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Murray J, Santos IS, Bertoldi AD, Murray L, Arteche A, Tovo-Rodrigues L, Cruz S, Anselmi L, Martins R, Altafim E, Soares TB, Andriotti MG, Gonzalez A, Oliveira I, da Silveira MF, Cooper P. The effects of two early parenting interventions on child aggression and risk for violence in Brazil (The PIÁ Trial): protocol for a randomised controlled trial. Trials 2019; 20:253. [PMID: 31046826 PMCID: PMC6498476 DOI: 10.1186/s13063-019-3356-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/03/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children in many low- and middle-income countries (LMICs) are at high risk for exposure to violence and later violent behaviour. The World Health Organization has declared an urgent need for the evaluation and implementation of low-cost parenting interventions in LMICs to prevent violence. Two areas of significant early risk are harsh parenting and poor child cognitive and socio-emotional development. Parenting interventions suitable for LMIC contexts have been developed targeting these risk factors and have been shown to have promising effects. However, their impact on child aggression, a key precursor of violence, has yet to be determined. The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) has been designed to address this issue. METHODS We are conducting a randomised controlled trial to evaluate two early parenting interventions for mothers of children aged between 30 and 42 months in a Brazilian city. The first of these, dialogic book-sharing (DBS), aims to promote child cognitive and socio-emotional development; and the second, the ACT Raising Safe Kids Program (ACT), is designed to reduce harsh parenting. These interventions are being compared with a control group receiving neither intervention. Three hundred and sixty-nine families in a birth cohort are being randomly allocated to one of the three groups (DBS, ACT, Control). Facilitators deliver the interventions to groups of five to 10 mothers at weekly sessions for 8 weeks in DBS and 9 weeks in ACT. Independent assessments of parenting and child development are being made before the interventions, shortly afterwards, and at follow-up 6 months later. The primary outcome is child aggression, and the two main secondary outcomes are: (1) child cognitive and socio-emotional development and (2) harsh parenting. Longer-term outcomes will be investigated as the birth cohort is followed into late childhood, adolescence, and adulthood. DISCUSSION The Pelotas Trial of Parenting Interventions for Aggression (PIÁ) aims to evaluate the impact of two early parenting interventions on child aggression and several other key risk factors for the development of violence, including aspects of parenting and child cognition and socio-emotional functioning. The study is being carried out in a LMIC context where violence constitutes a major social and health burden. Since the two interventions are brief and, with modest levels of training, readily deliverable in LMIC settings, a demonstration that they benefit parenting and reduce risk factors for violence would be of major significance. TRIAL REGISTRATION Brazilian Ministry of Health Register of Clinical Trials, ID: RBR-2kwfsk . Registered on 6 June 2018.
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Rieder AD, Roth SL, Musyimi C, Ndetei D, Sassi RB, Mutiso V, Hall GB, Gonzalez A. Impact of maternal adverse childhood experiences on child socioemotional function in rural Kenya: Mediating role of maternal mental health. Dev Sci 2019; 22:e12833. [PMID: 30943319 DOI: 10.1111/desc.12833] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 01/19/2019] [Accepted: 03/20/2019] [Indexed: 01/20/2023]
Abstract
Mothers in low- and middle-income countries (LMIC) suffer heightened vulnerability for adverse childhood experiences (ACEs), which is exacerbated by the multitude of risk factors associated with poverty and may lead to increased risk of psychiatric disorder. The constellation of complex, co-occurring biological, environmental, social, economic and psychological risk factors are in turn transmitted to her child, conferring vulnerability for adverse development. This study examines the association between maternal intra- and extra-familial ACEs, maternal education and the mental health of her child, mediated by maternal mental health. Mother-child dyads (n = 121) in Machakos, Kenya were examined cross-sectionally using self-report measures of ACEs, maternal mental health and child internalizing and externalizing mental health problems. The four models proposed to examine the relationship between intra- and extra-familial maternal ACEs and child internalizing and externalizing problems demonstrated indirect pathways through maternal mental health. These effects were found to be conditional on levels of maternal education, which served as a protective factor at lower levels of maternal ACEs. These models demonstrate how the impact of ACEs persists across the lifespan resulting in a negative impact on maternal mental health and conferring further risk to subsequent generations. Elucidating the association between ACEs and subsequent intergenerational sequelae, especially in LMIC where risk is heightened, may improve targeted caregiver mental health programs for prevention and intervention.
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McLennan JD, MacMillan HL, Afifi TO, McTavish J, Gonzalez A, Waddell C. Routine ACEs screening is NOT recommended. Paediatr Child Health 2019; 24:272-273. [PMID: 31241059 DOI: 10.1093/pch/pxz042] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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154
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Gomez-Iturriaga A, Buchser D, Minguez P, Espinosa J, Perez F, Cacicedo J, Suarez F, Gonzalez A, Bilbao P, Casquero F. OC-0283 Pattern of relapse and dosimetric analysis of a single dose 19Gy HDR-brachytherapy phase II trial. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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155
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Büchser D, Casquero F, Espinosa J, Perez F, Minguez P, Martinez-Indart L, Suarez F, Gonzalez A, Cacicedo J, Miguel IS, Bilbao P, Gomez-Iturriaga A. EP-2153 Late toxicity after single dose HDR-BT and EBRT for prostate cancer: clinical-dosimetric predictors. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32573-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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156
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Fernández Arias M, Mazarico E, Gonzalez A, Muniesa M, Molinet C, Almeida L, Gómez Roig MD. Genetic risk assessment of thrombophilia in patients with adverse obstetric outcomes. PLoS One 2019; 14:e0211114. [PMID: 30811416 PMCID: PMC6392221 DOI: 10.1371/journal.pone.0211114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 01/08/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the incidence of inherited thrombophilias in patients with adverse obstetric outcomes and to compare detection rates of thrombophilias between standard blood tests and a novel genetic test. METHODS This is a case-control prospective study performed in Hospital Sant Joan de Déu in Barcelona, Spain. Cases had a history of intrauterine growth restriction requiring delivery before 34 weeks gestation, placental abruption before 34 weeks gestation, or severe preeclampsia. Controls had at least two normal, spontaneously conceived pregnancies at term, without complications or no underlying medical disease. At least 3 months after delivery, all case and control women underwent blood collection for standard blood tests for thrombophilias and saliva collection for the genetic test, which enables the diagnosis of 12 hereditary thrombophilias by analyzing genetic variants affecting different points of the blood coagulation cascade. RESULTS The study included 33 cases and 41 controls. There were no statistically significant differences between cases and controls in the standard blood tests for thrombophilias in plasma or the TiC test for genetic variables. One clinical-genetic model was generated using variables with the lowest P values: ABO, body mass index, C_rs5985, C_rs6025, and protein S. This model exhibited good prediction capacity, with an area under the curve of almost 0.7 (P <0.05), sensitivity of almost 67%, and specificity of 70%. CONCLUSION Although some association may exist between hypercoagulability and pregnancy outcomes, no significant direct correlation was observed between adverse obstetric outcomes and inherited thrombophilias when analyzed using either standard blood tests or the genetic test. Future studies with a larger sample size are required to create a clinical-genetic model that better discriminates women with a history of adverse pregnancy outcomes and an increased risk of poor outcomes in subsequent pregnancies.
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Andrews K, Gonzalez A. Contextual risk factors impacting the colonization and development of the intestinal microbiota: Implications for children in low- and middle-income countries. Dev Psychobiol 2019; 61:714-728. [PMID: 30663777 DOI: 10.1002/dev.21823] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 12/11/2022]
Abstract
Early adversities, such as poverty, maternal stress, and malnutrition, can affect the structure and functioning of the developing brain with implications for biological systems such as the intestinal microbiota. To date, most studies examining the impact of these risk factors on the development and functioning of the intestinal microbiota have primarily been conducted in high-income countries. However, arguably, children in low- and middle-income countries may be at increased risk given cumulative biological and psychosocial adversities during their development. Accumulating evidence in low- and middle-income countries has linked dysbiosis of the intestinal microbiota to child health outcomes such as stunting, malnutrition, and diarrheal diseases characterized by reduced microbial diversity and elevated pathogenic bacteria, which has implications for psychosocial outcomes. This review summarizes empirical findings that highlight the association between risk factors prevalent in low- and middle-income countries and the intestinal microbiota of children. Additionally, we briefly survey the current evidence regarding the effect of nutritional interventions on the microbial composition of children in low- and middle-income countries. We conclude that these empirical studies have the capacity to inform future research investigating the influence of preventive interventions on biological systems by targeting the predominant risk factors faced by children in low- and middle-income countries.
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La A, Nguyen T, Tran K, Sauble E, Tu D, Gonzalez A, Kidane TZ, Soriano C, Morgan J, Doan M, Tran K, Wang CY, Knutson MD, Linder MC. Mobilization of iron from ferritin: new steps and details. Metallomics 2019; 10:154-168. [PMID: 29260183 DOI: 10.1039/c7mt00284j] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Much evidence indicates that iron stored in ferritin is mobilized through protein degradation in lysosomes, but concerns about this process have lingered, and the mechanistic details of its aspects are lacking. In the studies presented here, 59Fe-labeled ferritin was induced by preloading hepatic (HepG2) cells with radiolabeled Fe. Placing these cells in a medium containing desferrioxamine resulted in the loss of ferritin-59Fe, but adding high concentrations of reducing agents or modulating the internal GSH concentration failed to alter the rates of ferritin-59Fe release. Confocal microscopy showed that Fe deprivation increased the movement of ferritin into lysosomes and hyperaccumulation was observed when lysosomal proteolysis was inhibited. It also resulted in the rapid movement of DMT1 to lysosomes, which was inhibited by bafilomycin. Ferrihydrite crystals isolated from purified rat liver/spleen ferritin were solubilized at pH 5 and 7 by GSH, ascorbate, citrate and lysosomal fluids obtained from livers and J774a.1 macrophages. The inhibition of DMT1/Nramp2 and siRNA knockdown of Nramp1 each reduced the transfer of 59Fe from lysosomes to the cytosol; and hepatocyte-specific knockout of DMT1 in mice prevented the release of Fe from the liver responding to EPO treatment, but did not inhibit lysosomal ferritin degradation. We conclude that ferritin-Fe mobilization does not occur through changes in cellular concentrations of reducing/chelating agents but by the coordinated movement of ferritin and DMT1 to lysosomes, where the ferrihydrite crystals exposed by ferritin degradation dissolve in the lysosomal fluid, and the reduced iron is transported back to the cytosol via DMT1 in hepatocytes, and by both DMT1 and Nramp1 in macrophages, prior to release into the blood or storage in ferritin.
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Spiegal S, Nyamuryekung’e S, Estell R, Cibils A, James D, Gonzalez A, McIntosh M. PSXI-34 Diet selection by Raramuri Criollo and Angus crossbreds in the Chihuahuan Desert. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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160
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Klopatek S, Rivera C, Gonzalez A, Rotz A, Mitloehner F. 249 Effects of Heat Stress Mitigation Techniques on Feedlot Cattle Performance, Environmental, and Economical Outcomes in a Hot Climate. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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161
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Tiwari A, Gonzalez A. Biological alterations affecting risk of adult psychopathology following childhood trauma: A review of sex differences. Clin Psychol Rev 2018; 66:69-79. [DOI: 10.1016/j.cpr.2018.01.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 01/22/2018] [Accepted: 01/29/2018] [Indexed: 01/10/2023]
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Nofech-Mozes J, Pereira J, Gonzalez A, Atkinson L. Cortisol secretion moderates the association between mother-infant attachment at 17 months and child behavior at age 5 years. Dev Psychobiol 2018; 61:239-253. [DOI: 10.1002/dev.21799] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/21/2018] [Accepted: 09/26/2018] [Indexed: 01/14/2023]
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Gonzalez A, Sar S, Artazcoz S, Carugno J. Laparoscopic Abdominal Cerclage. A Simplified Approach of a Challenging Procedure. J Minim Invasive Gynecol 2018. [DOI: 10.1016/j.jmig.2018.09.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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164
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Gonzalez A, Mirza M, Vergote I, Li Y, Hazard S, Clark R, Graybill W, Pothuri B, Monk B. A prospective evaluation of tolerability of niraparib dosing based upon baseline body weight (wt) and platelet (blplt) count: Blinded pooled interim safety data from the PRIMA Study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy285.150] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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165
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Anguera Palacios G, del Carpio L, Molina MA, Aguado C, Gras-Cabrerizo J, Leon X, Gonzalez-Cao M, Karachaliou N, Mozos A, Gonzalez A, Barnadas A, Rosell R, Majem M. Molecular analysis of NRAS, BRAF, C-KIT, ROS1, ALK and RET alterations in serial biopsies in sinonasal mucosal melanoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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166
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Higuera I, Gonzalez A, Aguado A, Martín M, Sancho S. Evaluation of two nutritional screening methods in oncological patients with active treatment. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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167
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Pardo Sanz A, Santoro C, Hinojar R, Garcia A, Salido Tahoces L, Abellas M, Marco A, Gonzalez A, Jimenez Nacher JJ, Del Val D, Del Prado S, Valverde M, Hernandez-Antolin R, Zamorano JL, Fernandez-Golfin C. 4921Differences in right ventricular function in patients with severe aortic stenosis with normal flow/low flow undergoing TAVI. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.4921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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168
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Eiros R, Treibel T, Scully P, Bhuva A, Patel K, Badiani S, Lopez B, Gonzalez A, Fontana M, Manistry C, Diez J, Moon JC. P6490Myocardial T2 in aortic stenosis: compensatory vasodilatation or subacute inflammation? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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169
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Pardo Sanz A, Abellas M, Garcia A, Rincon LM, Moya JL, Casas E, Gonzalez A, Hinojar R, Jimenez-Nacher JJ, Monteagudo JM, Rodriguez D, Franco E, Moreno J, Zamorano JL, Fernandez-Golfin C. P6468Echocardiographic predictors for early recurrence of atrial fibrillation undergoing catheter ablation. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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170
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Almanza-Sepulveda ML, Chico E, Gonzalez A, Hall GB, Steiner M, Fleming AS. Executive function in teen and adult women: Association with maternal status and early adversity. Dev Psychobiol 2018; 60:849-861. [DOI: 10.1002/dev.21766] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 01/07/2023]
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171
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Ludmer JA, Gonzalez A, Kennedy J, Masellis M, Meinz P, Atkinson L. Association between maternal childhood maltreatment and mother-infant attachment disorganization: Moderation by maternal oxytocin receptor gene and cortisol secretion. Horm Behav 2018; 102:23-33. [PMID: 29673618 DOI: 10.1016/j.yhbeh.2018.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/10/2018] [Accepted: 04/13/2018] [Indexed: 10/17/2022]
Abstract
This study examined maternal oxytocin receptor (OXTR, rs53576) genotype and cortisol secretion as moderators of the relation between maternal childhood maltreatment history and disorganized mother-infant attachment in the Strange Situation Procedure (SSP). A community sample of 314 mother-infant dyads completed the SSP at infant age 17 months. Self-reported maltreatment history more strongly predicted mother-infant attachment disorganization score and disorganized classification for mothers with more plasticity alleles of OXTR (G), relative to mothers with fewer plasticity alleles. Maltreatment history also more strongly predicted mother-infant attachment disorganization score and classification for mothers with higher SSP cortisol secretion, relative to mothers with lower SSP cortisol secretion. Findings indicate that maltreatment history is related to disorganization in the next generation, but that this relation depends on maternal genetic characteristics and cortisol.
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Mazorra Z, Popa X, Garcia B, Huerta V, Viada C, Neninger E, Rodriguez P, Gonzalez Z, Gonzalez A, Crombet T. PO-486 Surrogate biomarkers of clinical efficacy in stage IIIB/IV non-small-cell lung cancer patients treated with an optimised EGF-based vaccination schedule. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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173
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England-Mason G, Casey R, Ferro M, MacMillan HL, Tonmyr L, Gonzalez A. Child maltreatment and adult multimorbidity: results from the Canadian Community Health Survey. Canadian Journal of Public Health 2018; 109:561-572. [PMID: 29981095 DOI: 10.17269/s41997-018-0069-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/03/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study investigated associations between three types of child maltreatment (exposure to intimate partner violence, sexual, and physical abuse) and multimorbidity (chronic physical conditions, pain conditions, and mental disorders) in adults. METHODS Multinomial logistic regression was used to analyze weighted data from the 2012 Canadian Community Health Survey (CCHS - MH 2012), a representative population sample (N = 23,846) of respondents ages 18+. RESULTS All three subtypes of child maltreatment independently predicted increased odds of experiencing multimorbidity as an adult, while adjusting for covariates (adjusted odds ratios ranged from 1.34 (95% CI = 1.00, 1.80) to 4.87 (95% CI = 2.75, 8.63)). A dose-response relationship between the number of child maltreatment subtypes and risk for multimorbidity was also observed (adjusted odds ratios ranged from 1.38 (95% CI = 1.11, 1.73) to 10.96 (95% CI = 6.12, 19.64)). CONCLUSION The current results highlight the importance of considering a range of childhood adversities and suggest that public health approaches that aim to decrease the prevalence and severity of child maltreatment have the potential to ameliorate adult multimorbidities. Future research is encouraged to investigate these issues using longitudinal population-level data.
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Sanmamed MF, Perez-Gracia JL, Schalper KA, Fusco JP, Gonzalez A, Rodriguez-Ruiz ME, Oñate C, Perez G, Alfaro C, Martín-Algarra S, Andueza MP, Gurpide A, Morgado M, Wang J, Bacchiocchi A, Halaban R, Kluger H, Chen L, Sznol M, Melero I. Changes in serum interleukin-8 (IL-8) levels reflect and predict response to anti-PD-1 treatment in melanoma and non-small-cell lung cancer patients. Ann Oncol 2018; 28:1988-1995. [PMID: 28595336 DOI: 10.1093/annonc/mdx190] [Citation(s) in RCA: 298] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Surrogate biomarkers of efficacy are needed for anti-PD1/PD-L1 therapy, given the existence of delayed responses and pseudo-progressions. We evaluated changes in serum IL-8 levels as a biomarker of response to anti-PD-1 blockade in melanoma and non-small-cell lung cancer (NSCLC) patients. Patients and methods Metastatic melanoma and NSCLC patients treated with nivolumab or pembrolizumab alone or nivolumab plus ipilimumab were studied. Serum was collected at baseline; at 2-4 weeks after the first dose; and at the time-points of response evaluation. Serum IL-8 levels were determined by sandwich ELISA. Changes in serum IL-8 levels were compared with the Wilcoxon test and their strength of association with response was assessed with the Mann-Whitney test. Accuracy of changes in IL-8 levels to predict response was estimated using receiver operation characteristics curves. Results Twenty-nine melanoma patients treated with nivolumab or pembrolizumab were studied. In responding patients, serum IL-8 levels significantly decreased between baseline and best response (P <0.001), and significantly increased upon progression (P = 0.004). In non-responders, IL-8 levels significantly increased between baseline and progression (P = 0.013). Early changes in serum IL-8 levels (2-4 weeks after treatment initiation) were strongly associated with response (P <0.001). These observations were validated in 19 NSCLC patients treated with nivolumab or pembrolizumab (P = 0.001), and in 15 melanoma patients treated with nivolumab plus ipilimumab (P <0.001). Early decreases in serum IL-8 levels were associated with longer overall survival in melanoma (P = 0.001) and NSCLC (P = 0.015) patients. Serum IL-8 levels also correctly reflected true response in three cancer patients presenting pseudoprogression. Conclusions Changes in serum IL-8 levels could be used to monitor and predict clinical benefit from immune checkpoint blockade in melanoma and NSCLC patients.
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Pereira J, Ludmer JA, Gonzalez A, Atkinson L. Mothers' Personal and Interpersonal Function as Potential Mediators Between Maternal Maltreatment History and Child Behavior Problems. CHILD MALTREATMENT 2018; 23:147-156. [PMID: 29034733 DOI: 10.1177/1077559517734937] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study examined maternal depressive symptoms, social support, parenting, and adult attachment as mediators explaining the relation between maternal childhood maltreatment and child behavior in offspring. We assessed a community sample of 96 mother-child dyads. At child age 16 months, mothers self-reported maltreatment history, adult attachment, depressive symptoms, and social support, and maternal sensitivity was assessed via 2 hr of direct behavioral observation. Maternal reports of child behavior were collected at 5 years. Single and parallel mediation models were constructed. Only maternal depressive symptoms mediated the relation between maternal maltreatment history and children's internalizing problems. Maternal sensitivity emerged as a suppressor variable. With respect to the relation between maternal maltreatment history and children's externalizing problems, when entered singly, maternal depressive symptoms, social support, and avoidant attachment emerged as mediators. When examined in parallel, only maternal depressive symptoms and avoidant attachment accounted for unique mediating variance. Findings have implications with respect to important maternal factors that might be targeted to reduce the probability of maladaptive child behavior.
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