Bottle Feeding Associated with Increased Risk of Stomach Obstruction in Infants

AppId is over the quota
AppId is over the quota

Newswise — Bottle feeding appears to increase the risk infants will develop hypertrophic pyloric stenosis (HPS), a form of stomach obstruction, and that risk seems to be magnified when mothers are older and have had more than one child, according to a study published by JAMA Pediatrics, a JAMA Network publication.

HPS typically occurs during an infant’s first two months of life and surgery is needed to correct the obstruction, which occurs because of a thickening of the smooth muscle layer of the pylorus (the passage between the stomach and small intestines). Despite how frequently the condition occurs (about 2 cases per 1,000 births), its cause remains unknown, the authors write in the study background.

Jarod P. McAteer, M.D., M.P.H., of the Seattle Children’s Hospital, and colleagues used Washington state birth certificates and discharge data to examine births between 2003 and 2009. The study included 714 infants admitted with HPS who had a procedure code for HPS surgery (pyloromyotomy). Study controls were infants without HPS. Breastfeeding status was recorded on Washington state birth certificates for all infants during the study period.

The findings indicate that that the incidence of HPS decreased from 14 per 10,000 births in 2003 to 9 per 10,000 births in 2009. Breastfeeding prevalence increased during that time from 80 percent in 2003 to 94 percent in 2009. Infants who developed HPS were more likely to be bottle fed compared with controls (19.5 percent vs. 9.1 percent). The odds of an infant developing HPS also increased when mothers were 35 years and older and multiparous (having given birth more than once).

“These data suggest that bottle feeding may play a role in HPS etiology, and further investigations may help to elucidate the mechanisms underlying the observed effect modification by age and parity,” the study concludes.
(JAMA Pediatr. Published online October 21, 2013. doi:10.1001/jamapediatrics.2013.2857. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Epidemiology to Enlighten the Pathogenesis of Hypertrophic Pyloric Stenosis

In a related editorial, Douglas C. Barnhart, M.D., M.S.P.H., of the Primary Children’s Hospital, Salt Lake City, writes: “One thing that one could hope for is to understand the cause of a disease that is among the most common causes for operation in infants. The fact that pyloric stenosis is still described as idiopathic despite its incidence of 2 per 1,000 is disappointing. In this issue of JAMA Pediatrics, McAteer and colleagues bring us a step closer to being able to drop idiopathic from hypertrophic pyloric stenosis.”

“While the data seem convincing that bottle feeding increases the risk, the reason is not clear,” he continues.

“Further understanding of the pathogenesis of hypertrophic pyloric stenosis will come from both basic research and more detailed epidemiologic studies,” Barnhart concludes.
(JAMA Pediatr. Published online October 21, 2013. doi:10.1001/jamapediatrics.2013.3899. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: Please see the articles for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

# # #

New Offering: Essentials of Management Leadership Program (EMLP)

AppId is over the quota
AppId is over the quota

Newswise — The newest addition to the Tuck Executive Education portfolio, Essentials of Management Leadership Program (EMLP), is designed to develop effective leaders in general management. The immersive five-day program provides successful functional managers and new middle managers with an integrated view of the fundamentals of business, strategy and leadership.

In explaining the rationale for creating this new program, faculty director William Joyce explains, “There is no shortage of leadership programs available today. But we discovered that offerings at other schools and corporate in-house programs often fail to address what rising middle managers really need to be successful at the next level—namely the integration of ‘soft’ leadership skills combined with a broad understanding of the ‘hard’ fundamentals of business. That’s what participants will get by working with Tuck MBA faculty in EMLP.”

Participant Profile?

The program is specifically designed for successful functional managers with 5-10 years management experience. Participants have just taken on or are about to assume broader middle management responsibilities.

EMLP is also appropriate for technical professionals with scientific, engineering, technology, R&D, project management, healthcare management and other technical backgrounds who are transferring to broader management.

Program Takeaways

Learn the hard skills of business, strategy and finance combined with the softer skills of leadership, including how to influence others in the organization without direct authority
Become a more effective leader by moving beyond functional expertise towards executing on the broader objectives of the organization to make a bigger impact.

Who are the faculty teaching in EMLP?

The same faculty who have made Tuck’s MBA program among the world’s highest ranked also teach in the Essentials of Management Leadership Program. They are highly accessible during the program and care deeply about helping participants develop their business acumen and self-awareness as a leader.

William “Bill” Joyce is the program’s faculty director. An expert on strategy and organizational design, Bill is joined by Tuck’s top faculty in the areas of leadership, influence, finance, operations, marketing and strategy.

See the full faculty list.
See program details.
Dates and Location

EMLP will be held November 17-22 at the Tuck School of Business at Dartmouth, in Hanover, NH. For more information, please visit the program website or contact us.

Founded in 1900, Tuck is the first graduate school of management in the country and consistently ranks among the top business schools worldwide. Tuck remains distinctive among the world's great business schools by combining human scale with global reach, rigorous coursework with experiences requiring teamwork, and valued traditions with innovation.

New Study Indicates Risk of Amazon Rainforest Dieback Due to Global Warming is Higher than Previously Projected

AppId is over the quota
AppId is over the quota

Newswise — (BOSTON) A new study co-authored by Boston University Professor of Earth & Environment Ranga Myneni suggests the southern portion of the Amazon rainforest is at a much higher risk of dieback due to climate change than projections made in the latest report by the Intergovernmental Panel on Climate Change (IPCC). If severe enough, the loss of rainforest could cause the release of large volumes of the greenhouse gas carbon dioxide into the atmosphere. It could also disrupt plant and animal communities in one of the regions of highest biodiversity in the world.

Using ground-based rainfall measurements from the last three decades, the researchers found that since 1979, the dry season in southern Amazonia has lasted about a week longer per decade. At the same time, the annual fire season has become longer. According to the study, the most likely explanation for the lengthening dry season is global warming.

“The dry season over the southern Amazon is already marginal for maintaining rainforest,” says Rong Fu, co-author and professor at The University of Texas at Austin’s Jackson School of Geosciences Fu. “At some point, if it becomes too long, the rainforest will reach a tipping point.”

The new results are in stark contrast to forecasts made by climate models used by the IPCC. Even under future scenarios in which atmospheric greenhouse gases rise dramatically, the models project the dry season in the southern Amazon to be only a few to ten days longer by the end of the century and therefore the risk of climate change-induced rainforest dieback should be relatively low.

The report appears this week in the journal Proceedings of the National Academy of Sciences.

“The length of the dry season in the southern Amazon is the most important climate condition controlling the rainforest,” says Fu. “If the dry season is too long, the rainforest will not survive.”

To see why the length of dry season is such a limiting factor, imagine there is heavier than usual rainfall during the wet season. The soil can only hold so much water and the rest runs off. The water stored in the soil at the end of the wet season is all that the rainforest trees have to last them through the dry season. The longer the dry season lasts, regardless of how wet the wet season was, the more stressed the trees become and the more susceptible they are to fire.

The researchers say the most likely explanation for the lengthening dry season in the southern Amazon in recent decades is human-caused greenhouse warming which inhibits rainfall in two ways: First, it makes it harder for warm, dry air near the surface to rise up and freely mix with cool, moist air above. And second, it blocks cold front incursions from outside the tropics that could trigger rainfall. The climate models used by the IPCC do a poor job representing these processes, which might explain why they project only a slightly longer Amazonian dry season, says Fu.

The Amazon rainforest normally removes the greenhouse gas carbon dioxide from the atmosphere, but during a severe drought in 2005, it released 1 petagram of carbon (about one tenth of annual human emissions) to the atmosphere.

“The more severe 2010 drought impacted twice the forested area than the 2005 drought and could have likely resulted in substantial carbon loss from the forests,” says Myneni, who has previously studied these droughts with NASA satellite sensor data.

Myneni and his colleagues estimate that if dry seasons continue to lengthen at just half the rate of recent decades, the Amazon drought of 2005 could become the norm, rather than the exception, by the end of this century.

Some scientists have speculated that the combination of longer dry seasons, higher surface temperatures and more fragmented forests due to ongoing human-caused deforestation could eventually convert much of southern Amazonia from rainforest to savanna.

Earlier studies have shown that human-caused deforestation in the Amazon can alter rainfall patterns. But the researchers didn’t see a strong signal of deforestation in the pattern of increasing dry season length. The dry season length increase was most pronounced in the southwestern Amazon while the most intense deforestation occurred in the southeastern Amazon.

Because the northwestern Amazon has much higher rainfall and a shorter dry season than the southern Amazon, the researchers think it is much less vulnerable to climate change.

The co-authors of this study include Rong Fu, Lei Yin, Robert Dickinson, Lei Huang and Sudip Chakraborty at The University of Texas at Austin’s Jackson School of Geosciences; Wenhong Li at Duke University; Paola A. Arias at Universidad de Antioquia in Colombia; Katia Fernandes at Columbia University’s Lamont-Doherty Earth Observatory; Brant Liebmann at the National Oceanic & Atmospheric Administration (NOAA); Rosie Fisher at the National Center for Atmospheric Research; and Ranga Myneni at Boston University.

This work is supported by the National Science Foundation (AGS 0937400) and NOAA Climate Program Office Modeling, Analysis, Prediction and Projection Program (NA10OAAR4310157) and the NASA Earth Science Division.

Note to Reporters: A preprint of the article is available to journalists on the following secure reporters-only web site: http://www.eurekalert.org/pio/pnas.php

About Boston University—Founded in 1839, Boston University is an internationally recognized private research university with more than 30,000 students participating in undergraduate, graduate, and professional programs. As Boston University’s largest academic division, the College and Graduate School of Arts & Sciences is the heart of the BU experience with a global reach that enhances the University’s reputation for teaching and research. In 2012, BU joined the Association of American Universities (AAU), a consortium of 62 leading research universities in the United States and Canada.

# # #