Maternal prenatal metal exposure and neonatal neurodevelopment: testing moderations by psychosocial stressors

Prenatal overexposure to many metals has been associated with decrements to child cognitive and socioemotional development. Further, there is recent interest in the joint effects of stressors experienced across the physical and social environments. We examined the effects of prenatal lead, cadmium, manganese, and arsenic exposure on neonatal brain volumes (hippocampus, amygdala, thalamus, cerebellum, frontal lobes, total grey matter, total intracranial volume). We additionally tested for moderations between metals and psychosocial stressors on neonatal brain volumes. Prenatal lead was significantly (ps<0.05) associated with reduced right and left hippocampus volumes (|βs|= 0.63-0.79), right and left thalamus volumes (|βs|=0.62), left amygdala volume (β=-0.62) and total grey matter (β=-0.13), whereas arsenic was associated with larger right and left cerebellum volumes (βs=0.19-0.20) and total grey matter (β=0.06). Psychosocial stress did not moderate the effects of prenatal metals on brain volumes. Results are discussed with respect to possible mechanisms and future directions.Master of Art

Membrane-Bound Steel Factor Maintains a High Local Concentration for Mouse Primordial Germ Cell Motility, and Defines the Region of Their Migration

Steel factor, the protein product of the Steel locus in the mouse, is a multifunctional signal for the primordial germ cell population. We have shown previously that its expression accompanies the germ cells during migration to the gonads, forming a “travelling niche” that controls their survival, motility, and proliferation. Here we show that these functions are distributed between the alternatively spliced membrane-bound and soluble forms of Steel factor. The germ cells normally migrate as individuals from E7.5 to E11.5, when they aggregate together in the embryonic gonads. Movie analysis of Steel-dickie mutant embryos, which make only the soluble form, at E7.5, showed that the germ cells fail to migrate normally, and undergo “premature aggregation” in the base of the allantois. Survival and directionality of movement is not affected. Addition of excess soluble Steel factor to Steel-dickie embryos rescued germ cell motility, and addition of Steel factor to germ cells in vitro showed that a fourfold higher dose was required to increase motility, compared to survival. These data show that soluble Steel factor is sufficient for germ cell survival, and suggest that the membrane-bound form provides a higher local concentration of Steel factor that controls the balance between germ cell motility and aggregation. This hypothesis was tested by addition of excess soluble Steel factor to slice cultures of E11.5 embryos, when migration usually ceases, and the germ cells aggregate. This reversed the aggregation process, and caused increased motility of the germ cells. We conclude that the two forms of Steel factor control different aspects of germ cell behavior, and that membrane-bound Steel factor controls germ cell motility within a “motility niche” that moves through the embryo with the germ cells. Escape from this niche causes cessation of motility and death by apoptosis of the ectopic germ cells

Mindfulness and Acceptance as Potential Protective Factors for Mothers of Children With Fragile X Syndrome

Women with an FMR1 premutation may be at increased genetic risk for stress vulnerability. This increased vulnerability, when combined with stressful parenting that can result from raising children with fragile X syndrome (FXS), may result in negative physical and emotional outcomes. Mindfulness and acceptance have been found to be protective factors for parents of children with similar behavioral challenges, but these traits have not previously been explored among mothers with a child with FXS. This study explored the associations of child disability severity with maternal stress, anxiety, depression, and physical health symptoms in 155 biological mothers of children with FXS. Women completed an online survey using standardized measures of stress, mindfulness, and acceptance. General mindfulness, mindfulness in the parenting role, and general acceptance were explored as potential protective factors between the child disability severity and maternal outcomes. Trait mindfulness and acceptance were significant predictors of lower stress, anxiety, depression, and daily health symptoms, while mindful parenting was associated with lower stress, anxiety, and depression. Acceptance was found to attenuate the effects of child severity on maternal stress and depression. These findings suggest that interventions focused on improving mindfulness and acceptance may promote health and well-being for mothers of children with FXS and have important health implications for all individuals with an FMR1 premutation

Where Do We Go From Here? The Need for Genetic Referrals in Patients who are Deaf or Hard of Hearing: Findings from a Regional Survey

Purpose: The purpose of this study was to assess primary health care providers’ knowledge and use of genetic services for children whose hearing screening indicates they may be deaf/hard of hearing (D/HH) and identify areas in which health care providers can be supported to increase family education and referral of families for genetic consultation. Methodology: A survey was developed on current practices, knowledge, and perceived beliefs regarding genetic education and referrals for deafness. The surveys were distributed to pediatricians, family medicine physicians, nurse practitioners, and physician assistants in DC, DE, MD, NJ, NY, PA, VA, and WV. Results: Among 266 respondents, 80% were uninformed about Early Hearing Detection Intervention (EHDI) 1-3-6 guidelines prior to taking the survey. Approximately 55% were not confident about the genetic causes of deafness, 44% rarely consulted genetics professionals, 41% had not referred families to genetics, and 37% were not confident about the importance of genetic referrals. Conclusions: Integrated, targeted, and user-friendly genetics education strategies in the existing EHDI framework are needed to ensure adequate awareness and delivery of genetics services for D/HH children

Racial differences in the associations between adiposity, placental growth hormone and inflammatory cytokines in pregnant women

Background The prevalence of obesity among women of child-bearing age has contributed to an increased risk of pregnancy complications with a disproportional impact on women of lower socioeconomic status and among certain racial groups. In particular, socio-demographic and historical factors have resulted in higher rates of premature births and small-for-gestational age infants among Black women, which may be associated with placental function during pregnancy. The current study investigated the influence of maternal pre-pregnancy adiposity and race on the associations between inflammatory proteins, placental growth hormone (PGH), and infant birthweight. This information was collected for a subsample of 109 participants (Black, n = 39 vs. White, n = 70) from the Brain and Early Experiences (BEE) study. Methods Serum samples were acquired late in the second trimester to assess PGH levels, C-reactive protein (CRP), interleukin 6 (IL-6), interleukin 8 (IL-8), and interleukin-1 receptor antagonist (IL-1Ra). Participant questionnaire responses provided information on pre-pregnancy BMI, health, race, educational attainment, and infant birthweight. Bivariate correlations and multiple linear regression models were utilized to evaluate associations by race between preconception adiposity, inflammatory markers and PGH. Results After controlling for covariates including maternal age and education, gestational age, and fetal sex, regression models indicated that pre-pregnancy BMI was negatively associated with PGH (β=-0.42, p<0.05) and IL-8 was positively associated with PGH (β=0.35, p<0.05) among the Black mothers only; neither were significantly associated with PGH in the White mothers. When extending models to birth outcomes, BMI was positively associated with birthweight corrected for gestational age (BWz) (β=0.24, p<0.05) and educational attainment was negatively associated with BWz (β=0.28, p<0.05) for infants of White women. In contrast, neither variable was predictive of BWz for infants of Black mothers. Conclusion Future work is needed to investigate racial differences in the association between adiposity and placental functioning, which are likely to contribute to differential effects on pregnancy outcomes and fetal growth

What needs to happen for school autonomy to be mobilised to create more equitable public schools and systems of education?

The series of responses in this article were gathered as part of an online mini conference held in September 2021 that sought to explore different ideas and articulations of school autonomy reform across the world (Australia, Canada, England, Ireland, the USA, Norway, Sweden and New Zealand). It centred upon an important question: what needs to happen for school autonomy to be mobilised to create more equitable public schools and systems of education? There was consensus across the group that school autonomy reform creates further inequities at school and system levels when driven by the logics of marketisation, competition, economic efficiency and public accountability. Against the backdrop of these themes, the conference generated discussion and debate where provocations and points of agreement and disagreement about issues of social justice and the mobilisation of school autonomy reform were raised. As an important output of this discussion, we asked participants to write a short response to the guiding conference question. The following are these responses which range from philosophical considerations, systems and governance perspectives, national particularities and teacher and principal perspectives

Advance Choices, and Medical Decision Making in Intensive Care Situations : Paper by the Law Society of Scotland

[We offer a basic formulation (previously lacking) of the doctor-patient relationship, and resulting obligations, responsibilities and potential liabilities, in any situation where medical decision-making cannot proceed at all, or sufficiently quickly, in accordance with the competent and informed consent of the patient. The formulation is derived from existing principles in Scots law and some similar legal systems. Adequate clarity and certainty are however at present lacking in Scots law. It is urgently necessary to provide it, in the interests of doctors, patients and all others who might be concerned. In the matter of withholding or withdrawing life-sustaining treatment, we have considered, commented upon and evaluated the 1995 proposals by Scottish Law Commission (which were never implemented), together with such case law as has developed, as a basis for formulating legislative provision that would provide the clarity, certainty and protections for medical practitioners acting properly, that is at present lacking in Scotland. Our recommendations include suggestions as to how both topics may be taken forward to the drafting, introduction and implementation of legislation, including suggestions as to further research, consultation, and – following upon the introduction of legislation – a coordinated approach to all aspects of its successful implementation.

Cerebellar Modules and Their Role as Operational Cerebellar Processing Units

The compartmentalization of the cerebellum into modules is often used to discuss its function. What, exactly, can be considered a module, how do they operate, can they be subdivided and do they act individually or in concert are only some of the key questions discussed in this consensus paper. Experts studying cerebellar compartmentalization give their insights on the structure and function of cerebellar modules, with the aim of providing an up-to-date review of the extensive literature on this subject. Starting with an historical perspective indicating that the basis of the modular organization is formed by matching olivocorticonuclear connectivity, this is followed by consideration of anatomical and chemical modular boundaries, revealing a relation between anatomical, chemical, and physiological borders. In addition, the question is asked what the smallest operational unit of the cerebellum might be. Furthermore, it has become clear that chemical diversity of Purkinje cells also results in diversity of information processing between cerebellar modules. An additional important consideration is the relation between modular compartmentalization and the organization of the mossy fiber system, resulting in the concept of modular plasticity. Finally, examination of cerebellar output patterns suggesting cooperation between modules and recent work on modular aspects of emotional behavior are discussed. Despite the general consensus that the cerebellum has a modular organization, many questions remain. The authors hope that this joint review will inspire future cerebellar research so that we are better able to understand how this brain structure makes its vital contribution to behavior in its most general form