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Higher Incidence of Common Polymorphisms in the Genes of Folate and Methionine Cycles in Children With Orofacial Clefs and Congenital Heart Defects Compared to their Unaffected Siblings 与未受影响的兄弟姐妹相比,口唇裂和先天性心脏缺陷患儿叶酸和蛋氨酸循环基因中常见多态性的发生率更高。
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-10-29 DOI: 10.1002/bdr2.2408
Nataša Karas Kuželički, Alenka Šmid, Maša Vidmar Golja, Tina Kek, Andreja Eberlinc, Borut Geršak, Uroš Mazič, Irena Mlinarič-Raščan, Ksenija Geršak

Background

Uninterrupted folate metabolism plays a vital role in embryonic development, ensuring a supply of one-carbon-activated folate cofactors for essential processes. Folate deficiency has been implicated in the development of orofacial clefts (OFC) and congenital heart disease (CHD). Although both malformations have been extensively studied in lieu of folate deficiency, the results of corresponding studies are ambiguous due to the interplay of maternal and fetal genomes controlling folate metabolism in the developing fetus.

Methods

We used the innovative study design to compare affected and unaffected siblings from the same mother, thus minimizing the effect of the maternal genome. Thus, it might be possible to identify genetic markers of congenital malformations that pertain exclusively to the child. This study compared demographic and environmental factors between OFC or CHD-affected and unaffected pregnancies as well as the presence of polymorphisms in genes of folate metabolism between OFC or CHD-affected and unaffected siblings.

Results

Only the maternal fever in the first trimester was a risk factor for OFC, whereas the maternal advanced age, medication administration, and common polymorphism in the FPGS gene increased the risk of CHD formation. Both OFC and CHD formation were associated with a higher number of variant loci in genes of folate–methionine cycles.

Conclusions

Both OFC and CHD formation were associated with a higher number of mutated loci in genes of folate–methionine cycles, indicating polygenic and possibly multifactorial inheritance.

背景:不间断的叶酸代谢在胚胎发育过程中起着至关重要的作用,它确保了重要过程所需的一碳活化叶酸辅助因子的供应。叶酸缺乏与口唇裂(OFC)和先天性心脏病(CHD)的发生有关。虽然这两种畸形已被广泛研究以替代叶酸缺乏,但由于母体和胎儿基因组在胎儿发育过程中控制叶酸代谢的相互作用,相应的研究结果并不明确:我们采用了创新性的研究设计,将来自同一母亲的受影响和未受影响的兄弟姐妹进行比较,从而将母体基因组的影响降至最低。因此,我们有可能找出只与孩子有关的先天性畸形遗传标记。本研究比较了受 OFC 或 CHD 影响的妊娠与未受影响的妊娠之间的人口和环境因素,以及受 OFC 或 CHD 影响的兄弟姐妹与未受影响的兄弟姐妹之间叶酸代谢基因的多态性:结果:只有孕妇在怀孕头三个月发烧才是导致OFC的风险因素,而孕妇高龄、服用药物和FPGS基因的常见多态性则会增加CHD形成的风险。OFC和CHD的形成都与叶酸-蛋氨酸循环基因中较多的变异位点有关:结论:OFC和CHD的形成都与叶酸-蛋氨酸循环基因中较多的变异位点有关,这表明是多基因遗传,也可能是多因素遗传。
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引用次数: 0
Pregnancy and Long-Term Postnatal Outcomes of Congenital Sacrococcygeal Teratoma: A Single Institution's 18-Year Experience 先天性骶尾部畸胎瘤的妊娠和产后长期疗效:一家医疗机构的 18 年经验
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-10-18 DOI: 10.1002/bdr2.2405
Ava D. Mandelbaum, Raphael C. Sun, Amanda J. H. Kim, Roya Sohaey, Melanie Hakar, Saharnaz Tavoosi, Lucy Ward, Monica Rincon, Allison J. Allen, Stephanie Dukhovny, Andrew H. Chon

Objective

The objective of this study is to evaluate outcomes of fetal sacrococcygeal teratoma (SCT) from an academic tertiary center.

Study Design

This is a retrospective study evaluating pregnancy and postnatal outcomes of fetal SCT management at a single institution between 2006 and 2023. Results are reported as median (range).

Results

Fourteen patients with fetal SCT were studied. Hydrops fetalis occurred in 2 (14.3%) cases. Pregnancy course included expectant management in 12 (85.7%) and palliative preterm induction in 1 patient (7.1%). Indications for delivering timing included fetal deterioration in 7 patients (50%), preeclampsia in 3 (21.4%), elective induction of delivery in 3 (21.4%), and preterm labor in 1 (7.1%). Delivery GA was 36.4 weeks (26.4–40.1 weeks), with 11 (78.5%) cesareans and 3 (21.4%) vaginal deliveries. There were 13 (92.9%) live births and 11 (78.6%) long-term survivors. Postnatal resection pathology demonstrated 7 (53.8%) mature, 3 (23.1%) immature, and 3 (23.1%) malignant SCTs. Of the 11 long-term survivors, 3 (27.3%) had teratoma recurrences, including 2 (18.2%) with metastatic disease requiring chemotherapy. Notable long-term complications involved gastrointestinal (n = 7, 63.6%), genitourinary (n = 4, 36.4%), and musculoskeletal (n = 2, 18.2%) systems.

Conclusion

SCT confers significant morbidity to both the pregnant patient and neonate. Multidisciplinary prenatal and postnatal care is needed to comprehensively manage this complex condition.

研究目的 本研究旨在评估一家三级学术中心的胎儿骶尾部畸胎瘤(SCT)的治疗效果。 研究设计 这是一项回顾性研究,评估 2006 年至 2023 年间在一家医疗机构进行胎儿骶尾部畸胎瘤治疗的妊娠和产后结局。结果以中位数(范围)报告。 结果 研究了 14 例胎儿 SCT 患者。2例(14.3%)发生了胎儿水肿。12名患者(85.7%)的妊娠过程包括预产期管理,1名患者(7.1%)的妊娠过程包括姑息性早产引产。时机分娩的指征包括:7 名患者(50%)的胎儿情况恶化、3 名患者(21.4%)的子痫前期、3 名患者(21.4%)的选择性引产和 1 名患者(7.1%)的早产。产程为 36.4 周(26.4-40.1 周),其中 11 例(78.5%)剖宫产,3 例(21.4%)阴道分娩。活产 13 例(92.9%),长期存活 11 例(78.6%)。产后切除病理显示,7 例(53.8%)为成熟性 SCT,3 例(23.1%)为不成熟性 SCT,3 例(23.1%)为恶性 SCT。在11名长期存活者中,3人(27.3%)畸胎瘤复发,其中2人(18.2%)患有转移性疾病,需要接受化疗。值得注意的长期并发症涉及胃肠道系统(7 例,占 63.6%)、泌尿生殖系统(4 例,占 36.4%)和肌肉骨骼系统(2 例,占 18.2%)。 结论 SCT 会给孕妇和新生儿带来严重的发病率。需要多学科的产前和产后护理来全面处理这种复杂的病症。
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引用次数: 0
Genetic Variants in METTL16 Affect the Risk of Non-Syndromic Orofacial Clefts METTL16 基因变异影响非综合征性口腔颚裂的风险
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-10-15 DOI: 10.1002/bdr2.2403
Xinze Xu, Xiaofeng Li, Minxuan Han, Changyue Xing, Guirong Zhu, Xing Cui, Lin Wang, Shu Lou, Yongchu Pan

Objective

N6-methyladenosine (m6A) is the most prevalent modification of RNA in eukaryotes which is associated with many cellular processes and diseases. Here, our objective is to explore whether genetic variants in m6A modification genes are associated with the risk of non-syndrome orofacial clefts (NSOCs).

Methods

The transmission disequilibrium test (TDT) was performed to calculate the association between single nucleotide polymorphisms (SNPs) in m6A modification genes and NSOCs risk in 944 case-parent trios. The function of SNP was predicted by HaploReg, RegulomeDB and histone enrichment data. The expression quantitative trait locus (eQTL) analysis was examined using Genotype-Tissue Expression (GTEx) and eQTLGen. The role of gene in the development of NSOCs was assessed with correlation and enrichment analysis based on gene expression data in mice craniofacial tissue and zebrafish embryo.

Results

We identified that rs8078195 (A > C) in METTL16 was suggestively associated with the increased risk of NSOCs (OR = 1.32, p = 1.80E − 03). The region surrounding rs8078195 was subjected to deoxyribonuclease hypersensitivity and enriched with multiple histone modifications. In addition, it had a significant eQTL effect with METTL16 in skin tissue and human peripheral blood, which played an important role in NSOCs development. Bioinformatic analysis indicated that METTL16 contributed to the development of NSOCs probably by regulating cell cycle process.

Conclusions

Rs8078195 in METTL16 was associated with the occurrence of NSOCs.

目的 N6-甲基腺苷(m6A)是真核生物中最常见的 RNA 修饰,与许多细胞过程和疾病有关。在此,我们的目的是探讨 m6A 修饰基因的遗传变异是否与非综合征口面裂(NSOCs)的风险有关。 方法 采用传递不平衡检验(TDT)计算 944 例父母三人中 m6A 修饰基因中单核苷酸多态性(SNPs)与非综合征口面裂(NSOCs)风险之间的关联。通过HaploReg、RegulomeDB和组蛋白富集数据预测了SNP的功能。利用基因型-组织表达(GTEx)和 eQTLGen 对表达定量性状位点(eQTL)进行了分析,并根据小鼠颅面部组织和斑马鱼胚胎中的基因表达数据,通过相关性和富集分析评估了该基因在 NSOCs 发病中的作用。 结果 我们发现,METTL16 中的 rs8078195 (A > C) 与 NSOC 风险的增加有提示性关联(OR = 1.32,p = 1.80E-03)。围绕 rs8078195 的区域受到脱氧核糖核酸酶超敏反应的影响,富含多种组蛋白修饰。此外,它与皮肤组织和人体外周血中的 METTL16 具有显著的 eQTL 效应,在 NSOCs 的发生发展中起着重要作用。生物信息学分析表明,METTL16 可能通过调控细胞周期过程促进了 NSOCs 的发展。 结论 METTL16 中的 Rs8078195 与 NSOCs 的发生有关。
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引用次数: 0
Cardiovascular Ultrasound Predictors for Brain Alterations in Fetuses With Heart Disease: An Exploratory Review of the Literature 心血管超声预测患有心脏病的胎儿脑部变化:文献探索性综述
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-10-14 DOI: 10.1002/bdr2.2402
María Alejandra Aguirre Martínez, Luisa Fernanda Cano Bautista, Mauricio Hernández-Carrillo, Armicson Felipe Solano Montero

Objective

To identify cardiovascular ultrasound predictors for brain anomalies in fetuses with heart disease.

Methods

A literature search was performed in the following databases: MEDLINE through OVID, EMBASE, Cochrane Registry Center for Controlled Trials (CENTRAL), and LILACS, from their inception until May 2023. Clinical studies, cross-sectional studies, case–control studies, cohorts, and systematic reviews were included. Data extraction was performed, and the risk of bias was assessed using the QUADAS-2 tool.

Results

Among 2705 studies evaluated, after filtering information, 10 articles were selected that met the inclusion criteria. These studies noted the following outcomes: a decrease in fetal head circumference, changes in brain maturation measured in days, decreased depth of brain fissures, and a decrease in total brain volume. The studies show a statistically significant correlation with the presence of the following cardiovascular predictors: low or mixed oxygen content in the ascending aorta (p < 0.001), retrograde flow in the aortic arch (p < 0.001), lower z values of the MCA-PI (p < 0.05), higher UA-PI z values (p < 0.01), and lower CPR (p < 0.05). In addition, lower values of left ventricular flow (p < 0.01), ductus arteriosus (p < 0.0001), and combined cardiac output index (p < 0.01) were reported.

Conclusions

This review describes the most relevant evidence correlating the effects of hemodynamic changes that lead to states of chronic hypoxia related to the aforementioned changes in the central nervous system.

目的 确定心血管超声预测心脏病胎儿脑异常的指标。 方法 在以下数据库中进行文献检索:MEDLINE through OVID、EMBASE、Cochrane Registry Center for Controlled Trials (CENTRAL) 和 LILACS。纳入了临床研究、横断面研究、病例对照研究、队列研究和系统综述。进行了数据提取,并使用 QUADAS-2 工具评估了偏倚风险。 结果 在评估的 2705 项研究中,经过信息筛选,选出了 10 篇符合纳入标准的文章。这些研究指出了以下结果:胎儿头围减小、以天数为单位的大脑成熟度变化、脑裂深度减小以及大脑总体积减小。这些研究显示,以下心血管预测因素与胎儿的存在有显著的统计学相关性:升主动脉氧含量低或混合(p < 0.001)、主动脉弓逆流(p < 0.001)、MCA-PI z 值低(p < 0.05)、UA-PI z 值高(p < 0.01)和心肺复苏率低(p < 0.05)。此外,左心室血流(p <0.01)、动脉导管(p <0.0001)和合并心输出量指数(p <0.01)的值也较低。 结论 本综述描述了最相关的证据,这些证据表明,导致慢性缺氧状态的血液动力学变化的影响与中枢神经系统的上述变化有关。
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引用次数: 0
Congenital Anomalies of the Gastrointestinal Tract in Conjunction of Congenital Heart Diseases in Infants With Trisomy 21 21 三体综合征婴儿先天性胃肠道畸形与先天性心脏病并发症。
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-10-09 DOI: 10.1002/bdr2.2406
Allison M. Peluso, Mohsen A. A. Farghaly, Hany Aly, Mohamed A. Mohamed

Background

Infants with Trisomy 21 are known to have increased incidence congenital anomalies including congenital heart diseases (CHD) and congenital gastrointestinal anomalies. It is not known if there are patterns of coexistence.

Objectives

To examine the coexistence of CHD with various gastrointestinal anomalies in infants with Trisomy 21.

Methods

We assessed a sample of infants with Trisomy 21 from the National Inpatient Sample (NIS), and its KID subversion, produced by the Healthcare Cost and Utilization Project for 2003–2015. We identified CHD using international classification of diseases version 9 (ICD9) and categorized them into four groups: left sided lesions, right sided lesions, conotruncal lesions, and shunt lesions. We identified small intestinal atresia and Hirschsprung disease with ICD9 codes.

Results

The sample included 81,561 newborn infants diagnosed with Trisomy 21; 45% of them had CHD; 4.7% had small intestinal atresia, and 1.6% had Hirschsprung disease. All subcategories of CHD were associated with increased incidence of both small intestinal atresia and Hirschsprung disease, p value < 0.05 compared to infants with Trisomy 21 who did not have CHD.

Conclusions

Among infants with Trisomy 21, the presence of CHD increased the odds of a concomitant congenital GI anomaly.

背景:众所周知,21 三体综合征婴儿的先天性畸形发病率较高,包括先天性心脏病(CHD)和先天性胃肠道畸形。目前尚不清楚是否存在共存模式:研究 21 三体综合征婴儿的先天性心脏病与各种胃肠道畸形并存的情况:我们评估了2003-2015年全国住院病人样本(NIS)及其KID子版本中的21三体综合征婴儿样本,该样本由医疗成本与利用项目(Healthcare Cost and Utilization Project)编制。我们使用国际疾病分类第 9 版(ICD9)确定了先天性心脏病,并将其分为四组:左侧病变、右侧病变、锥体病变和分流病变。我们用 ICD9 编码识别了小肠闭锁和赫氏prung 病:结果:样本包括 81561 名确诊为 21 三体综合征的新生儿,其中 45% 患有先天性心脏病,4.7% 患有小肠闭锁,1.6% 患有赫氏普隆病。所有子类别的先天性心脏病都与小肠闭锁和赫氏普隆病的发病率增加有关,P 值为 结论:在 21 三体综合征婴儿中,存在先天性心脏病会增加同时出现先天性消化道异常的几率。
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引用次数: 0
Correction to “Pilot Test of Prenatal Surveillance for Birth Defects in South Texas” 对 "德克萨斯州南部出生缺陷产前监测试点测试 "的更正。
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-09-23 DOI: 10.1002/bdr2.2401

Ethen, M. K., M. A. Canfield, P. de Forest, and J. Trevino. 2007. “Pilot Test of Prenatal Surveillance for Birth Defects in South Texas.” Birth Defects Research Part A: Clinical and Molecular Teratology 79: 788–791. https://doi.org/10.1002/bdra.20405.

In the originally published article, author Peter de Forest was inadvertently left off the author list. This has been corrected in the online version of the article.

We apologize for this error.

Ethen, M. K., M. A. Canfield, P. de Forest, and J. Trevino.2007."德克萨斯州南部出生缺陷产前监测试点测试"。出生缺陷研究 A 部分:临床和分子畸形学 79: 788-791。https://doi.org/10.1002/bdra.20405.In,在最初发表的文章中,作者 Peter de Forest 因疏忽而被排除在作者名单之外。我们对这一错误表示歉意。
{"title":"Correction to “Pilot Test of Prenatal Surveillance for Birth Defects in South Texas”","authors":"","doi":"10.1002/bdr2.2401","DOIUrl":"10.1002/bdr2.2401","url":null,"abstract":"<p>Ethen, M. K., M. A. Canfield, P. de Forest, and J. Trevino. 2007. “Pilot Test of Prenatal Surveillance for Birth Defects in South Texas.” <i>Birth Defects Research Part A: Clinical and Molecular Teratology</i> 79: 788–791. https://doi.org/10.1002/bdra.20405.</p><p>In the originally published article, author Peter de Forest was inadvertently left off the author list. This has been corrected in the online version of the article.</p><p>We apologize for this error.</p>","PeriodicalId":9121,"journal":{"name":"Birth Defects Research","volume":"116 9","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/bdr2.2401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association Between Self-Reported Infections and Seropositivity Among Pregnant Women With Gastroschisis: A Case Control Study, With Emphasis on Chlamydia trachomatis 患有胃泌素瘤的孕妇自述感染与血清阳性之间的关系:以沙眼衣原体为重点的病例对照研究
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-09-17 DOI: 10.1002/bdr2.2400
M. L. Feldkamp, E. Baum-Jones, E. Y. Enioutina, S. Krikov, K. Kamath
<div> <section> <h3> Background</h3> <p>Gastroschisis is a birth defect with the greatest risk among women <20 years of age.</p> </section> <section> <h3> Methods</h3> <p>Pregnant women attending the University of Utah's Maternal-Fetal Medicine Diagnostic Center between 2011 and 2017 for either their routine diagnostic ultrasound or referral were recruited (cases: pregnant women with fetal gastroschisis, <i>n</i> = 53 participated/57, 93%; controls: pregnant women without fetal abnormalities, <i>n</i> = 102 participated/120, 85%). A clinic coordinator consented and interviewed women and obtained a blood sample and prenatal medical records. We evaluated self-reported maternal characteristics, risk factors, and infections. To assess pathogen seropositivity we used Serimmune's Serum Epitope Repertoire Analysis validated 35 pathogen panels and <i>Chlamydia trachomatis</i> and compared seropositivity to self-report and prenatal medical record screening to assess sensitivity.</p> </section> <section> <h3> Results</h3> <p>Cases were more likely to report a younger age at sexual debut (<i>p</i> = <0.01), more sexual partners (<i>p</i> = 0.02), being unmarried (<i>p</i> < 0.01), changing partners between pregnancies (<i>p</i> = <0.01), smoking cigarettes (<0.01), and a recent sexually transmitted infection (STI) (<i>p</i> = 0.02). No differences were observed for self-report of illicit drug use or periconceptional urinary tract infections. Cases had a higher seropositivity for cytomegalovirus (<i>p</i> = 0.01). No differences were observed for herpes simplex I, II, or Epstein–Barr. Though based on small numbers, <i>C. trachomatis</i> seropositivity was highest in cases (17%) compared to controls (8.8%) with the highest proportion observed in case women <20 years of age (cases 33%; controls 0%). Any STI (self-report or seropositivity) was also highest among cases <20 years of age (cases 47%; controls 0%). Among <i>C. trachomatis</i> seropositive women, self-report and prenatal medical record sensitivity was 27.8% and 3%, respectively.</p> </section> <section> <h3> Conclusions</h3> <p>Cases were more likely to engage in behaviors that can increase their risk of exposure to sexually transmitted pathogens. Case women <20 years of age had the highest proportion of <i>C. trachomatis</i> seropositivity and any STI. Prenatal medical records and self-report were inadequate to identify a recent chlamydial infection whereas, the SERA assay is a novel approach for evaluating subclinical infections that may impact the developing embryo.</p>
背景 胃畸形是一种出生缺陷,在 20 岁女性中风险最大。 方法 招募 2011 年至 2017 年期间到犹他大学母胎医学诊断中心进行常规超声诊断或转诊的孕妇(病例:患有胎儿胃裂的孕妇,n = 53 人/57 人,占 93%;对照:没有胎儿畸形的孕妇,n = 102 人/120 人,占 85%)。一名诊所协调员在征得孕妇同意后对其进行了访谈,并获取了血样和产前病历。我们对孕妇自我报告的特征、风险因素和感染情况进行了评估。为了评估病原体血清阳性率,我们使用了 Serimmune 的血清表位汇分析验证了 35 种病原体和沙眼衣原体,并将血清阳性率与自我报告和产前病历筛查进行了比较,以评估敏感性。 结果 病例更有可能报告初次性行为的年龄较小(p = <0.01)、性伴侣较多(p = 0.02)、未婚(p = <0.01)、在两次怀孕之间更换性伴侣(p = <0.01)、吸烟(<0.01)以及最近感染过性传播疾病(STI)(p = 0.02)。在自我报告使用非法药物或围产期尿路感染方面没有观察到差异。病例的巨细胞病毒血清阳性率较高(p = 0.01)。在单纯疱疹 I 型、II 型或 Epstein-Barr 病毒方面未观察到差异。沙眼衣原体血清阳性率在病例中最高(17%),而在对照组中仅为 8.8%,病例中年龄在 20 岁以下的女性比例最高(病例为 33%;对照组为 0%)。任何性传播感染(自我报告或血清阳性)在病例 <20 岁中的比例也最高(病例 47%;对照组 0%)。在沙眼衣原体血清阳性的妇女中,自我报告和产前病历的敏感性分别为 27.8% 和 3%。 结论 病例更有可能从事会增加其接触性传播病原体风险的行为。20 岁的病例妇女沙眼衣原体血清阳性和任何性传播感染的比例最高。产前医疗记录和自我报告不足以确定最近是否有衣原体感染,而 SERA 检测法是评估可能影响发育中胚胎的亚临床感染的一种新方法。
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引用次数: 0
Community-Engaged Research and the Use of Open Access ToxVal/ToxRef In Vivo Databases and New Approach Methodologies (NAM) to Address Human Health Risks From Environmental Contaminants 社区参与研究以及使用开放式 ToxVal/ToxRef 活体数据库和新方法 (NAM) 解决环境污染物对人类健康造成的风险问题
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-09-12 DOI: 10.1002/bdr2.2395
Marilyn Silva, Shosha Capps, Jonathan K. London

Background

The paper analyzes opportunities for integrating Open access resources (Abstract Sifter, US EPA and NTP Toxicity Value and Toxicity Reference [ToxVal/ToxRefDB]) and New Approach Methodologies (NAM) integration into Community Engaged Research (CEnR).

Methods

CompTox Chemicals Dashboard and Integrated Chemical Environment with in vivo ToxVal/ToxRef and NAMs (in vitro) databases are presented in three case studies to show how these resources could be used in Pilot Projects involving Community Engaged Research (CEnR) from the University of California, Davis, Environmental Health Sciences Center.

Results

Case #1 developed a novel assay methodology for testing pesticide toxicity. Case #2 involved detection of water contaminants from wildfire ash and Case #3 involved contaminants on Tribal Lands. Abstract Sifter/ToxVal/ToxRefDB regulatory data and NAMs could be used to screen/prioritize risks from exposure to metals, PAHs and PFAS from wildfire ash leached into water and to investigate activities of environmental toxins (e.g., pesticides) on Tribal lands. Open access NAMs and computational tools can apply to detection of sensitive biological activities in potential or known adverse outcome pathways to predict points of departure (POD) for comparison with regulatory values for hazard identification. Open access Systematic Empirical Evaluation of Models or biomonitoring exposures are available for human subpopulations and can be used to determine bioactivity (POD) to exposure ratio to facilitate mitigation.

Conclusions

These resources help prioritize chemical toxicity and facilitate regulatory decisions and health protective policies that can aid stakeholders in deciding on needed research. Insights into exposure risks can aid environmental justice and health equity advocates.

背景 本文分析了将开放存取资源(Abstract Sifter、US EPA 和 NTP 毒性值和毒性参考 [ToxVal/ToxRefDB])和新方法 (NAM) 整合到社区参与研究 (CEnR) 中的机会。 方法 在三个案例研究中介绍了 CompTox 化学品仪表板和集成化学环境,以及体内 ToxVal/ToxRef 和 NAMs(体外)数据库,以说明如何将这些资源用于加州大学戴维斯分校环境健康科学中心的社区参与研究 (CEnR) 试点项目。 结果 案例 1 开发了一种用于检测农药毒性的新型检测方法。案例 2 涉及检测野火灰烬中的水污染物,案例 3 涉及部落土地上的污染物。摘要 Sifter/ToxVal/ToxRefDB 监管数据和 NAMs 可用于筛选/优先处理野火灰烬浸入水中的金属、多环芳烃和全氟辛烷磺酸的暴露风险,以及调查部落土地上环境毒素(如农药)的活动。开放存取的 NAM 和计算工具可用于检测潜在或已知不利结果途径中的敏感生物活动,以预测出发点 (POD),并与监管值进行比较,从而确定危害。开放存取的系统经验评估模型或生物监测暴露可用于人类亚群,并可用于确定生物活性(POD)与暴露的比率,以促进缓解。 结论 这些资源有助于确定化学品毒性的优先次序,促进监管决策和健康保护政策的制定,从而帮助利益相关者决定所需的研究。对暴露风险的深入了解有助于环境正义和健康公平的倡导者。
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引用次数: 0
Survival of Children With Critical Congenital Heart Defects in the National Birth Defects Prevention Study 全国出生缺陷预防研究中先天性心脏病患儿的存活率
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-09-11 DOI: 10.1002/bdr2.2394
Nina E. Forestieri, Andrew F. Olshan, Matthew E. Oster, Elizabeth C. Ailes, Michael P. Fundora, Sarah C. Fisher, Charles Shumate, Paul A. Romitti, Rebecca F. Liberman, Wendy N. Nembhard, Suzan L. Carmichael, Tania A. Desrosiers, The National Birth Defects Prevention Study

Background

Critical congenital heart defects (CCHDs) are associated with considerable morbidity and mortality. This study estimated survival of children with nonsyndromic CCHDs and evaluated relationships between exposures of interest and survival by CCHD severity (univentricular or biventricular function).

Methods

This analysis included 4380 infants with CCHDs (cases) born during 1999–2011 and enrolled in the National Birth Defects Prevention Study, a multisite, population-based case–control study of major birth defects. Cases were linked to state death files. Nonparametric Kaplan–Meier survival functions were used to estimate 1- and 5-year survival probabilities overall and by severity group (univentricular/biventricular) stratified by demographic and clinical exposure variables of interest. The log-rank test was used to determine whether stratified survival curves were equivalent. Survival and 95% confidence intervals (CIs) were also estimated using Cox proportional hazards modeling adjusted for maternal age, education, race/ethnicity, study site, and birth year.

Results

One- and five-year survival rates were 85.8% (CI 84.7–86.8) and 83.7% (CI 82.5–84.9), respectively. Univentricular 5-year survival was lower than biventricular case survival [65.3% (CI 61.7–68.5) vs. 89.0% (CI 87.8–90.1; p < 0.001)]. Clinical factors (e.g. preterm birth, low birthweight, and complex/multiple defects) were associated with lower survival in each severity group. Sociodemographic factors (non-Hispanic Black race/ethnicity, <high school education, smoking, and lower household income) were only associated with survival among biventricular cases.

Conclusions

Mortality among children with CCHDs occurred primarily in the first year of life. Survival was lower for those with univentricular defects, and social determinants of health were most important in predicting survival for those with biventricular defects.

背景 严重先天性心脏缺陷(CCHD)与相当高的发病率和死亡率有关。本研究估算了非综合征先天性心脏病患儿的存活率,并根据先天性心脏病的严重程度(单心室或双心室功能)评估了相关暴露与存活率之间的关系。 方法 该分析包括 1999-2011 年间出生的 4380 名患有 CCHD 的婴儿(病例),他们都参加了全国出生缺陷预防研究(National Birth Defects Prevention Study),该研究是一项针对重大出生缺陷的多地点、基于人群的病例对照研究。病例与州死亡档案相关联。采用非参数 Kaplan-Meier 生存函数估算了总体的 1 年和 5 年生存概率,以及根据人口统计学和临床暴露变量分层的严重程度组(单心室/双心室)的生存概率。对数秩检验用于确定分层生存曲线是否相同。此外,还根据产妇年龄、教育程度、种族/民族、研究地点和出生年份,使用 Cox 比例危险度模型估算了存活率和 95% 置信区间 (CI)。 结果 一年和五年存活率分别为 85.8%(CI 84.7-86.8)和 83.7%(CI 82.5-84.9)。单心室病例的 5 年存活率低于双心室病例[65.3% (CI 61.7-68.5) vs. 89.0% (CI 87.8-90.1; p <0.001)]。临床因素(如早产、低出生体重和复杂/多重缺陷)与各严重程度组中较低的存活率有关。社会人口因素(非西班牙裔黑人种族/人种、高中教育程度、吸烟和较低的家庭收入)仅与双心室病例的存活率有关。 结论 CCHD患儿的死亡主要发生在出生后的第一年。单心室缺损患儿的存活率较低,而健康的社会决定因素对预测双心室缺损患儿的存活率最为重要。
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引用次数: 0
A Comparison of Active and Passive Surveillance Strategies for Selected Birth Defects in New York 纽约部分出生缺陷的主动和被动监测策略比较。
IF 1.6 4区 医学 Q4 DEVELOPMENTAL BIOLOGY Pub Date : 2024-09-05 DOI: 10.1002/bdr2.2399
Meredith M. Howley, Eva Williford, Amanda M. St. Louis, Adrian M. Michalski, Marilyn L. Browne, Sarah C. Fisher

Background

The New York State Birth Defects Registry (BDR) has passive and active components. As part of statewide passive ascertainment, the BDR receives reports of International Classification of Diseases, Tenth Revision (ICD-10) codes and descriptive narratives on a wide range of birth defects. The BDR conducts enhanced active surveillance for selected birth defects in 14 counties, which includes medical record abstraction and clinician review. We sought to quantify agreement between the two surveillance approaches.

Methods

The analysis included live-born infants born with one of the 16 birth defects in 2018–2021 in the active surveillance counties (n = 1069 infants). We calculated positive predictive values (PPV) and 95% confidence intervals for each defect, defined as the percentage of cases confirmed in active surveillance among those in passive surveillance. Additionally, we calculated the percentage with each birth defect missed by passive surveillance.

Results

The PPV varied greatly by birth defect. The PPV was >90% for gastroschisis and cleft lip, but <70% for spina bifida, diaphragmatic hernia, truncus arteriosus, tricuspid atresia, hypoplastic left heart syndrome, coarctation of the aorta, and pulmonary atresia. The percentage missed by passive surveillance ranged from 2% for tetralogy of Fallot to 39% for tricuspid atresia.

Conclusions

Active surveillance is an important strategy for ruling out false positive case reports for certain birth defects that we assessed, but not all of them. Passive surveillance programs can use our findings to develop targeted strategies for improving data quality of specific birth defects using active surveillance methods, thus optimizing limited resources.

背景:纽约州出生缺陷登记处 (BDR) 包括被动和主动两部分。作为全州被动确定的一部分,BDR 接收有关各种出生缺陷的国际疾病分类第十版 (ICD-10) 代码和描述性叙述的报告。BDR 在 14 个县对选定的出生缺陷进行强化主动监测,包括病历摘录和临床医生审查。我们试图量化这两种监测方法之间的一致性:分析对象包括 2018-2021 年在主动监测县出生的患有 16 种出生缺陷之一的活产婴儿(n = 1069 名婴儿)。我们计算了每种缺陷的阳性预测值(PPV)和 95% 置信区间,其定义为主动监测确诊病例占被动监测病例的百分比。此外,我们还计算了被动监测遗漏的每种出生缺陷的百分比:不同出生缺陷的 PPV 差异很大。胃裂和唇裂的 PPV>90%,但结论:对于我们评估的某些出生缺陷,主动监测是排除假阳性病例报告的重要策略,但并非所有病例都是如此。被动监测项目可利用我们的研究结果制定有针对性的策略,利用主动监测方法提高特定出生缺陷的数据质量,从而优化有限的资源。
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引用次数: 0
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