Do maternal opioids reduce neonatal regional brain volumes? A pilot study

OBJECTIVE

A substantial number of children exposed to gestational opioids have neurodevelopmental, behavioral and cognitive problems. Opioids are not neuroteratogens but whether they affect the developing brain in more subtle ways (for example, volume loss) is unclear. We aimed to determine the feasibility of using magnetic resonance imaging (MRI) to assess volumetric changes in healthy opioid-exposed infants.

STUDY DESIGN

Observational pilot cohort study conducted in two maternity hospitals in New South Wales, Australia. Maternal history and neonatal urine and meconium screens were obtained to confirm drug exposure. Volumetric analysis of MRI scans was performed with the ITK-snap program.

RESULT

Scans for 16 infants (mean (s.d.) gestational age: 40.9 (1.5) weeks, birth weight: 3022.5 (476.6) g, head circumference (HC): 33.7 (1.5 cm)) were analyzed. Six (37.5%) infants had HC <25th percentile. Fourteen mothers used methadone, four used buprenorphine and 11 used more than one opioid (including heroin, seven). All scans were structurally normal whole brain volumes (357.4 (63.8)) and basal ganglia (14.5 (3.5)) ml were significantly smaller than population means (425.4 (4.8), 17.1 (4.4) ml, respectively) but lateral ventricular volumes (3.5 (1.8) ml) were larger than population values (2.1(1.5)) ml.

CONCLUSION

Our pilot study suggests that brain volumes of opioid-exposed babies may be smaller than population means and that specific regions, for example, basal ganglia, that are involved in neurotransmission, may be particularly affected. Larger studies including correlation with neurodevelopmental outcomes are warranted to substantiate this finding.

Effect of salt intake and potassium supplementation on brachial-ankle pulse wave velocity in Chinese subjects: an interventional study

Accumulating evidence has suggested that high salt and potassium might be associated with vascular function. The aim of this study was to investigate the effect of salt intake and potassium supplementation on brachial-ankle pulse wave velocity (PWV) in Chinese subjects. Forty-nine subjects (28-65 years of age) were selected from a rural community of northern China. All subjects were sequentially maintained on a low-salt diet for 7 days (3.0 g/day NaCl), a high-salt diet for an additional 7 days (18.0 g/day NaCl), and a high-salt diet with potassium supplementation for a final 7 days (18.0 g/day NaCl+4.5 g/day KCl). Brachial-ankle PWV was measured at baseline and on the last day of each intervention. Blood pressure levels were significantly increased from the low-salt to high-salt diet, and decreased from the high-salt diet to high-salt plus potassium supplementation. Baseline brachial-ankle PWV in salt-sensitive subjects was significantly higher than in salt-resistant subjects. There was no significant change in brachial-ankle PWV among the 3 intervention periods in salt-sensitive, salt-resistant, or total subjects. No significant correlations were found between brachial-ankle PWV and 24-h sodium and potassium excretions. Our study indicates that dietary salt intake and potassium supplementation, at least in the short term, had no significant effect on brachial-ankle PWV in Chinese subjects.

Association analysis of polymorphisms in OAS1 with susceptibility and severity of hand, foot and mouth disease

Hand, foot and mouth disease (HFMD) is a common childhood illness that mainly affects Asian children under the age of 5 years. Human enterovirus 71 (EV71) and coxsackievirus A16 (CA16) are the most common pathogens of HFMD. It is imperative that the susceptible population is screened early and that the severe illness population can be identified via genetic variation detection in children. Four single-nucleotide polymorphisms (SNP) [2'-5'-oligoadenylate synthetase1 (OAS1) rs10774671, selectin P ligand (SELPLG) rs2228315, scavenger receptor class B member 2 (SCARB2) rs41284767 and interleukin 28B (IL28B) rs12979860] were determined by Taqman assays in 333 HFMD samples and 163 control samples. The rs2228315, rs41284767 and rs12979860 polymorphisms did not differ significantly between HFMD patients and the controls, but the prevalence of the rs10774671 polymorphism was significantly different between the control children and children infected with CA16 (GG genotype vs. AA + AG genotype, P < 0.05). Children with the GG genotype were more susceptible to CA16-type HFMD. Furthermore, the rs10774671 genotype distribution was clearly different between children with severe HFMD and those with mild HFMD [P < 0.05, OR 0.240, 95% CI (0.071-0.809)]. HFMD children with the AA+AG genotype were more likely to progress to encephalitis than were those with the GG genotype. Plasma γ-interferon (IFN) expression levels among control children and the mild and severe HFMD children were detected by ELISA. Those with mild HFMD had higher γ-IFN expression levels compared with those with severe HFMD (P < 0.05). In addition, there is a significant correlation between γ-IFN levels and OAS1 rs10774671 SNP, as analysed by linear correlation assay. The GG genotype correlated with higher γ-IFN levels (P < 0.05). In short, the OAS1 rs10774671 SNP GG genotype contributed to CA16 susceptibility and was associated with the development of mild HFMD.

Finished sequence and assembly of the DUF1220-rich 1q21 region using a haploid human genome

Background

Although the reference human genome sequence was declared finished in 2003, some regions of the genome remain incomplete due to their complex architecture. One such region, 1q21.1-q21.2, is of increasing interest due to its relevance to human disease and evolution. Elucidation of the exact variants behind these associations has been hampered by the repetitive nature of the region and its incomplete assembly. This region also contains 238 of the 270 human DUF1220 protein domains, which are implicated in human brain evolution and neurodevelopment. Additionally, examinations of this protein domain have been challenging due to the incomplete 1q21 build. To address these problems, a single-haplotype hydatidiform mole BAC library (CHORI-17) was used to produce the first complete sequence of the 1q21.1-q21.2 region.

Results

We found and addressed several inaccuracies in the GRCh37sequence of the 1q21 region on large and small scales, including genomic rearrangements and inversions, and incorrect gene copy number estimates and assemblies. The DUF1220-encoding NBPF genes required the most corrections, with 3 genes removed, 2 genes reassigned to the 1p11.2 region, 8 genes requiring assembly corrections for DUF1220 domains (~91 DUF1220 domains were misassigned), and multiple instances of nucleotide changes that reassigned the domain to a different DUF1220 subtype. These corrections resulted in an overall increase in DUF1220 copy number, yielding a haploid total of 289 copies. Approximately 20 of these new DUF1220 copies were the result of a segmental duplication from 1q21.2 to 1p11.2 that included two NBPF genes. Interestingly, this duplication may have been the catalyst for the evolutionarily important human lineage-specific chromosome 1 pericentric inversion.

Conclusions

Through the hydatidiform mole genome sequencing effort, the 1q21.1-q21.2 region is complete and misassemblies involving inter- and intra-region duplications have been resolved. The availability of this single haploid sequence path will aid in the investigation of many genetic diseases linked to 1q21, including several associated with DUF1220 copy number variations. Finally, the corrected sequence identified a recent segmental duplication that added 20 additional DUF1220 copies to the human genome, and may have facilitated the chromosome 1 pericentric inversion that is among the most notable human-specific genomic landmarks.

PRoNTo: pattern recognition for neuroimaging toolbox

In the past years, mass univariate statistical analyses of neuroimaging data have been complemented by the use of multivariate pattern analyses, especially based on machine learning models. While these allow an increased sensitivity for the detection of spatially distributed effects compared to univariate techniques, they lack an established and accessible software framework. The goal of this work was to build a toolbox comprising all the necessary functionalities for multivariate analyses of neuroimaging data, based on machine learning models. The “Pattern Recognition for Neuroimaging Toolbox” (PRoNTo) is open-source, cross-platform, MATLAB-based and SPM compatible, therefore being suitable for both cognitive and clinical neuroscience research. In addition, it is designed to facilitate novel contributions from developers, aiming to improve the interaction between the neuroimaging and machine learning communities. Here, we introduce PRoNTo by presenting examples of possible research questions that can be addressed with the machine learning framework implemented in PRoNTo, and cannot be easily investigated with mass univariate statistical analysis.

Body mass index and risk of pneumonia: a systematic review and meta-analysis

The aims of our meta-analysis were to examine the pattern and gender's influence on body mass index (BMI) - pneumonia relationship. Published studies were searched from PubMed, Web of Science, Cochrane Library databases using keywords of pneumonia, BMI and epidemiologic studies. Random-effects analysis was applied to estimate pooled effect sizes from individual studies. The Cochrane Q-test and index of heterogeneity (I(2) ) were used to evaluate heterogeneity, and Egger's test was used to evaluate publication bias. Random-effects meta-regression was applied to examine the pattern and gender's influence on BMI-pneumonia relationship. A total of 1,531 studies were initially identified, and 25 studies finally were included. The pooled relative risk (RR) and meta-regression model revealed a J-shaped relationship between BMI and risk of community-acquired pneumonia (underweight, RR 1.8, 95% confidence interval [CI], 1.4-2.2, P < 0.01; overweight, 0.89, 95%CI, 0.8-1.03, P, 0.1; obesity, 1.03, 95% CI, 0.8-1.3, p. 8) and U-shaped relationship between BMI and risk of influenza-related pneumonia (underweight, RR 1.9, 95% CI, 1.2-3, P < 0.01; overweight, 0.89, 95% CI, 0.79-0.99, P, 0.03; obesity, 1.3, 95% CI, 1.05-1.63, p. 2; morbidity obesity, 4.6, 95% CI, 2.2-9.8, P < 0.01); whereas, no difference in risk of nosocomial pneumonia was found across the BMI groups. Gender difference did not make significant contribution in modifying BMI-pneumonia risk relationship.

Involvement of DNA-PKcs in the pro-inflammtory cytokine and type I IFN response to CpG-ODN in dendritic cells is mediated by its interaction with TRAF6 (P1359)

CpG-ODN stimulates dendritic cells (DCs) to produce cytokines, which are important for autoimmune disorder development and vaccine strategy for cancer. CpG-ODN activates the TLR9/TRAF6 cascade leading to IKK-NF-κB and IKK-IRF7 activation, which is critical for production of pro-inflammatory cytokines and the type I IFNs, respectively. However, whether other molecules are involved in activation of CpG-ODN signaling is still unclear. Here we report that the catalytic subunit of DNA-dependent protein kinase (DNA-PKcs) is involved in this activation process. DNA-PKcs-deficient DCs exhibited a defect in the IL-6 and IL-12 response to CpG-ODN in a dose- and time- dependent manner. Also, loss of DNA-PKcs impaired the IFNa response to CpG-ODN and blockade of IFNR signaling further reduced the IL-6 and IL-12 response to CpG-ODN in DNA-PKcs deficient DCs. Additionally, loss of DNA-PKcs impaired phosphorylation of IKKa, IκBα, NF-κB, JNK, IRF7 and STAT1 in response to CpG-ODN. Interestingly, TLR9- and DNA-PKcs/TLR9- deficient DCs showed almost no IL-6 and IL-12 response to CpG-ODN, but they exhibited about 2/3 to 3/4 defect in the IFNa production compared to WT controls. Finally, CpG-ODN bound DNA-PKcs in the absence of TLR9, whereas it induced DNA-PKcs’s association with TRAF6 in a TLR9-dependent manner. Our data suggest that DNA-PKcs is a player in CpG-ODN signaling and may explain why DNA-PKcs is implicated in the pathogenic process of autoimmune disease.

Transformation of LTP gene into Brassica napus to enhance its resistance to Sclerotinia sclerotiorum

Rapeseed (Brassica napus L.) is one of the most important economic crops worldwide, and Sclerotinia sclerotiorum is the most dangerous disease that affects its yield greatly. Lipid transfer protein (LTP) has broad-spectrum anti-bacterial and fungal activities. In this study, B. napus was transformed using Agrobacterium tumefaciens harboring the plasmid-containing LTP gene to study its possible capability of increasing plant's resistance. First, we optimized the petiole genetic transformation system by adjusting the days of explants, bacterial concentrations, ratio of hormones, and cultivating condition. Second, we obtained 8 positive plants by PCR analysis of T0 generation. The PCR results of T1 generation were positive, indicating that the LTP gene had been integrated into B. napus. Third, T1 transgenic plants inoculated by detached leaves with mycelia of S. sclerotiorum showed better disease resistance than non-transformants. Oxalic acid belongs to secondary metabolites of S. sclerotiorum, and several studies have demonstrated that the resistance of rapeseed to oxalic acid is significantly consistent with its resistance to S. sclerotiorum. The result from the seed germination assay showed that when T1 seeds were exposed to oxalic acid stress, their germination rate was evidently higher than that of non-transformant seeds. In addition, we measured some physiological changes in T1 plants and control plants under oxalic acid stress. The results showed that T1 transgenic plants had lower malondialdehyde (MDA) content, higher super oxide dismutase (SOD), and peroxidase (POD) activities than non-transformants, whereas disease resistance was related to low MDA content and high SOD and POD activities.

Focal facial dermal dysplasia, type IV, is caused by mutations in CYP26C1

Focal facial dermal dysplasia (FFDD) Type IV is a rare syndrome characterized by facial lesions resembling aplasia cutis in a preauricular distribution along the line of fusion of the maxillary and mandibular prominences. To identify the causative gene(s), exome sequencing was performed in a family with two affected siblings. Assuming autosomal recessive inheritance, two novel sequence variants were identified in both siblings in CYP26C1-a duplication of seven base pairs, which was maternally inherited, c.844_851dupCCATGCA, predicting p.Glu284fsX128 and a missense mutation, c.1433G>A, predicting p.Arg478His, that was paternally inherited. The duplication predicted a frameshift mutation that led to a premature stop codon and premature chain termination, whereas the missense mutation was not functional based on its in vitro expression in mammalian cells. The FFDD skin lesions arise along the sites of fusion of the maxillary and mandibular prominences early in facial development, and Cyp26c1 was expressed exactly along the fusion line for these facial prominences in the first branchial arch in mice. Sequencing of four additional, unrelated Type IV FFDD patients and eight Type II or III TWIST2-negative FFDD patients revealed that three of the Type IV patients were homozygous for the duplication, whereas none of the Type II or III patients had CYP26C1 mutations. The seven base pairs duplication was present in 0.3% of healthy controls and 0.3% of patients with other birth defects. These findings suggest that the phenotypic manifestations of FFDD Type IV can be non-penetrant or underascertained. Thus, FFDD Type IV results from the loss of function mutations in CYP26C1.

SU-E-T-97: Intra and Inter Variability in Beam Data Commissioning among Water Phantom Scanning Systems

PURPOSE

There are many water-phantom scanning systems with advanced features to collect accurate commissioning data. However the intra- and inter-variability of commissioning data has not been reported which is attempted in this study.

METHODS

Four vendors with modern water-phantom scanning systems; PTW, Sun Nuclear (SN), Standard Imaging (SI) and IBA were invited to an institution to demonstrate beam data collection. Each system was used to collect percent depth dose (PDD) and profiles several times in a day with their choice of detector for four different machines for photon and electron beam commissioning. This provided information on intra-variability. At the end, each vendor was allowed to setup and collect data on a single unit for inter-variability. All data were sent to a central location for analysis and evaluation.

RESULTS

The depth dose and profiles for 2×2cm² and 10×10cm² fields were analyzed for intra- and inter-variability. With repeated measurements, the intra-variability provided a detailed degree of fidelity of data collection. This was shown to be with (± 0.1%) among all vendors. Ignoring data in buildup region and comparing with one system (PTW), the PDDs variability were slightly larger 0.02±0.17%, 0.14±0.21%, 0.17±0.2%, for SI, SN and IBA, respectively. The profiles inter-variability in central region were <0.1 %, however in penumbra up to ± 4.8%were observed. The polarity effect was also noted up to 3% which was depth and detector dependent.

CONCLUSIONS

Intra- and inter-variability among various scanning system are very small indicting that all modern systems if used properly could collect data within±0.2% accuracy. The selection of device should be based on institutional comfort and personal preference of software and hardware. This study provides unique opportunity to compare data among systems which is otherwise not possible.

Differential roles of DNA-PKcs in the innate response to CpG-DNA (180.9)

CpG-DNA and its analog CpG-ODN powerfully activate dendritic cells (DCs) to produce pro-inflammatory cytokines, which are critical for vaccine strategies for allergy, infectious disease and cancer. There are two major types of CpG-DNAs, CpG-A and CpG-B. CpG-A activates the IFNa/b pathway, which requires IRF1 and 7, while CpG-B triggers the pro-inflammatory pathway, which requires AP-1 and NF-kB. Primarily, CpG-A triggers the IFNa/b response in pDCs in a complete TLR9- dependent manner. Yet, CpG-A together with DOTAP clearly activates DCs to produce IFNa/b in both TLR9 dependent and independent manners. Also, CpG-B induces IFNb production in DCs. To further understand how CpG-DNA activates innate immunity, we investigated a role of DNA-PKcs in this activation. Our results showed that loss of DNA-PKcs reduced pro-inflammatory cytokine response to CpG-B in DCs in a time and dose dependent manner. Interestingly, the IFNa/b response to CpG-A was defective in DNA-PKcs-deficient DCs, whereas the IFNb response to CpG-B was enhanced in the same cells. Also, Stat1 phosphorylation was diminished in either DNA-PKcs or TLR9 deficient DCs, and was further reduced in DNA-PKcs/TLR9 double deficient DCs. Additionally, our data showed that DNA-PKcs associated with TRAF6, which is critical for the IFNa/b and the pro-inflammatory cytokine responses to CpG-DNA. Together, our results suggest DNA-PKcs plays a differential role in regulating the innate immune response to CpG-DNA.

Abstract 2157: A novel role for Giα proteins in differentially regulating activation of RTK-mediated signaling

The activation of the extracellular-signal-regulated protein kinase (ERK) pathway and the PI3K/Akt/mTORC pathway by growth factors is mediated by the receptor tyrosine kinases (RTKs), and plays a crucial role in physiological and pathological processes including cell proliferation, growth, survival, migration, tumorigenesis and metastasis. We previously reported that the activation of the PI3K/Akt/mTORC1 in mouse embryonic fibroblasts (MEFs) by epidermal growth factor (EGF) and its family growth factors is mediated by the heterotrimeric G protein alpha inhibitory (Giα). Herein we demonstrated that Giα proteins are able to differentially regulate RTKs-mediated activation of the ERK and the Akt/mTORC1 pathways. Loss of Giα proteins in MEFs impaired activation of the ERK pathway by EGF, insulin-like growth factor (IGF) and Insulin, but not basic fibroblast growth factor (bFGF). Intriguingly, while activation of the Akt/mTORC1 pathway by EGF and bFGF was severely defective in Giα protein deficient cells, this activation was only slightly reduced in response to insulin and IGF. Also, Giα proteins were able to alter activation of the Akt/mTORC1 and the ERK pathways by serum and platelet-derived growth factor (PDGF) in a dose dependent manner. To further understand that how Giα proteins differentially regulate RTK-mediated activation of the Akt/mTORC1 and ERK pathways, we performed an immuno-precipitation study. Our results showed that growth factors were able to induce the association of Giα proteins with growth factor receptors and their downstream adaptor proteins. Loss of Giα proteins in MEFs impaired the association of growth factor receptors with their adaptor proteins indicating that Giα proteins act downstream of RTKs but upstream of the adaptor proteins. Finally, we examined a role of Giα proteins in cancer biology. Similar to results obtained from Giα deficient MEFs, knockdown of Giα proteins in several human cancer cell lines diminished activation of the Akt/mTORC1 and the ERK pathways by growth factors. As a result, Giα protein deficiency inhibited cancer cell growth and migration. Given the fact that growth factors and their receptor pathways play pivotal roles in tumorigenesis and metastasis of cancer, our findings may promote further understanding the molecular mechanism underline RTK signaling regulation in cancer biology and may have implications for cancer therapy. Supported by Department of Defense, Leukemia and Lymphoma Society and NIH.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2157. doi:1538-7445.AM2012-2157

Effects of the mixing ratio of the CaAl12O19:mn and Zn2SiO4:mn color-conversion layer on the color tunable emissions of white organic light-emitting devices

The optical properties of white organic light-emitting devices (WOLEDs) fabricated utilizing a CaAl12O19:Mn and Zn2SiO4:Mn phosphor layer were investigated. X-ray diffraction patterns for CaAl12O19:Mn and Zn2SiO4:Mn phosphors showed that Mn ions in the CaAl12O19:Mn phosphors were completely substituted into Ca ions and that Mn ions in the Zn2SiO4:Mn phosphors were completely substituted into Zn ions. Field emission scanning electron microscopy images showed that the size of the CaAl12O19:Mn phosphor was approximately between 0.1 and 3 microm, and that the size of the Zn2SiO4:Mn phosphor was smaller than 7 microm. The color coordinates of the electroluminescence spectra for WOLEDs with phosphor thicknesses of 0.25 and 0.35 mm shifted to the white emission side because the generated blue light from the blue OLEDs combined with the red and green lights was converted by the CaAl12O19:Mn and the Zn2SiO4:Mn phosphor down-conversion layers.

Mitochondrial DNA sequence variation and risk of pancreatic cancer

Although the mitochondrial genome exhibits high mutation rates, common mitochondrial DNA (mtDNA) variation has not been consistently associated with pancreatic cancer. Here, we comprehensively examined mitochondrial genomic variation by sequencing the mtDNA of participants (cases = 286, controls = 283) in a San Francisco Bay Area pancreatic cancer case-control study. Five common variants were associated with pancreatic cancer at nominal statistical significance (P < 0.05) with the strongest finding for mt5460g in the ND2 gene [OR = 3.9; 95% confidence interval (CI), 1.5-10; P = 0.004] which encodes an A331T substitution. Haplogroup K was nominally associated with reduced pancreatic cancer risk (OR = 0.32; 95% CI, 0.13-0.76; P = 0.01) when compared with the most common haplogroup, H. A total of 19 haplogroup-specific rare variants yielded nominal statistically significant associations (P < 0.05) with pancreatic cancer risk, with the majority observed in genes involved in oxidative phosphorylation. Weighted-sum statistics were used to identify an aggregate effect of variants in the 22 mitochondrial tRNAs on pancreatic cancer risk (P = 0.02). While the burden of singleton variants in the HV2 and 12S RNA regions was three times higher among European haplogroup N cases than controls, the prevalence of singleton variants in ND4 and ND5 was two to three times higher among African haplogroup L cases than in controls. Together, the results of this study provide evidence that aggregated common and rare variants and the accumulation of singleton variants are important contributors to pancreatic cancer risk.

Generic drug prescriptions following hospital discharge: a prospective study in France

AIMS

Systematic generic prescription at discharge could reduce confusion on drug-name usage, decrease commercial influence on medicine, and reduce drug-related expenditures. This study aimed to analyze generic drug prescriptions at discharge from hospital and to estimate the potential savings associated with a total substitution policy (substitution of every substitutable drug for its cheapest generic counterpart).

METHODS

Drug prescriptions before admission and at discharge of all patients from three medical units of a university hospital were prospectively collected for five weeks without informing prescribers.

RESULTS

Prescriptions from 85 patients were analyzed. On admission, 68 patients (80%) received 413 drugs; 141 were substitutable brand-name drugs and 23 (16%), which were directly prescribed as generics. At discharge, 488 drugs were prescribed to the 85 patients; 180 were substitutable drugs but only 5 (2.8%) were written as generics on prescription pads, a decrease of 78% (p<0.0001) compared to admission. In average, generics were 18% less expensive than brand-name drugs. Some common therapeutic classes offered even greater price difference, such as proton-pump inhibitors (42%), statins (32%), or antihypertensive agents (28%). Potential savings from a total substitution policy at discharge were estimated to €1512 per 1000 patients per week; for lifetime drugs, savings amounted to €18,960 per 1000 patients per year.

CONCLUSIONS

Very few drugs are written as generics on medical forms at discharge in France. Hospital practitioners should be encouraged to prescribe generics, particularly in chronic diseases. A broad generic prescription policy at hospital discharge would result in substantial savings for health insurance.