On language acquisition amongst children and on maternal sensitivity in families subject to risk factors and those free of risk factors. A study in Ecuador

Risikofaktoren können zu Störungen in allen kindlichen Entwicklungsbereichen und somit auch zu Störungen im Spracherwerb als auch zu Problemen in der frühen Eltern-Kind-Beziehung führen. Beim gemeinsamen Auftreten von mehreren Risikobedingungen, wie es oft der Fall bei unter Armut lebenden Menschen ist, steigt die Risikobelastung und somit die Wahrscheinlichkeit von Entwicklungsbeeinträchtigungen (Laucht, Esser & Schmidt, 1998; Wustmann, 2004). In der vorliegenden Untersuchung wurde eine Stichprobe von Familien, die unter Armut leben (San Pedro, Ecuador), mit einer Stichprobe von Familien aus der Mittelschicht (Quito, Ecuador) verglichen. Es wurde geprüft, ob unterschiedlich viele Risikobedingungen vorliegen und ob sich Unterschiede in den sprachlichen Kompetenzen der Kinder sowie in der mütterlichen Feinfühligkeit zeigen. Darüber hinaus wurde geprüft, ob Beziehungen zwischen der mütterlichen Feinfühligkeit und den kommunikativen Kompetenzen bestehen. Die Ergebnisse weisen auf einen negativen Einfluss der Risikobedingungen auf den kindlichen Spracherwerb und auf die mütterlichen intuitiven und sensitiven Kompetenzen hin. Bei den Risikokindern zeigten die Ergebnisse ein Überwiegen von Sprachentwicklungsverzögerungen bzw. -störungen. Die Mütter der Risikostichprobe wiesen ein geringeres Feinfühligkeitsmaß als die der Kontrollgruppe auf. Weiterhin zeigte sich ein Zusammenhang zwischen der mütterlichen Feinfühligkeit und einzelnen kommunikativen Kompetenzbereichen. Diese Studie weist auf die Notwendigkeit der Erhebung von kindlichen Sprachentwicklungsverzögerungen und von Mutter Kind-Interaktionen hin, vor allem in Familien mit erheblichen Belastungen und vielfältigen Risikofaktoren. Die Erhebung von Entwicklungsrisiken kann zur Prävention oder Intervention genutzt werden, die das Risiko negativer Konsequenzen reduzieren und positive Anpassung fördern. (DIPF/Orig.)Risk factors can lead to disturbance of all areas of a child’s development, and thus also of language acquisition and to problems in early relationships between parent and child. In the event of multiple risk factors, as it is often the case amongst people living in poverty, the burden of risks and therefore the probability of developmental disturbance rises (Laucht, Esser & Schmidt, 1998; Wustmann, 2004). In the present study a sample amongst families living in poverty (San Pedro, Ecuador) was compared with a sample taken from middle-class families (Quito, Ecuador). An examination was carried out whether there was a varying number of risk factors and whether there were differences in the language competence of the child as well as in the mother’s sensitivity. There was a further examination of whether there was a correlation between maternal sensitivity and communicative competences. The results indicate a negative influence of risk conditions on the language acquisition of the children and on the intuitive and sensitive maternal competences. In the risk group, the results showed a preponderance of delays and disturbances in language development of the children. The mothers from the risk sample group displayed less sensitivity than the control group. There was also a correlation between maternal sensitivity and individual areas of competence. This study shows that it is necessary to ascertain the delays in children’s language acquisition and mother-child interaction, particularly amongst families with serious burdens and multiple risk factors. Ascertaining these developmental risks can be used for prevention or intervention which can reduce the risk of negative consequences and aid positive adaptation. (DIPF/Orig.

Prospective Clinical Trial for Septic Arthritis:Cartilage Degradation and Inflammation Are Associated with Upregulation of Cartilage Metabolites

Background. Intra-articular infections can rapidly lead to osteoarthritic degradation. The aim of this clinical biomarker analysis was to investigate the influence of inflammation on cartilage destruction and metabolism. Methods. Patients with acute joint infections were enrolled in a prospective clinical trial and the cytokine composition of effusions (n=76) was analyzed. Characteristics of epidemiology and disease severity were correlated with levels of cytokines with known roles in cartilage turnover and degradation. Results. Higher synovial IL-1β concentrations were associated with clinical parameters indicating a higher disease severity (p<0.03) excluding the incidence of sepsis. Additionally, intra-articular IL-1β levels correlated with inflammatory serum parameters as leucocyte counts (LC) and C-reactive protein concentrations (p<0.05) but not with age or comorbidity. Both higher LC and synovial IL-1β levels were associated with increased intra-articular collagen type II cleavage products (C2C) indicating cartilage degradation. Joints with preinfectious lesions had higher C2C levels. Intra-articular inflammation led to increased concentrations of typical cartilage metabolites as bFGF, BMP-2, and BMP-7. Infections with Staphylococcus species induced higher IL-1β expression but less cartilage destruction than other bacteria. Conclusion. Articular infections have bacteria-specific implications on cartilage metabolism. Collagen type II cleavage products reliably mark destruction, which is associated with upregulation of typical cartilage turnover cytokines. This trial is registered with DRKS00003536, MISSinG

Identification of women with an increased risk of developing radiation-induced breast cancer: a case only study

Introduction: Radiation exposure at a young age is one of the strongest risk factors for breast cancer. Germline mutations in genes involved in the DNA-damage repair pathway (DDRP) may render women more susceptible to radiation-induced breast cancer. Methods: We evaluated the contribution of germline mutations in the DDRP genes BRCA1, BRCA2, CHEK2 and ATM to the risk of radiation-induced contralateral breast cancer (CBC). The germline mutation frequency was assessed, in a case-only study, in women who developed a CBC after they had a first breast cancer diagnosed before the age of 50 years, and who were (n = 169) or were not (n = 78) treated with radiotherapy for their first breast tumour. Results: We identified 27 BRCA1, 5 BRCA2, 15 CHEK2 and 4 truncating ATM germline mutation carriers among all CBC patients tested (21%). The mutation frequency was 24.3% among CBC patients with a history of radiotherapy, and 12.8% among patients not irradiated for the first breast tumour (odds ratio 2.18 (95% confidence interval 1.03 to 4.62); p = 0.043). The association between DDRP germline mutation carriers and risk of radiation-induced CBC seemed to be strongest in women who developed their second primary breast tumour at least 5 years after radiotherapy. Th

Genetic determinants of heel bone properties: genome-wide association meta-analysis and replication in the GEFOS/GENOMOS consortium

Quantitative ultrasound of the heel captures heel bone properties that independently predict fracture risk and, with bone mineral density (BMD) assessed by X-ray (DXA), may be convenient alternatives for evaluating osteoporosis and fracture risk. We performed a meta-analysis of genome-wide association (GWA) studies to assess the genetic determinants of heel broadband ultrasound attenuation (BUA; n = 14 260), velocity of sound (VOS; n = 15 514) and BMD (n = 4566) in 13 discovery cohorts. Independent replication involved seven cohorts with GWA data (in silico n = 11 452) and new genotyping in 15 cohorts (de novo n = 24 902). In combined random effects, meta-analysis of the discovery and replication cohorts, nine single nucleotide polymorphisms (SNPs) had genome-wide significant (P < 5 × 10(-8)) associations with heel bone properties. Alongside SNPs within or near previously identified osteoporosis susceptibility genes including ESR1 (6q25.1: rs4869739, rs3020331, rs2982552), SPTBN1 (2p16.2: rs11898505), RSPO3 (6q22.33: rs7741021), WNT16 (7q31.31: rs2908007), DKK1 (10q21.1: rs7902708) and GPATCH1 (19q13.11: rs10416265), we identified a new locus on chromosome 11q14.2 (rs597319 close to TMEM135, a gene recently linked to osteoblastogenesis and longevity) significantly associated with both BUA and VOS (P < 8.23 × 10(-14)). In meta-analyses involving 25 cohorts with up to 14 985 fracture cases, six of 10 SNPs associated with heel bone properties at P < 5 × 10(-6) also had the expected direction of association with any fracture (P < 0.05), including three SNPs with P < 0.005: 6q22.33 (rs7741021), 7q31.31 (rs2908007) and 10q21.1 (rs7902708). In conclusion, this GWA study reveals the effect of several genes common to central DXA-derived BMD and heel ultrasound/DXA measures and points to a new genetic locus with potential implications for better understanding of osteoporosis pathophysiology

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity