamins for chimpanzees (Pan troglodytes), yet nutritional data based on actual intake are lacking. Drawing on observations from 2008 to 2010 and recently published nutritional assays, we determined the energy, macronutrient and mineral yields for termite-fishing (Macrotermes), ant-dipping (Dorylus), and ant-fishing (Camponotus) by the Kasekela chimpanzees of Gombe National Park, Tanzania. We also estimated the yields from consumption of weaver ants (Oecophylla) and termite alates (Macrotermes and Pseudacanthotermes). On days when chimpanzees were observed to prey on insects, the time spent in insectivorous behavior ranged from <1 min to over 4 h. After excluding partial bouts and those of <1 min duration, ant-dipping bouts were of significantly shorter duration than the other two forms of tool-assisted insectivory but provided the highest mass intake rate. Termite-fishing bouts were of significantly longer duration than ant-dipping and had a lower mass intake rate, but provided higher mean and maximum mass yields. Ant-fishing bouts were comparable to termite-fishing bouts in duration but had significantly lower mass intake rates. Mean and maximum all-day yields from termite-fishing and ant-dipping contributed to or met estimated recommended intake (ERI) values for a broad array of minerals. The mean and maximum all-day yields of other insects consistently contributed to the ERI only for manganese. All forms of insectivory provided small but probably non-trivial amounts of fat and protein. We conclude that different forms of insectivory have the potential to address different nutritional needs for Kasekela chimpanzees. Other than honeybees, insects have received little attention as potential foods for hominins. Our results suggest that ants and (on a seasonal basis) termites would have been viable sources of fat, high-quality protein and minerals for extinct hominins employing Pan-like subsistence technology in East African woodlands.
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Affiliation(s)
- Robert C O'Malley
- Center for the Advanced Study of Hominid Paleobiology, Department of Anthropology, The George Washington University, Washington, DC 20052, USA.
| | - Michael L Power
- Nutrition Laboratory and Conservation Ecology Center, Smithsonian Conservation Biology Institute, National Zoological Park, Washington, DC 20008, USA.
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