Association of Pyrethroid Pesticide Exposure With Attention-Deficit/Hyperactivity Disorder in a Nationally Representative Sample of U.S. Children

Background Pyrethroid pesticides cause abnormalities in the dopamine system and produce an ADHD phenotype in animal models, with effects accentuated in males versus females. However, data regarding behavioral effects of pyrethroid exposure in children is limited. We examined the association between pyrethroid pesticide exposure and ADHD in a nationally representative sample of US children, and tested whether this association differs by sex. Methods Data are from 8–15 year old participants (N = 687) in the 2001–2002 National Health and Nutrition Examination Survey. Exposure was assessed using concurrent urinary levels of the pyrethroid metabolite 3-phenoxybenzoic acid (3-PBA). ADHD was defined by either meeting Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition criteria on the Diagnostic Interview Schedule for Children (DISC) or caregiver report of a prior diagnosis. ADHD symptom counts were determined via the DISC. Multivariable logistic regression examined the link between pyrethroid exposure and ADHD, and poisson regression investigated the link between exposure and ADHD symptom counts. Results Children with urinary 3-PBA above the limit of detection (LOD) were twice as likely to have ADHD compared with those below the LOD (adjusted odds ratio [aOR] 2.42; 95 % confidence interval [CI] 1.06, 5.57). Hyperactive-impulsive symptoms increased by 50 % for every 10-fold increase in 3-PBA levels (adjusted count ratio 1.50; 95 % CI 1.03, 2.19); effects on inattention were not significant. We observed possible sex-specific effects: pyrethroid biomarkers were associated with increased odds of an ADHD diagnosis and number of ADHD symptoms for boys but not girls. Conclusions We found an association between increasing pyrethroid pesticide exposure and ADHD which may be stronger for hyperactive-impulsive symptoms compared to inattention and in boys compared to girls. Given the growing use of pyrethroid pesticides, these results may be of considerable public health import

Insight from OPN1LW Gene Haplotypes into the Cause and Prevention of Myopia

Nearsightedness (myopia) is a global health problem of staggering proportions that has driven the hunt for environmental and genetic risk factors in hopes of gaining insight into the underlying mechanism and providing new avenues of intervention. Myopia is the dominant risk factor for leading causes of blindness, including myopic maculopathy and retinal detachment. The fundamental defect in myopia—an excessively elongated eyeball—causes blurry distance vision that is correctable with lenses or surgery, but the risk of blindness remains. Haplotypes of the long-wavelength and middle-wavelength cone opsin genes (OPN1LW and OPN1MW, respectively) that exhibit profound exon-3 skipping during pre-messenger RNA splicing are associated with high myopia. Cone photoreceptors expressing these haplotypes are nearly devoid of photopigment. Conversely, cones in the same retina that express non-skipping haplotypes are relatively full of photopigment. We hypothesized that abnormal contrast signals arising from adjacent cones differing in photopigment content stimulate axial elongation, and spectacles that reduce contrast may significantly slow myopia progression. We tested for an association between spherical equivalent refraction and OPN1LW haplotype in males of European ancestry as determined by long-distance PCR and Sanger sequencing and identified OPN1LW exon 3 haplotypes that increase the risk of common myopia. We also evaluated the effects of contrast-reducing spectacles lenses on myopia progression in children. The work presented here provides new insight into the cause and prevention of myopia progression

Screening fathers for postpartum depression in a maternal-child health clinic: a program evaluation in a midwest urban academic medical center

Abstract Background Postpartum depression (PPD) impacts fathers as well as mothers, and is estimated to affect between 8 and 13% of fathers. Paternal PPD is a risk factor for worsened quality of life, poor physical and mental health, and developmental and relational harms in the father-mother-child triad. There are no current recommendations for PPD screening among fathers. Paternal PPD screening was piloted in an intergenerational postpartum primary care clinic. Methods The pilot was carried out in an intergenerational postpartum primary care clinic located at a Midwest urban academic safety net health system from October 2021 to July 2022. Fathers actively involved in relationships with mothers or infants receiving primary care in the clinic were approached with mothers’ permission. A novel survey instrument was used to collect demographic/social data, as well as mental health history and current stress levels; an Edinburgh Postnatal Depression Scale (EPDS) was also administered. Screenings were completed by social workers; data were collected in REDCap and descriptive statistics were calculated in SAS. Results 29 fathers were contacted and 24 completed screening (83%). Mean age was 31 years (range 19–48). Most (87%) identified as belonging to a racial or ethnic minority group. Fathers self-reported low rates of stress and preexisting mental health conditions, but 30% screened positive for PPD on EPDS (score of ≥ 8, or suicidal ideation). Gaps in health care were found, as one-quarter (26%) of fathers were uninsured and half (54%) did not have a primary care provider. After screening, two requested mental health services, and three established new primary care with a physician. Conclusions Participation was high in a PPD screening pilot for fathers in a primary care setting. This small sample of fathers demonstrated significant peripartum mental health challenges unlikely to have been identified otherwise. For some participants, engaging in PPD screening was an effective tool to prompt their subsequent engagement with general health care. This pilot is a step toward incorporating the health of fathers into models for supporting the health of families. Expanding screening for paternal PPD into routine primary care is necessary to reach more affected fathers

Race- and Sex-Related Differences in Retinal Thickness and Foveal Pit Morphology

This study provides key insight into the underlying mechanism behind the reported race- and sex-related differences in retinal thickness. Variation in foveal pit morphology is shown to underlie apparent racial differences in central retinal thickness

Integrity of the Cone Photoreceptor Mosaic in Oligocone Trichromacy

Oligocone trichromacy (OT) is an unusual cone dysfunction syndrome associated with normal or near-normal color vision. In this paper, the authors describe novel observations on the underlying structural basis of OT at the level of the cone mosaic

Independent effects of acute estradiol or progesterone on perimenstrual changes in suicidal ideation, affective symptoms, and 3α-reduced progesterone metabolites: A crossover randomized controlled trial

Background: Across several patient cohorts recruited for recent suicidal ideation (SI), current affective disorder, and natural menstrual cycles, we have observed a dimensional (present to varying degrees) perimenstrual (PM) worsening of SI and depressed mood, specifically relative to an early luteal (EL) nadir. In our prior crossover trial, PM administration of combined estradiol (E2) and progesterone (P4) reduced this exacerbation of SI and depressive symptoms versus placebo (PBO). This three-period crossover trial extended this work by examining independent effects of E2, P4, and PBO on PM worsening of SI and related depressive symptoms. Further, we examined two neuroactive steroid metabolites of P4 (3α,5α-tetrahydroxyprogesterone or allopregnanolone/ALLO, 3α,5β-tetrahydroxyprogesterone or pregnanolone/PA), since some have hypothesized that NAS withdrawal contributes to PM affective changes. Methods: A naturally-cycling transdiagnostic sample with affective disorder and past-month SI (N(per-protocol)=23; N(intent-to-treat)=44) completed three double-blind, counterbalanced conditions: perimenstrual administration of (1) .1mg/day transdermal E2 (plus PBO pills), (2) 200mg/day oral micronized P4 (plus PBO patch), and (3) PBO patch and pills. From three visits per condition (+7, +14, and +22 days after an LH surge of >= 40 mIU/ml), blood was assayed (via GC/MS) for E2, P4, ALLO, and PA. Results: Despite the fact that only P4 (vs. PBO) prevented PM withdrawal of ALLO and PA, P4 (vs. PBO) increased PM worsening of SI, but had no other symptom effects. In contrast, E2 (vs. PBO) reduced PM worsening of SI, depressed mood, hopelessness, anxiety, overwhelm, rejection sensitivity, and perceived burdensomeness—even though it did not prevent ALLO or PA withdrawal. Conclusions: Cyclical worsening of depressive symptoms and SI are improved with perimenstrual E2 administration, implicating E2 withdrawal or depletion as a mechanism. Cyclical withdrawal or depletion from P4, ALLO, or PA may not contribute to cyclical affective changes, and P4 administration may worsen SI