Case report: Long-term management of occlusion after surgical-orthodontic treatment for a patient with drug-induced open bite developed after the onset of schizophrenia.

Background: Schizophrenia is a major mental disorder, with an estimated incidence of 1%. Since they are sensitive to sensory changes, orthodontic treatment to move teeth should be avoided as aggressively as possible in these patients because of strong concerns about the possibility of causing adverse psychological effects, thus there are few reports on orthodontic treatment for schizophrenia patients. We report a case of severe open bite caused by medication after the onset of schizophrenia, even though the patient's occlusion had been stable for a long time after surgical orthodontic treatment. Medication control and the use of a minimally invasive orthodontic appliance improved the occlusion without adversely affecting the patient's mental health. Case: A 22-year-old woman presented to the clinic with a chief complaint of an anterior open bite. Intraoral findings showed an overbite (vertical overlap of the incisor teeth) of -3.0 mm and an overjet (horizontal overlap of the incisor teeth) of -0.5 mm. The preoperative orthodontic treatment included bilateral extraction of the maxillary first premolars. Subsequently, orthognathic surgery was performed to achieve a harmonized skeletal relationship and occlusion. Occlusion was stable for 3 years after surgery. However, 10 years after surgery, the patient returned to the clinic complaining of an anterior open bite (overbite = -4.0 mm). Six years prior to the return, the patient was diagnosed with schizophrenia. We thought that ignoring the patient's strong desire to treat her open bite might also cause psychological problems; therefore, in addition to medication control, we treated her using a minimally invasive removable orthodontic appliance (retainer with tongue crib). Her anterior open bite improved (overbite, +1.0 mm) to within the normal range. Conclusion: In this case, medication control was thought to be essential to improve her drug-induced open bite. However, minimally invasive orthodontic treatment, such as the use of a removable appliance, might be helpful in promoting her mental stability as well as for improving occlusion. Careful support is required to obtain information about the patient's mental state and medications through close cooperation with psychiatrists.

Evaporation Patterns of Dextran-Poly(Ethylene Glycol) Droplets with Changes in Wettability and Compatibility.

The dextran−PEG system is one of the most famous systems exhibiting phase separation. Various phase behaviors, including the evaporation process of the dextran−PEG system, have been studied in order to understand the physicochemical mechanism of intracellular phase separation and the effect of condensation on the origin of life. However, there have been few studies in dilute regime. In this study, we focused on such regimes and analyzed the pattern formation by evaporation. The specificity of this regime is the slow onset of phase separation due to low initial concentration, and the separated phases can have contrasting wettability to the substrate as evaporation progresses. When the polymer concentration is rather low (<5 wt%), the dextran−PEG droplets form a phase-separated pattern, consisting of PEG at the center and dextran ring of multiple strings pulling from the ring. This pattern formation is explained from the difference in wettability and compatibility between dextran and PEG upon condensation. At the initial dilute stage, the dextran-rich phase with higher wettability accumulates at the contact line of the droplet to form a ring pattern, and then forms multiple domains due to density fluctuation. The less wettable PEG phase recedes and pulls the dextran domains, causing them to deform into strings. Further condensation leads to phase separation, and the condensed PEG with improved wettability stops receding and prevents a formed circular pattern. These findings suggest that evaporation patterns of polymer blend droplets can be manipulated through changes in wettability and compatibility between polymers due to condensation, thus providing the basis to explore origins of life that are unique to the process of condensate formation from dilute systems.

Chronic stress and age-related pattern of blood pressure: A cross-sectional study in rural China.

OBJECTIVE: Chronic stress is a risk factor for hypertension in adults. However, there is conflicting evidence for older adults. We hypothesized that age-related arterial stiffening, which leads to a lower blood pressure (especially diastolic blood pressure [DBP]), is more pronounced among older adults with high vs low stress. The objectives of this study were (a) to investigate age-related trends in systolic and DBPs among adults in rural Fujian, China, and (b) to examine differences in age-related blood pressure trends according to levels of stress by using Epstein-Barr virus (EBV) antibody titer as a marker of chronic stress status. METHODS: We collected cross-sectional data from 764 rural community-dwelling adults in rural Fujian, China (mean age = 59.4). Participants were categorized into high and low stress groups by median split of EBV antibody titer. A least-squares regression analysis was used to investigate the association between age and blood pressures. RESULTS: We observed an inverted U-shaped association between age and DBP, while there was a linear association between age and systolic blood pressure in the overall sample. When stratified by stress, the inverted U-shaped associations with age (both systolic and DBPs) were seen only among those with high stress; DBP peaked at the age of ~68 years, and the declining trend later in life was more clearly observed among those with high chronic stress. DISCUSSION: Decrease of DBP was more pronounced among older adults with high vs low chronic stress in rural China.

Protective role of selenium in the shortening of telomere length in newborns induced by in utero heavy metal exposure.

The effects of toxic heavy metals, such as arsenic (As), cadmium (Cd), and lead (Pb), on telomere length (TL) have been reported previously. Although selenium (Se) is considered as an anti-oxidant which may detoxify the effects, there are no data on whether Se could protect against the TL-shortening effects of heavy metals. Thus, the aim of this study was to evaluate the protective role of Se against heavy metal-induced TL shortening. A birth cohort study was conducted in Myanmar in 2016, including 408 mother-infant pairs. First, pregnant women in the third trimester were interviewed concerning their socioeconomic, and pregnancy and birth characteristics using a pre-validated questionnaire. Maternal spot urine samples were collected after the interview. During the follow-up period (1-3 months), blood samples were collected from the umbilical cord at birth by local health workers. Metal concentrations were measured using inductively coupled plasma mass spectrometry (ICP-MS). TL was measured by quantitative real-time polymerase chain reaction (PCR). Relative TL was calculated as the ratio of telomere genes to single-copy genes. To evaluate the effect of Se on TL shortening, molar ratios were calculated. Linear regression analyses were performed to examine the associations between heavy metals and TL, individually and after adjustment for Se level. The effects of As, Cd, and Pb exposure on TL were smaller after adjustment for the Se level, especially for Pb (unadjusted ß = -0.10; 95% CI: 0.18, -0.01; adjusted ß = -0.03; 95% CI: 0.13, 0.05). On stratifying the data by Se concentration, there was no significant association between Cd or Pb exposure and TL in the high-Se group. Our study indicated a protective effect of Se against the TL shortening induced by heavy metal exposure, where the effect sizes were smaller after adjusting for the Se level, compared to individual metal exposure.

The association between family members' migration and Epstein-Barr virus antibody titers among people left behind in rural Fujian, China.

OBJECTIVES: In contrast to the health of migrants, which has been extensively studied, little attention has been paid to the health of adults left behind by family members who out-migrated to other locations. This study was performed to investigate the association between being left behind and the Epstein-Barr virus (EBV) antibody titer, which is an indicator of cellular immune functioning previously shown to be associated with psychological stress. METHODS: A cross-sectional survey was conducted in rural communities in Fujian, China, in 2015. Questionnaire data and dried blood spot samples were collected from 748 adults. A mixed effect regression analysis was conducted to investigate the association. RESULTS: Results indicated that the EBV antibody titers were higher among people who had been left behind compared with those who had not. CONCLUSIONS: Our findings suggest that, in rural Fujian, China, family separation following the out-migration of family members is an important determinant of psychological stress.

Arsenic exposure through drinking Water and oxidative stress Status: A cross-sectional study in the Ayeyarwady region, Myanmar.

Arsenic is a well-known toxic heavy metal that is naturally dispersed in groundwater. Whereas arsenic is widely accepted to be involved in oxidative stress damage, little is known about arsenic-induced oxidative damage in relationship to contaminated drinking water as a source. The aim of this study was to determine the association between arsenic exposure through drinking water and oxidative stress status by measuring levels of urinary 8-hydroxydeoxyguanosine (8-OHdG) as a biomarker of oxidative stress damage in a Myanmar population. A questionnaire-based survey and drinking water and urine sampling (n = 198) were performed to assess the association between arsenic exposure and urinary 8-OHdG concentration in the Ayeyarwady Region, Myanmar. Urinary arsenic concentrations were significantly correlated with drinking water arsenic concentrations (Spearman's rho = 0.32, p < 0.001). Multivariate linear regression analysis showed that higher urinary arsenic concentrations were significantly associated with higher 8-OHdG concentrations (coefficient = 0.09, 95% confidence interval, 0.03 - 0.15; p = 0.002). The present study identified that exposure to arsenic through drinking water could induce an increase in the urinary 8-OHdG concentration, reflecting increased oxidative DNA damage. These findings provide evidence that may explain the role of arsenic-induced oxidative stress in the pathophysiology of arsenic-induced diseases including cancers.

Combination of estrogen deficiency and excessive mechanical stress aggravates temporomandibular joint osteoarthritis in vivo.

OBJECTIVE: It has been suggested that degenerative conditions of the temporomandibular joint (TMJ), such as osteoarthritis (OA) and progressive condylar resorption, are caused by multiple etiological factors, such as hormonal imbalance and excessive mechanical stress. However, it is unclear whether these factors interrelate in the degenerative process of the condyle. The aim of this study was to observe the effects of combined hormonal imbalance and excessive mechanical stress on the condyle using a mouse model. MATERIALS AND METHODS: Ovariectomy (OVX) was performed in 8-week-old female mice. Three weeks after OVX, a build-up resin was bonded to the right maxillary molars to create imbalanced occlusion (increased occlusal vertical dimension, iOVD). Mice were divided into four groups: control, OVX, iOVD, and OVX + iOVD. RESULTS: Histomorphometric analysis showed the lowest cartilage thickness and the highest TMJ-OA score in the OVX + iOVD group. Bone structural analysis showed significantly lower subchondral bone mass in all experimental groups. Additionally, the OVX + iOVD group showed up-regulated osteoclastic activity and increased apoptosis in the condyle. Gene expression analysis showed significantly elevated expression of pre-inflammatory cytokines in the OVX + iOVD group. These data showed that the OVX + iOVD group exhibited the most severe inflammatory TMJ-OA. Upregulation of ERα and activation of the ERK pathway was observed in the OVX + iOVD group. CONCLUSIONS: Additive effects of estrogen deficiency and excessive mechanical stress on the condyle exacerbate TMJ-OA. Furthermore, estrogen deficiency and excessive mechanical stress combined may exacerbate TMJ-OA though activation of the ERK pathway.

Nuclear import of transcriptional corepressor BCOR occurs through interaction with karyopherin α expressed in human periodontal ligament.

Mutations in the gene encoding BCL-6 corepressor (BCOR) are responsible for oculofaciocardiodental (OFCD) syndrome, which is a rare X-linked dominant disorder characterized by radiculomegaly of permanent teeth as the most typical symptom. To function as a transcriptional corepressor, BCOR needs to enter the nucleus; however, the molecular pathway for its nuclear translocation during dental root formation remains unclear. The purpose of this study was to determine the mechanism underlying BCOR transport into the nucleus. Our results showed that human periodontal ligament (PDL) cells expressed karyopherin α (KPNA)2, KPNA4, and KPNA6 belonging to a family of nuclear import proteins, which interacted with BCOR in the immunoprecipitation assay. Site-directed mutagenesis targeting the two nuclear localization signals (NLSs) within BCOR reduced its nuclear translocation; however, co-expression of KPNA2, KPNA4, or KPNA6 with BCOR carrying a previously described mutation which eliminated one of the two NLSs significantly increased nuclear accumulation of the mutant BCOR, indicating participation of KPNA in BCOR nuclear translocation. Comparative expression profiling of PDL cells isolated from normal and OFCD patients revealed significant downregulation of SMAD4, GLI1, and nuclear factor 1-C (NFIC) mRNA expression, suggesting that BCOR mutations cause hyperactive root formation in OFCD syndrome by inhibiting SMAD4-Hedgehog-NFIC signaling implicated in dental root development. Our study contributes to understanding of the mechanisms providing nuclear import of BCOR during root formation.

Epstein-Barr virus antibody titer as a stress biomarker and its association with social capital in rural Fujian communities, China.

OBJECTIVES: There has been little research on the association between social capital and psychological stress measured by a biomarker, particularly in developing countries. Our objective was to investigate the association between Epstein-Barr virus (EBV) antibody titer, an indicator of cellular immune function previously shown to be associated with psychological stress, and social capital among rural community dwellers in Fujian Province, China. METHODS: We conducted a cross-sectional survey in seven rural communities in Fujian in 2015. We used questionnaire data and dried blood spot samples for the measurement of biomarkers collected from 734 local residents for the analysis. We conducted a mixed effects regression analysis to investigate the association between EBV antibody titer and four social capital variables, which included cognitive and structural social capital assessed both at individual and community levels. RESULTS: Community-level structural social capital was inversely associated with psychological stress (coefficient = -0.96, 95% confidence interval [CI] = -1.91, -0.01) while individual-level structural social capital was positively associated with it (coefficient = 0.21, 95% CI = 0.07, 0.36). Neither individual- nor community-level cognitive social capital was associated with psychological stress status. CONCLUSIONS: In rural Fujian, China, social capital seemed to be an important determinant of psychological health. While living in a community with active social interaction may benefit the residents psychologically, social interaction in the form of strongly bonded relationships may be a source of psychological stress at the individual level due to the potential demands and obligations that may be associated with such connections.

Cell-size confinement effect on protein diffusion in crowded poly(ethylene)glycol solution.

Micrometric membrane confinements and macromolecular crowding of cytoplasm are key factors that regulate molecular diffusion in live cells. Previous studies have shown that macromolecular crowding delays molecular diffusion. However, the effect of cell-size confinement on diffusion in the crowding environment is yet to be elucidated. Using fluorescence correlation spectroscopy (FCS), we analyzed protein diffusion in microdroplets containing polymer solution covered with lipid membranes that mimic cells. As a result, we found that a synergistic condition of crowding and micrometric confinement results in accelerated protein diffusion on a sub-millisecond time scale. This acceleration rate strongly depended on the size of the confined space and the degree of crowding. These findings indicate that cell-size confinement supports protein diffusion in highly crowded cytoplasm.

U-shaped association between fertility and mortality in a community-based sample of Japanese women.

BACKGROUND: Prospective cohort studies of contemporary populations in both Western and Asian settings have reported a U-shaped association between fertility and mortality. We examined whether an association exists between fertility and all-cause and cause-specific mortality in a sample of Japanese women. METHODS: A prospective cohort study was conducted in one rural and one urban community in Gunma Prefecture, Japan, in 1993. A follow-up survey was conducted in the year 2000 in 4858 women aged 47-77 years, and information on demographic and lifestyle characteristics was collected. Mortality and migration data through December 2008 were obtained. A Cox proportional hazard model was used to examine the relationship between parity and mortality. RESULTS: Compared with women with 2-4 children (reference group), higher total mortality was observed among women with 0-1 or 5+ children. Low (HR 1.7, 95% CI 1.2 to 2.3) and high (HR 2.1, 95% CI 1.0 to 4.7) parities were both associated with higher all-cause mortality even after adjusting for potential confounders. Mortality due to ischaemic heart disease exhibited a significant association with parity; the HRs were 3.2 (95% CI 1.1 to 9.2) for women with 0-1 child and 8.7 (95% CI 1.7 to 45.5) for women with 5 or more children. No significant association was observed for mortality from malignancies, cancer of the digestive system, cardiovascular disease or cerebrovascular disease. CONCLUSIONS: There exists a U-shaped association between parity and all-cause mortality and cause-specific mortality due to ischaemic heart disease among Japanese women.

Association of cadmium and arsenic exposure with salivary telomere length in adolescents in Terai, Nepal.

BACKGROUND: Cadmium and arsenic are ubiquitous metals commonly found in the environment which can harm human health. A growing body of research shows telomere length as a potential biomarker of future disease risk. Few studies have examined the effects of metals on telomere length and none have focused on adolescents. OBJECTIVES: In this study, the impact of cadmium and arsenic on salivary telomere length was studied in adolescents in Terai, Nepal. METHODS: Adolescents aged 12-16 years old (n=351)were recruited where questionnaire interviews and both saliva and urine collection took place. Telomere length was determined by quantitative polymerase chain reaction using DNA extracted from saliva. Urinary cadmium and arsenic concentration were measured by inductively coupled plasma mass spectrometry. Multivariable linear regression was used to examine associations between urinary metals and salivary telomere length. RESULTS: The geometric means and standard deviations of cadmium and arsenic were 0.33±0.33µg/g creatinine and 196.0±301.1µg/g creatinine, respectively. Urinary cadmium concentration was negatively associated with salivary telomere length after adjustment for confounders (ß=-0.24, 95% CI -0.42,-0.07). Arsenic showed positive associations with telomere length but did not reach statistical significance. CONCLUSIONS: This is the first study to demonstrate that cadmium may shorten adolescent telomeres, even at exposure levels that may be considered low. These results agree with prior experimental and adult epidemiological studies, and also help identify the mechanism of DNA damage by cadmium. This study expanded current evidence on the harmful effects of cadmium exposure on telomere length even to adolescents.

Associations of Socioeconomic Status with Diet and Physical Activity in Migrant Bougainvilleans in Port Moresby, Papua New Guinea.

Urban migrants in Papua New Guinea have undergone a nutritional transition. The present study investigated associations of socioeconomic status with dietary and physical activity patterns among migrant Bougainvilleans from Nassioi territory in the capital city of Port Moresby, Papua New Guinea. All adults Naasioi migrants residing in Port Moresby were identified (N = 185) and 70 were included. The International Physical Activity Questionnaire was used to evaluate physical activity, and dietary patterns were assessed by per-week consumption frequency of food items. Principal component analysis was applied to produce a composite score for socioeconomic status. Least square regression analysis indicated that socioeconomic status was positively correlated with consumption of a traditional diet (p = .03) and negatively with walking-related physical activity (p = .02), but it was not correlated with MET-minutes of moderate/vigorous activity. Different patterns of nutritional transition occur among migrants in urban Papua New Guinea, depending on socioeconomic status.

Stability of mRNA influences osteoporotic bone mass via CNOT3.

Osteoclastogenesis is under the control of posttranscriptional and transcriptional events. However, posttranscriptional regulation of osteoclastogenesis is incompletely understood. CNOT3 is a component of the CCR4 family that regulates mRNA stability, but its function in bone is not known. Here, we show that Cnot3 deficiency by deletion of a single allele induces osteoporosis. Cnot3 deficiency causes an enhancement in bone resorption in association with an elevation in bone formation, resulting in high-turnover type bone loss. At the cellular level, Cnot3 deficiency enhances receptor activator of NF-κB ligand (RANKL) effects on osteoclastogenesis in a cell-autonomous manner. Conversely, Cnot3 deficiency does not affect osteoblasts directly. Cnot3 deficiency does not alter RANKL expression but enhances receptor activator of NF-κB (RANK) mRNA expression in bone in vivo. Cnot3 deficiency promotes RANK mRNA stability about twofold in bone marrow cells of mice. Cnot3 knockdown also increases RANK mRNA expression in the precursor cell line for osteoclasts. Anti-CNOT3 antibody immunoprecipitates RANK mRNA. Cnot3 deficiency stabilizes luciferase reporter expression linked to the 3'-UTR fragment of RANK mRNA. In contrast, Cnot3 overexpression destabilizes the luciferase reporter linked to RANK 3'-UTR. In aged mice that exhibit severe osteoporosis, Cnot3 expression levels in bone are reduced about threefold in vivo. Surprisingly, Cnot3 deficiency in these aged mice further exacerbates osteoporosis, which also occurs via enhancement of osteoclastic activity. Our results reveal that CNOT3 is a critical regulator of bone mass acting on bone resorption through posttranscriptional down-regulation of RANK mRNA stability, at least in part, even in aging-induced osteoporosis.

Arsenic contamination in groundwater and its effects on adolescent intelligence and social competence in Bangladesh with special reference to daily drinking/cooking water intake.

OBJECTIVE: The present study aims to investigate the relationship between arsenic (As) exposure and intelligence quotient (IQ) or social competence (SC) of Bangladeshi adolescents (aged 14 or 15 years) in Sonargaon thana. METHODS: Information about socioeconomic status (SES) was collected as confounding factors. To evaluate the relative contribution of As sources to total As intake, the As concentrations in urine and drinking/cooking water, and the amount of water added in cooking, were assessed on site using a food frequency questionnaire (FFQ). RESULTS: The results confirmed that As exposure was essential to lower adolescent IQ or SC because they were negatively associated with As exposure after controlling for SES (particularly household income). Except for cooking water, the amount of drinking water varied with season and appeared to be the major As source because the As concentration in water was generally correlated with the As concentration in urine, and they were related to lower IQ or SC (even after controlling for SES). The FFQ survey revealed that rice was consumed the most frequently (more than once daily), followed by daal (bean) soup and nonleafy vegetables, but fish, meat, and eggs were consumed approximately once a week. Water intake per meal from cooked rice was estimated to be 616 mL/person, followed by bean soup (258 mL/person) and cooked vegetables (82 mL/person). CONCLUSIONS: Our results suggest that water used for cooking might be an important source of As, and the cooking process can affect the amount of As in cooked food.

Epstein-Barr virus antibody titer and its association with the domain scores from the World Health Organization's Quality of Life questionnaire: Findings from Rural Hainan Province, China.

OBJECTIVE: Epstein-Barr virus (EBV) antibody titer has recently been used as a biomarker of psychological stress. This is the first study to investigate the association between EBV antibody titer and perceived quality of life (QOL) in Hainan Island, China. METHODS: Participants from two regions of Hainan Island, recruited into a larger study investigating the health impact of rapid economic development among rural residents, were stratified by age, sex, and region; 15 people were randomly selected from each of the 16 subgroups, to give a total sample size of 240. EBV antibody titer in dried blood spot samples was measured by enzyme-linked immunosorbent assay. The abbreviated version of the World Health Organization's Quality of Life questionnaire was used to gather information on six categories of QOL. Multiple linear regression analysis was used to examine the relationship between EBV antibody titer and QOL. RESULTS: After adjusting for the effects of age, sex, region and C-reactive protein concentration, EBV antibody titer was negatively associated with the physical (P = 0.044) and psychological QOL domains (P = 0.039). CONCLUSION: This study suggests that among individuals living in an environment in the initial stages of economic development EBV antibody titer, a biomarker of psychological stress, is not only associated with the psychological aspects of QOL but is also linked to physical problems.

Impact of lifestyle changes on stress in a modernizing rural population in Hainan Island, China.

OBJECTIVE: Little is known about inter-individual variation in psychological stress in modernizing rural populations in developing countries. The objective of this study was to investigate the association between Epstein-Barr virus (EBV) antibody titer, a biomarker of psychological stress, and lifestyle parameters in rural communities in Hainan Island, China. METHODS: EBV antibody titer was measured in dried blood spot (DBS) samples collected from 240 adults living in rural communities in Hainan Island. Measures of two major lifestyle changes in rural areas of Hainan Island, i.e., diet and commercial goods possession, were examined by using information on the weekly frequency of pork consumption and monthly mobile phone fees. Both parameters were standardized to create two composite scores: a total affluence index (TAI--the sum of these scores), and an investment tendency index (ITI--the difference between them). Least-squares regression analysis was used to investigate the association between EBV antibody titer and these lifestyle parameters. RESULTS: A positive association was found between the frequency f pork consumption and EBV antibody titer (P = 0.040), whereas a negative association was found between mobile phone fees and EBV antibody titer (P = 0.028). A negative association was also observed between ITI and EBV antibody titer (P = 0.002) after adjusting for the effect of TAI. CONCLUSION: Psychological stress among local residents was linked to the type of lifestyle changes they had experienced, where the adoption of a more market-oriented lifestyle, irrespective of current affluence, was associated with less psychological stress.

Microarray analysis of neonatal brain exposed to cadmium during gestation and lactation.

DNA microarray containing 30,000 genes was used to monitor the transcriptional response of the neonatal brain after cadmium (Cd) exposure. C57BL/6J pregnant mice were exposed to Cd (10 ppm) during gestation and lactation via drinking water. In a comparison between the Cd-exposed neonatal brain and control, three genes including transferrin receptor (Tfrc) were up-regulated and one gene was down-regulated.

Diet and physical activity among migrant Bougainvilleans in Port Moresby, Papua New Guinea: association with anthropometric measures and blood pressure.

OBJECTIVES: Obesity and hypertension are increasing in Papua New Guinea. This study investigated the association of dietary pattern and physical activity level with anthropometric measurements and blood pressure in migrant Bougainvilleans in the capital city of Port Moresby. METHODS: Adults who had moved from Naasioi territory on Bougainville Island and resided in Port Moresby during the study period were studied (n = 70). The International Physical Activity Questionnaire was used to evaluate physical activity, and dietary pattern was assessed by per week consumption frequency of food items. RESULTS: The least square regression analysis revealed that interindividual variation in body mass index and waist circumference was explained by variations in physical activity but not by dietary pattern. Blood pressure was not associated with physical activity level or dietary pattern. CONCLUSION: The individual variation in anthropometric measurements in urban Papua New Guinea is mainly influenced by physical activity level.

Cord blood levels of toxic and essential trace elements and their determinants in the Terai region of Nepal: a birth cohort study.

The purpose of this study is to evaluate the cord blood level of toxic and trace elements and to identify their determinants in Terai, Nepal. One hundred pregnant women were recruited from one hospital in Chitwan, Nepal in 2008. The cord blood levels of toxic [lead (Pb), arsenic (As), and cadmium (Cd)], essential trace elements [zinc (Zn), selenium (Se), and copper (Cu)], demographic, socioeconomic, and behavioral variables were measured. The mean values of Pb, As, Cd, Zn, Se, and Cu in cord blood level were found as 31.7, 1.46, 0.39, 2,286, 175, and 667 µg/L, respectively. In the multivariate regression model, cord blood As levels from less educated mothers were higher than those from educated mothers (coefficient = -0.01, 95% confidence interval [CI] = -0.02-0.00). The maternal age was positively associated with the cord blood Cd level (coefficient = 0.02, 95% CI = 0.01-0.03), while it was negatively associated with the cord blood As level (coefficient = -0.01, 95% CI = -0.03--0.01). Cord blood levels of Pb, Zn, Se, and Cu were not associated with maternal age, socioeconomic status, living environment, and smoking status. As and Cd levels were relatively lower than those reported in previous studies in Asia, while the levels of Pb and the trace elements were similar. Less educated mothers are more likely to become a higher in utero As source to their fetus, and fetuses of older mothers were more likely to have higher in utero Cd exposure in Terai, Nepal.