Higher Mortality in Pediatric Liver Transplant Candidates With Sarcopenia

Little is known about the impact of sarcopenia (reduced muscle mass and function) in pediatric chronic liver disease. We compared psoas muscle surface area (PMSA), measured at the 4th lumbar vertebrae, in children listed for liver transplantation (LT) to that of healthy controls and studied the impact of sarcopenia on transplant-associated outcomes. The effect of PMSA (raw value and z score) on survival was studied using multivariable proportional hazards, whereas the impact of PMSA on other transplant-associated outcomes was assessed by multivariable linear or logistic regression. The correlation of PMSA with anthropometric values and markers of disease severity was studied using Spearman's rank-order correlation. Mean PMSA was significantly lower in LT candidates (n = 57, 699.4 ± 591.9 mm² [mean ± SD]) than controls (n = 53, 1052.9 ± 960.7 mm² ; P = 0.02). For LT candidates, there was an increased risk of death (either while on the waiting list or following transplantation) with lower PMSA (hazard ratio [HR], 1.6 per 100 mm² [P = 0.03]; 95% confidence interval [CI], 1.1-2.8), amounting to a 4.9 times higher risk of death for every 1 unit decrease in PMSA z score (HR, 4.9 [P = 0.05], 95% CI, 1.2-34.5), adjusting for age and sex. PMSA did not correlate with posttransplant length of intubation, hospital length of stay, or perioperative complications. PMSA also did not correlate with calculated (r = 0.10, P = 0.60) or appealed Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease scores (r = 0.10, P = 0.69). Pediatric LT candidates have a significant reduction in muscle compared with controls. LT candidates with lower PMSA experience significant increases in mortality. As such, sarcopenia may provide a novel indicator of disease severity in children with chronic liver disease.

Reactive-oxygen-species-scavenging nanomaterials for resolving inflammation

Reactive oxygen species (ROS) mediate multiple physiological functions; however, the over-accumulation of ROS causes premature aging and/or death and is associated with various inflammatory conditions. Nevertheless, there are limited clinical treatment options that are currently available. The good news is that owing to the considerable advances in nanoscience, multiple types of nanomaterials with unique ROS-scavenging abilities that influence the temporospatial dynamic behaviors of ROS in biological systems have been developed. This has led to the emergence of next-generation nanomaterial-controlled strategies aimed at ameliorating ROS-related inflammatory conditions. Accordingly, herein we reviewed recent progress in research on nanotherapy based on ROS scavenging. The underlying mechanisms of the employed nanomaterials are emphasized. Furthermore, important issues in developing cross-disciplinary nanomedicine-based strategies for ROS-based inflammatory conditions are discussed. Our review of this increasing interdisciplinary field will benefit ongoing studies and clinical applications of nanomedicine based on ROS scavenging.

Doppler-based predictive model for methotrexate resistance in low-risk gestational trophoblastic neoplasia with myometrial invasion: prospective study of 147 patients

OBJECTIVES

This prospective clinical study aimed to evaluate the vascularization characteristics of low-risk gestational trophoblastic neoplasia (GTN) using Doppler imaging and to develop a predictive model for resistance to methotrexate (MTX).

METHODS

Patients with low-risk GTN receiving primary MTX treatment were enrolled from the Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China, from September 2012 to August 2018. The primary endpoint was to develop and internally validate a predictive model for resistance to MTX therapy in these patients. In the training set, clinical features and Doppler hemodynamic parameters before MTX therapy were analyzed using logistic regression to identify independent predictors of MTX resistance, which were integrated into the model. The predictive performance of the model was evaluated by leave-one-out cross-validation in the training dataset and internal validation in an independent-sample test dataset.

RESULTS

The entire imaging protocol was completed by 147 eligible patients, of which 110 comprised the training set and 37 the test set. In the training set, cases with myometrial invasion (81.8%; 90/110) showed vascular-enriched areas in the myometrium and high velocity and low impedance ratios of the uterine artery (UtA) compared to cases without myometrial invasion (18.2%; 20/110). On multivariate logistic regression analysis, time-averaged mean velocity in UtA (UtA-TAmean) and the International Federation of Gynecology and Obstetrics (FIGO) score were identified as independent predictors (P = 0.009 and P = 0.043, respectively) of MTX resistance. The Doppler-based predictive model, developed based on the 90 cases with myometrial invasion, was y = -2.95332 + 0.41696 × FIGO score + 0.03551 × UtA-TAmean. The model showed an area under the curve of 0.757 (95% CI, 0.653-0.862) and the optimal cut-off value was 0.50622, which had 45.2% sensitivity and 96.6% specificity. The model stratified patients with low-risk GTN into low (< 10%), intermediate (10-90%) and high (> 90%) probability of MTX resistance, based on the threshold values of -1.59544 and 0.10046. The model had an accuracy of 74.4% (95% CI, 64.5-82.3%) in the cross-validation and 72.7% (95% CI, 55.8-84.9%) in the internal validation.

CONCLUSIONS

The Doppler-based predictive model, combining a non-invasive marker of tumor vascularity with the FIGO scoring system, can differentiate cases with low from those with high probability of developing MTX resistance and therefore has the potential to guide treatment options in patients with low-risk GTN and myometrial invasion. © 2020 Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

Underreporting of energy intake in weight loss maintainers

BACKGROUND

Individuals with overweight or obesity commonly underreport energy intake (EI), but it is unknown if the tendency to underreport persists in formerly obese individuals who lose significant weight and maintain their weight loss over long periods of time.

OBJECTIVE

Assess the accuracy of self-reported EI in successful weight loss maintainers (WLM) compared with controls of normal body weight (NC) and controls with overweight/obesity (OC).

METHODS

Participants for this case-controlled study were recruited in 3 groups: WLM [n = 26, BMI (in kg/m2) 24.1 ± 2.3; maintaining ≥13.6 kg weight loss for ≥1 y], NC (n = 33, BMI 22.7 ± 1.9; similar to current BMI of WLM), and OC (n = 32, BMI 34.0 ± 4.6; similar to pre-weight loss BMI of WLM). Total daily energy expenditure (TDEE) was measured over 7 d using the doubly labeled water (DLW) method, and self-reported EI was concurrently measured from 3-d diet diaries. DLW TDEE and self-reported EI were compared to determine accuracy of self-reported EI.

RESULTS

WLM underreported EI (median, interquartile range) (-605, -915 to -314 kcal/d) to a greater degree than NC (-308, -471 to -68 kcal/d; P < 0.01) but not more than OC (-310, -970 to 18 kcal/d; P = 0.21). WLM also showed a greater degree of relative underreporting (-25.3%, -32.9% to -12.5%) compared with NC (-14.3%, -19.6% to -3.1%; P = 0.02) but not OC (-11.2%, -34.1% to -0.7%; P = 0.16). A greater proportion of WLM was classified as underreporters (30.8%) than NC (9.1%; P = 0.05) but not OC (28.1%; P = 1.00).

CONCLUSIONS

WLM underreported EI in both absolute and relative terms to a greater extent than NC but not OC. These findings call into question the accuracy of self-reported EI in WLM published in previous studies and align with recent data suggesting that WLM rely less on chronic EI restriction and more on high levels of physical activity to maintain weight loss. This trial was registered at clinicaltrials.gov as NCT03422380.

A multicenter study of three-dimensional echocardiographic evaluation of normal pediatric left ventricular volumes and function

BACKGROUND

Three-dimensional echocardiography (3DE) evaluation of left ventricular (LV) volume and function in pediatrics compares favorably with cardiac magnetic resonance imaging. The aim of this study was to establish from a multicenter, normal pediatric z-score values of 3DE left ventricular volumes and function.

METHODS

Six hundred and ninety-eight healthy children (ages 0-18 years) were recruited from five centers. LV 3DE was acquired from the 4-chamber view. A vendor-independent software analyzed end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), and ejection fraction (EF) using semi-automated quantification. Body surface area (BSA)-based z-scores were generated. Intraobserver and interobserver variability were calculated using intraclass correlation (ICC) and repeatability coefficient (RC).

RESULTS

Z-scores were generated for ESV, EDV, and SV. The ICC for intraobserver variability for EDV, ESV, and SV was 0.99, 0.99, and 0.99, respectively. The ICC for interobserver variability for EDV, ESV, and SV was 0.98, 0.94, and 0.98, respectively. The RC for intraobserver and interobserver variability for LV EF was 4.39% (95% CI: 3.01, 5.59) and interobserver was 7.08% (95%CI: 5.51, 8.42).

CONCLUSIONS

We report pediatric z-scores for normal LV volumes using the semi-automated method from five centers, enhancing its generalizability. 3DE evaluation of LV volumes and EF in pediatric patients is highly reproducible.

Right ventricular area strain from 3-dimensional echocardiography: Mechanistic insight of right ventricular dysfunction in pediatric pulmonary hypertension

BACKGROUND

Right ventricular (RV) function is a major contributor to the outcome of pulmonary arterial hypertension (PAH). Adult studies demonstrated that regional and global changes in RV deformation are prognostic in PAH using 3-dimensional echocardiography (3DE). However, regional and global dynamic changes in RV mechanics have not been described in pediatric PAH. We compared 3DE RV regional and global deformation between pediatric patients who had associated PAH with congenital heart disease (APAH-CHD), pediatric patients who had idiopathic PAH (IPAH), and normal controls, and evaluated the clinical outcomes.

METHODS

A total of 48 controls, 47 patients with APAH-CHD, and 45 patients with IPAH were evaluated. 3DE RV sequences were analyzed and post-processed to extract global and regional deformation (circumferential, longitudinal, and area strain). Statistical analyses compared the sub-groups on the basis of global and regional deformation, and outcome analysis was performed.

RESULTS

Patients with PAH had significantl8y different global and regional deformation (p < 0.001) compared with controls. Patients with APAH-CHD and and those with IPAH significantly differed in global circumferential strain (p < 0.010), area strain (inlet septum, p = 0.041), and circumferential strain at the inlet septum (p < 0.019), apex free wall (p < 0.004), and inlet free wall (p < 0.004). Circumferential strain at the inlet free wall and circumferential, longitudinal, and area strain at the apex free wall were predictors of adverse events.

CONCLUSIONS

RV regional and global strain differ between controls and pediatric patients with PAH. RV apical free-wall area strain provides insight into the mechanism of RV dysfunction in pediatric patients with PAH, with regional strain emerging as outcome predictors, suggesting that this novel measure may be considered as a future measure of RV function.

Upregulation of miR-146b promotes porcine ovarian granulosa cell apoptosis by attenuating CYP19A1

MicroRNAs (miRNAs) are 21- to 24-nucleotide long small noncoding RNAs, which play an important role in follicular atresia and granulosa cell (GC) apoptosis in the mammalian ovary. Here, we report that miR-146b, a conserved and ovary-enriched miRNA, modulates estradiol (E2) secretion, GC apoptosis, and follicular atresia in pigs. Genome-wide analysis and quantitative real-time PCR revealed that miR-146b was significantly upregulated during follicular atresia, and fluorescence-activated cell sorting showed that miR-146b functioned as a proapoptotic factor to induce GC apoptosis. MicroRNA-mRNA network analysis and luciferase reporter assays showed that CYP19A1, the pivotal enzyme for E2 synthesis signaling, was directly targeted by miR-146b. Furthermore, miR-146b interacted with the 3'untranslated region of CYP19A1 to prevent translation, thereby regulating CYP19A1-mediated E2 secretion and GC apoptosis. However, miR-146b was not regulated by the transcription factor SMAD4 or oxidative stress, both of which are critical regulators of CYP19A1. We, thus, conclude that miR-146b is a novel epigenetic factor regulating GC functions, follicular development, and female reproduction.

[Value of ALBI grade on precised estimation liver reserve function of patients with hepatocellular carcinoma]

Précised liver reserve function estimation is of great significance for predicting the survival time, post-hepatectomy liver failure and individualized comprehensive treatment strategies in hepatocellular carcinoma (HCC) patients. Currently, the widely used Child-Pugh (CP) classification and indocyanine green 15-minute retention rate (ICGR 15) have certain flaws and limitations. The albumin-bilirubin (ALBI) grading especially makes up for the deficiency of CP classification, and can provide an objective, simple, accurate and evidence-based method to estimate and guide the liver reserve function of HCC patients. This paper follows up and summarizes the research progress of ALBI grading estimation at home and abroad on liver reserve function of HCC patients.

The association between napping and the risk of cardiovascular disease and all-cause mortality: a systematic review and dose-response meta-analysis

Background

Napping is a habit prevalent worldwide and occurs from an early age. Some sleep specialists have suggested it as a potential public health tool due to the prevalence of sleep disorder. However, the association between napping and the risk of cardiovascular disease (CVD) and all-cause mortality remains unclear.

Purpose

To assess the association between napping and the risk of CVD and all-cause mortality.

Methods

We conducted a systematic search of Medline, Embase and Cochrane databases from inception through December 2019 for prospective cohort studies investigating the association between napping and the risk of CVD and/or all-cause mortality. Overall estimates were calculated using random effect models with inverse variance weighting. Dose-response meta-analysis was performed using restricted cubic spline models. The results were reported as hazard ratio (HR) and 95% confidence interval (CI).

Results

A total of 313651 participants (57.8% female, 38.9% took naps) from 20 cohort studies were included in the analysis. Overall, pooled analysis detected no association between daytime nap and CVD (HR 1.13, 95% CI 0.99–1.28). However, in subgroup analysis including only participants who were female (HR 1.31, 95% CI 1.09–1.58), older (age&gt;65 years) (HR 1.36, 95% CI 1.07–1.72), or took a longer nap (nap time&gt;60 minutes) (HR 1.34, 95% CI 1.05–1.63), napping was significantly associated with a higher risk of CVD comparing to not napping. All-cause mortality was associated with napping overall (HR 1.19, 95% CI 1.12–1.26), and effect sizes were even more pronounced in females (HR 1.22, 95% CI 1.13–1.31), older participants (HR 1.27, 95% CI 1.11–1.45) and those who took a long nap (HR 1.30, 95% CI 1.12–1.47). Furthermore, after stratifying participants by night sleep time (&lt;6 and &gt;6h/day), no significant association was detected except those who slept &gt;6h/day at night and took a long nap (HR 1.13, 95% CI 1.03–1.24). Dose-response analysis showed a J-curve relation between nap time and CVD (Figure 1). The HR decreased from 0 to 25 min/day, followed by a sharp increase in the risk at longer times. A positive linear relationship between nap time and all-cause mortality was also observed.

Conclusion

Long napping over 60 minutes per day is associated with increased risks of CVD and all-cause mortality. Night sleep duration may play a role in the relation between napping and all-cause mortality. Further, large-scale prospective cohort studies need to confirm our conclusion and investigate the underlying mechanisms driving these associations.

Funding Acknowledgement

Type of funding source: None

Reproducibility of Dietary Intake Measurement From Diet Diaries, Photographic Food Records, and a Novel Sensor Method

Objective: No data currently exist on the reproducibility of photographic food records compared to diet diaries, two commonly used methods to measure dietary intake. Our aim was to examine the reproducibility of diet diaries, photographic food records, and a novel electronic sensor, consisting of counts of chews and swallows using wearable sensors and video analysis, for estimating energy intake. Method: This was a retrospective analysis of data from a previous study, in which 30 participants (15 female), aged 29 ± 12 y and having a BMI of 27.9 ± 5.5, consumed three identical meals on different days. Four different methods were used to estimate total mass and energy intake on each day: (1) weighed food record; (2) photographic food record; (3) diet diary; and (4) novel mathematical model based on counts of chews and swallows (CCS models) obtained via the use of electronic sensors and video monitoring system. The study staff conducted weighed food records for all meals, took pre- and post-meal photographs, and ensured that diet diaries were completed by participants at the end of each meal. All methods were compared against the weighed food record, which was used as the reference method. Results: Reproducibility was significantly different between the diet diary and photographic food record for total energy intake (p = 0.004). The photographic record had greater reproducibility vs. the diet diary for all parameters measured. For total energy intake, the novel sensor method exhibited good reproducibility (repeatability coefficient (RC) of 59.9 (45.9, 70.4), which was better than that for the diet diary [RC = 79.6 (55.5, 103.3)] but not as repeatable as the photographic method [RC = 43.4 (32.1, 53.9)]. Conclusion: Photographic food records offer superior precision to the diet diary and, therefore, would be valuable for longitudinal studies with repeated measures of dietary intake. A novel electronic sensor also shows promise for the collection of longitudinal dietary intake data.

Gastric injury secondary to button battery ingestions: a retrospective multicenter review

BACKGROUND AND AIMS

Removal of gastric button batteries (BBs) remains controversial. Our aim was to better define the spectrum of injury and to characterize clinical factors associated with injury from retained gastric BBs.

METHODS

In this multicenter retrospective cohort study from January 2014 through May 2018, pediatric gastroenterologists from 4 pediatric tertiary care centers identified patients, aged 0 to 18 years, who had a retained gastric BB on radiography and subsequently underwent endoscopic assessment. Demographic and clinical information were abstracted from electronic health records using a standard data collection form.

RESULTS

Sixty-eight patients with a median age of 2.5 years underwent endoscopic retrieval of a gastric BB. At presentation, 17 (25%) were symptomatic. Duration from ingestion to endoscopic removal was known for 65 patients (median, 9 hours [interquartile range, 5-19]). Median time from ingestion to first radiographic evaluation was 2 hours. At endoscopic removal, 60% of cases had visual evidence of mucosal damage, which correlated with duration of BB retention (P = .0018). Time to retrieval of the BB was not statistically significant between symptomatic and asymptomatic subjects (P = .12). After adjusting for age and symptoms, the likelihood of visualizing gastric damage among patients who had BBs removed 12 hours post ingestion was 4.5 times that compared with those with BB removal within 12 hours of ingestion.

CONCLUSIONS

In this study, swallowed BBs posed a risk of damage to the stomach, including a single case of impaction and perforation of the gastric wall. Clinicians may want to consider retrieval within 12 hours of ingestion of gastric BBs. Larger prospective studies to assess risk of injury are needed.

Assessing the impact of drinking water iodine concentrations on the iodine intake of Chinese pregnant women living in areas with restricted iodized salt supply

PURPOSE

The supply of non-iodized salt and the water improvement project have been conducted to reduce the iodine concentration in drinking water in areas with elevated water iodine. We aimed to assess the impact of water iodine concentration (WIC) on the iodine intake of pregnant women in areas with restricted iodized salt supply, and determine the cutoff values of WIC in areas with non-iodized salt supply.

METHODS

Overall, 534 pregnant women who attended routine antenatal outpatient visits in Zibo Maternal and Child Health Hospital in Gaoqing County were recruited. The 24-h urine iodine excretion (UIE) in 534 samples and the iodine concentration in 534 drinking water samples were estimated. Urinary iodine excretion, daily iodine intake, and daily iodine intake from drinking water (WII) were calculated. The relationship between WIC and daily iodine take was analyzed.

RESULTS

The median WIC, spot urine iodine concentration (UIC), and 24-h UIE were 17 (6, 226) μg/L, 145 (88, 267) μg/L, and 190 (110, 390) μg/day, respectively. A significant positive correlation was found between WIC and UIE (R² = 0.265, p < 0.001) and UIC (R² = 0.261, p < 0.001). The contribution rate of WII to total iodine intake increased from 3.0% in the group with WIC of < 10 μg/L to 45.7% in the group with WIC of 50-99 μg/L.

CONCLUSION

The iodine content in drinking water is the major iodine source in pregnant women living in high-water iodine areas where iodized salt supply is restricted. The contribution rate of daily iodine intake from drinking water increases with the increase in water iodine concentration.

Impact of Combined Hormonal Contraceptive Use on Weight Loss: A Secondary Analysis of a Behavioral Weight-Loss Trial

OBJECTIVE

This study aimed to perform a preliminary investigation of the impact of combined hormonal contraceptive (CHC) use on weight loss during an 18-month behavioral weight-loss trial.

METHODS

Adults (n = 170; 18-55 years; BMI 27-42 kg/m² ) received a weight-loss intervention that included a reduced-calorie diet, a progressive exercise prescription, and group-based behavioral support. Premenopausal women (n = 110) were classified as CHC users (CHC, n = 17) or non-CHC users (non-CHC, n = 93). Changes in weight were examined within groups using a linear mixed model, adjusted for age and randomized group assignment.

RESULTS

At 6 M, weight was reduced from baseline in both CHC (mean, -6.7 kg; 95% CI: -9.8 to -3.7 kg) and non-CHC (-9.1 kg; -9.1 to -6.4 kg). Between 6 and 18 M, CHC regained weight (4.9 kg; 0.9 to 8.9 kg), while weight remained relatively unchanged in non-CHC (-0.1 kg; -1.8 to 1.6 kg). At 18 M, weight was relatively unchanged from baseline in CHC (-1.8 kg; -7.3 to 3.6 kg) and was reduced from baseline in non-CHC (-7.9 kg; -10.2 to -5.5 kg).

CONCLUSIONS

In this secondary data analysis, CHC use was associated with weight regain after initial weight loss. Prospective studies are needed to further understand the extent to which CHC use influences weight loss and maintenance.

SAT-575 Association Between Baseline Fitness and Changes in Physical Activity and Weight Loss in an 18-Month Behavioral Weight Loss Program

BACKGROUND: Baseline cardiovascular fitness may be a significant predictor of future success in a comprehensive behavioral weight loss program (BWLP). Yet, few studies have examined the association between baseline fitness and future weight loss.

PURPOSE: To determine the association between baseline fitness and changes in body weight and device-measured levels of moderate-to-vigorous physical activity (MVPA) during a BWLP.

METHODS: Adults (n=85) were enrolled in an 18-month BWLP combining a calorie-restricted diet, group-based behavioral support, and 6 months of supervised exercise (progressing to 300 min/wk of moderate-intensity) followed by 12 months of unsupervised exercise. Data from 60 completers (age 41.0±9.5 years, BMI 34.6±4.2 kg/m2, 80% female) were used in this analysis. MVPA was measured over 1 week with the Sensewear Armband at months 0, 6, 12, and 18. Fitness (VO2max) was measured on a treadmill using indirect calorimetry and categorized based on published age and sex norms (Physical Fitness Specialist Certification Manual, 1997). A linear mixed effects model with unstructured covariance was used to examine the association between baseline fitness category and changes in body weight, total MVPA, and MVPA in bouts ≥10 min at the four time points.

RESULTS: Of the 60 completers, 33% (n=20) were classified as having very poor fitness, 45% (n=27) poor, 18% (n=11) fair, 3% (n=2) good, and 0% (n=0) excellent or superior. Due to the low proportion of participants categorized as having fair or better fitness, we created a binary fitness variable (very poor vs. poor or better). Baseline BMI was higher in those in the very poor category compared to those in the poor or better category (36.2±4.2 vs 33.7±4.0, p=0.03). There were no significant differences between the two fitness categories in weight change at 6 or 12 months. However, at 18 months, mean weight loss was 4.3±1.7 kg in those in the very poor category and 8.2±1.2 kg in those in the poor or better category, with a marginally significant between-group difference (p=0.07). There were no differences in changes in total or bout MVPA. However, those with very poor fitness had lower bout MVPA at baseline vs. those with poor or better fitness (16±20 vs 33±31 min/d, p=0.03). At 18 months, both groups increased bout MVPA, however bout MVPA remained lower in the very poor vs. poor or better group (24±29 vs 42±29 min/d, p=0.03). Total MVPA showed a similar pattern.

CONCLUSION: Baseline fitness may moderate 18-month weight loss, as those with very poor fitness lost less weight compared to those with poor or better fitness levels. Those with poor or better fitness at baseline achieved significantly higher mean levels of MVPA at 18 months compared to those with very poor fitness. Participants with very poor fitness at baseline may require additional exercise support during a BWLP to achieve the high levels of MVPA recommended for weight loss maintenance.

Broadband, millimeter-wave antireflection coatings for large-format, cryogenic aluminum oxide optics

We present two prescriptions for broadband ($ {\sim} 77 - 252\;{\rm GHz} $), millimeter-wave antireflection coatings for cryogenic, sintered polycrystalline aluminum oxide optics: one for large-format (700 mm diameter) planar and plano-convex elements, the other for densely packed arrays of quasi-optical elements-in our case, 5 mm diameter half-spheres (called "lenslets"). The coatings comprise three layers of commercially available, polytetrafluoroethylene-based, dielectric sheet material. The lenslet coating is molded to fit the 150 mm diameter arrays directly, while the large-diameter lenses are coated using a tiled approach. We review the fabrication processes for both prescriptions, then discuss laboratory measurements of their transmittance and reflectance. In addition, we present the inferred refractive indices and loss tangents for the coating materials and the aluminum oxide substrate. We find that at 150 GHz and 300 K the large-format coating sample achieves $ (97 \pm 2)\% $ transmittance, and the lenslet coating sample achieves $ (94 \pm 3)\% $ transmittance.

Gender Differences in Emotion Dysregulation in an Autism Inpatient Psychiatric Sample

There is a wide range of emotion regulation (ER)-related impairment observed in autism spectrum disorder (ASD), which is associated with both internalizing and externalizing problems. Although the importance of ER is widely acknowledged in the ASD literature, little is known about factors associated with variability in ER impairment. Given the identified gender differences in ASD, gender may be a potential contributor to ER. This study examined gender differences in ER in an ASD inpatient psychiatric sample (n = 722; 146 females) aged 4-20 years, collected as part of the Autism Inpatient Collection. In addition, the study investigated whether age, nonverbal intelligence quotient (NVIQ), or verbal ability moderate the association between ER and gender. While both male and female inpatients with ASD presented with clinically elevated emotion dysregulation compared to general population norms, results suggest that female psychiatric inpatients have more severe dysregulation, including higher reactivity and dysphoria, than inpatient males. NVIQ and verbal ability did not moderate the association between gender and ER. Age moderated the association between gender and ER, with greater gender difference seen in older individuals, but only for dysphoria. However, overall, these effects were small. Improved understanding of ER presentation in males and females with ASD is critical, as these symptoms may differentially impact individuals with ASD and may warrant a different treatment emphasis. LAY SUMMARY: Previous research has identified several gender differences in presentation of autism spectrum disorder (ASD) symptoms, as well as difficulties with emotion regulation in individuals with ASD. In order to better understand the factors that may contribute to emotion regulation in ASD, this study examined whether psychiatrically hospitalized males and females with ASD differed in emotion regulation and what factors influenced the differences. Results suggest that females with ASD have slightly but significantly more difficulty with emotion regulation compared to males. Autism Res 2020, 13: 1343-1348. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.

Mothers with long QT syndrome are at increased risk for fetal death: findings from a multicenter international study

BACKGROUND

Most fetal deaths are unexplained. Long QT syndrome is a genetic disorder of cardiac ion channels. Affected individuals, including fetuses, are predisposed to sudden death. We sought to determine the risk of fetal death in familial long QT syndrome, in which the mother or father carries the long QT syndrome genotype. In addition, we assessed whether risk differed if the long QT syndrome genotype was inherited from the mother or father.

OBJECTIVE

This was a retrospective review of pregnancies in families with the 3 most common heterozygous pathogenic long QT syndrome genotypes in KCNQ1 (LQT1), KCNH2 (LQT2), or SCN5A (LQT3), which occur in approximately 1 in 2000 individuals. The purpose of our study was to compare pregnancy and birth outcomes in familial long QT syndrome with the normal population and between maternal and paternal carriers of the long QT syndrome genotype. We hypothesized that fetal death before (miscarriage) and after (stillbirths) 20 weeks gestation would be increased in familial long QT syndrome compared with the normal population and that the parent of origin would not affect birth outcomes.

STUDY DESIGN

Our study was a multicenter observational case series of 148 pregnancies from 103 families (80 mothers, 23 fathers) with familial long QT syndrome (60 with LQT1, 29 with LQT2, 14 with LQT3) who were recruited from 11 international centers with expertise in hereditary heart rhythm diseases, pediatric and/or adult electrophysiology, and high-risk pregnancies. Clinical databases from these sites were reviewed for long QT syndrome that occurred in men or women of childbearing age (18-40 years). Pregnancy outcomes (livebirth, stillbirth, and miscarriage), birthweights, and gestational age at delivery were compared among long QT syndrome genotypes and between maternal vs paternal long QT syndrome-affected status with the use of logistic regression analysis.

RESULTS

Most offspring (80%; 118/148) were liveborn at term; 66% of offspring (73/110) had long QT syndrome. Newborn infants of mothers with long QT syndrome were delivered earlier and, when the data were controlled for gestational age, weighed less than newborn infants of long QT syndrome fathers. Fetal arrhythmias were observed rarely, but stillbirths (fetal death at >20 weeks gestation) were 8 times more frequent in long QT syndrome (4% vs approximately 0.5%); miscarriages (fetal death at ≤20 weeks gestation) were 2 times that of the general population (16% vs 8%). The likelihood of fetal death was significantly greater with maternal vs paternal long QT syndrome (24.4% vs 3.4%; P=.036). Only 10% of all fetal deaths underwent postmortem long QT syndrome testing; 2 of 3 cases were positive for the family long QT syndrome genotype.

CONCLUSION

This is the first report to demonstrate that mothers with long QT syndrome are at increased risk of fetal death and to uncover a previously unreported cause of stillbirth. Our results suggest that maternal effects of long QT syndrome channelopathy may cause placental or myometrial dysfunction that confers increased susceptibility to fetal death and growth restriction in newborn survivors, regardless of long QT syndrome status.

Appetite-Related Responses to Overfeeding and Longitudinal Weight Change in Obesity-Prone and Obesity-Resistant Adults

OBJECTIVE

Appetite responses to 3 days of overfeeding (OF) were examined as correlates of longitudinal weight change in adults classified as obesity prone (OP) or obesity resistant (OR).

METHODS

OP (n = 22) and OR (n = 30) adults consumed a controlled eucaloric and OF diet (140% of energy needs) for 3 days, followed by 3 days of ad libitum feeding. Hunger and satiety were evaluated by visual analog scales. Ghrelin and peptide YY (PYY) levels were measured during a 24-hour inpatient visit on day 3. Body weight and composition were measured annually for 4.0 ± 1.3 years.

RESULTS

Dietary restraint and disinhibition were greater in OP than OR (mean difference: 3.5 ± 1.2 and 3.3 ± 0.9, respectively; P < 0.01) participants, and disinhibition was associated with longitudinal weight change (n = 48; r = 0.35; P = 0.02). Compared with the eucaloric diet, energy intake fell significantly in OR participants following OF (P = 0.03) but not in OP (P = 0.33) participants. Twenty-four-hour PYY area under the curve values increased with OF in OR (P = 0.02) but not in OP (P = 0.17) participants. Furthermore, changes in PYY levels with OF correlated with measured energy intake (r = -0.36; P = 0.01).

CONCLUSIONS

Baseline disinhibition and PYY responses to OF differed between OP and OR adults. Dietary disinhibition was associated with 5-year longitudinal weight gain. Differences in appetite regulation may underlie differences in propensity for weight gain.

Rice momilactone gene cluster: transcriptional response to barnyard grass (Echinochloa crus-galli)

Expression of genes involved in diterpene biosynthesis, especially momilactone and gibberellins (GAs), in rice plants (Oryza sativa L.) in response to barnyard grass (Echinochloa crus-galli) stress was examined. The three analyzed class II diterpene synthases had the highest fold change expression. Transcription patterns of genes for two homologs of momilactone synthases, OsMAS and OsMAS2, suggests their distinct roles in response to the presence of barnyard grass.

Dual roles of misshapen/NIK-related kinase (MINK1) in osteoarthritis subtypes through the activation of TGFβ signaling

OBJECTIVE

To identify the role of misshapen/NIK-related kinase (MINK1) in age-related Osteoarthritis (OA) and injury-induced OA, and the effects of enhanced TGFβ signaling in these progresses.

DESIGN

The effect of MINK1 was analyzed with MINK1 knock out (Mink1-/-) mice and C57BL/6J mice. OA progress was studied in age-related OA and instability-associated OA (destabilization of the medial meniscus, DMM) models. The murine knee joint was evaluated through histological staining, Osteoarthritis Research Society International (OARSI) scores, immunohistochemistry, and μCT analysis. Primary chondrocytes were isolated from wild type and Mink1-/- mice and subjected to osteogenic induction and Western blot analysis.

RESULTS

MINK1 is highly expressed during cartilage development and in normal cartilage. Mink1-/- mice displayed markedly lower OARSI scores, aggrecan degradation neoepitope positive cells and increased Safranin O and pSMAD2 staining in aging-related OA model. However, in injury-induced OA, loss of MINK1 accelerates extracellular matrix (ECM) destruction, osteophyte formation, and subchondral bone sclerosis. Accelerated subchondral bone remodeling in Mink1-/- mice was accompanied with increased numbers of nestin-positive mesenchymal stem cells (MSCs) and osterix-positive osteoprogenitors. pSMAD2 staining was increased in the subchondral bone marrow of Mink1-/- mice and overexpression of MINK1 inhibited SMAD2 phosphorylation in vitro.

CONCLUSIONS

This study shows for the first time that activation of TGFβ/SMAD2 by MINK1 deficiency plays opposite roles in aging-related and injury-induced OA. MINK1 deficiency protects cartilage from degeneration in aging joints through increased SMAD2 activation in chondrocytes, while accelerating OA progress in injury-induced model through enhanced osteogenesis of MSCs in the subchondral bone. These findings provide insights for developing precision OA therapeutics targeting TGFβ/SMAD2 signaling.