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BACKGROUND/OBJECTIVE: Children's diets in school-age are inherently unhealthy, with few meeting dietary recommendations. Yet, little is known about similarities and differences on dietary patterns across countries and their association with obesity. We aimed to derive dietary patterns in childhood and explore their association with adiposity-related outcomes in childhood and adolescence. SUBJCTS/METHODS: This study included data from six European countries (Spain, France, UK, Greece, Lithuania and Norway) during childhood (n = 1597) and adolescence (n = 803). Using a food frequency questionnaire, we derived data-driven dietary patterns through exploratory factor analyses and calculated the Mediterranean KIDMED index. We assessed body mass index z-score (zBMI), fat mass proportion and waist-to-height ratio at both visits. Associations were estimated using generalized linear regressions, adjusted for key-confounders. RESULTS: "Meat", "Dairy", "Western", "Healthy" and "Sweets and fats" dietary patterns were derived. Norwegian children showed better diet quality, with higher consumption of fruits and vegetables, and highest "Healthy pattern" adherence, and Lithuanian children, the worst, with higher sweets consumption, and highest "Western pattern" adherence. Children with lower intake of healthy foods (vegetables, fruits, fish) tended to have higher adiposity, e.g., children with average or low "Healthy pattern" adherence (vs. high) had higher fat mass proportion in childhood (average: ß (95% CI) 1.44 (0.48; 2.39), low: 1.10 (0.09; 2.12)). Low adherence to a "Healthy pattern" (vs. high) was associated with increased adolescent zBMI, and child and adolescent waist-to-height ratio. Low "Dairy pattern" adherence (vs. high), was associated with lower zBMI and fat mass in childhood, but not in adolescence. No significant associations were seen with the KIDMED index. CONCLUSIONS: Many European children have poor diets and a low adherence to a healthy diet pattern may be of concern for adiposity-related outcomes. Assessment of children's dietary patterns can help tailor dietary advice and provide support for families aiming to prevent future excess weight gain.
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OBJECTIVE: Interictal biomarkers are critical for identifying the epileptogenic focus. However, spikes and ripples lack specificity while fast ripples lack sensitivity. These biomarkers propagate from more epileptogenic onset to areas of spread. The pathophysiological mechanism of these propagations is elusive. Here, we examine zones where spikes and high frequency oscillations co-occur (SHFO), the spatiotemporal propagations of spikes, ripples, and fast ripples, and evaluate the spike-ripple onset overlap (SRO) as an epilepsy biomarker. METHODS: We retrospectively analyzed intracranial EEG data from 41 patients with drug-resistant epilepsy. We mapped propagations of spikes, ripples, and fast ripples, and identified their onset and spread zones, as well as SHFO and SRO. We then estimated the SRO prognostic value in predicting surgical outcome and compared it to onset and spread zones of spike, ripple, and fast ripple propagations, and SHFO. RESULTS: We detected spikes and ripples in all patients and fast ripples in 12 patients (29%). We observed spike and ripple propagations in 40 (98%) patients. Spike and ripple onsets overlapped in 35 (85%) patients. In good outcome patients, SRO showed higher specificity and precision (p < 0.05) in predicting resection compared to onset and zones of spikes, ripples, and SHFO. Only SRO resection predicted outcome (p = 0.01) with positive and negative predictive values of 82% and 57%, respectively. INTERPRETATION: SRO is a specific and precise biomarker of the epileptogenic zone whose removal predicts outcome. SRO is present in most patients with drug-resistant epilepsy. Such a biomarker may reduce prolonged intracranial monitoring and improve outcome.
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Epilepsia Refractaria , Humanos , Epilepsia Refractaria/cirugía , Epilepsia Refractaria/fisiopatología , Masculino , Femenino , Adulto , Estudios Retrospectivos , Adulto Joven , Adolescente , Electrocorticografía , Niño , Ondas Encefálicas/fisiología , Pronóstico , Persona de Mediana Edad , Electroencefalografía , Resultado del TratamientoRESUMEN
Importance: Prenatal exposure to ubiquitous endocrine-disrupting chemicals (EDCs) may increase the risk of metabolic syndrome (MetS) in children, but few studies have studied chemical mixtures or explored underlying protein and metabolic signatures. Objective: To investigate associations of prenatal exposure to EDC mixtures with MetS risk score in children and identify associated proteins and metabolites. Design, Setting, and Participants: This population-based, birth cohort study used data collected between April 1, 2003, and February 26, 2016, from the Human Early Life Exposome cohort based in France, Greece, Lithuania, Norway, Spain, and the UK. Eligible participants included mother-child pairs with measured prenatal EDC exposures and complete data on childhood MetS risk factors, proteins, and metabolites. Data were analyzed between October 2022 and July 2023. Exposures: Nine metals, 3 organochlorine pesticides, 5 polychlorinated biphenyls, 2 polybrominated diphenyl ethers (PBDEs), 5 perfluoroalkyl substances (PFAS), 10 phthalate metabolites, 3 phenols, 4 parabens, and 4 organophosphate pesticide metabolites measured in urine and blood samples collected during pregnancy. Main Outcomes and Measures: At 6 to 11 years of age, a composite MetS risk score was constructed using z scores of waist circumference, systolic and diastolic blood pressures, triglycerides, high-density lipoprotein cholesterol, and insulin levels. Childhood levels of 44 urinary metabolites, 177 serum metabolites, and 35 plasma proteins were quantified using targeted methods. Associations were assessed using bayesian weighted quantile sum regressions applied to mixtures for each chemical group. Results: The study included 1134 mothers (mean [SD] age at birth, 30.7 [4.9] years) and their children (mean [SD] age, 7.8 [1.5] years; 617 male children [54.4%] and 517 female children [45.6%]; mean [SD] MetS risk score, -0.1 [2.3]). MetS score increased per 1-quartile increase of the mixture for metals (ß = 0.44; 95% credible interval [CrI], 0.30 to 0.59), organochlorine pesticides (ß = 0.22; 95% CrI, 0.15 to 0.29), PBDEs (ß = 0.17; 95% CrI, 0.06 to 0.27), and PFAS (ß = 0.19; 95% CrI, 0.14 to 0.24). High-molecular weight phthalate mixtures (ß = -0.07; 95% CrI, -0.10 to -0.04) and low-molecular weight phthalate mixtures (ß = -0.13; 95% CrI, -0.18 to -0.08) were associated with a decreased MetS score. Most EDC mixtures were associated with elevated proinflammatory proteins, amino acids, and altered glycerophospholipids, which in turn were associated with increased MetS score. Conclusions and Relevance: This cohort study suggests that prenatal exposure to EDC mixtures may be associated with adverse metabolic health in children. Given the pervasive nature of EDCs and the increase in MetS, these findings hold substantial public health implications.
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Disruptores Endocrinos , Síndrome Metabólico , Efectos Tardíos de la Exposición Prenatal , Humanos , Femenino , Embarazo , Efectos Tardíos de la Exposición Prenatal/inducido químicamente , Efectos Tardíos de la Exposición Prenatal/epidemiología , Síndrome Metabólico/epidemiología , Síndrome Metabólico/inducido químicamente , Niño , Masculino , Disruptores Endocrinos/efectos adversos , Disruptores Endocrinos/orina , Factores de Riesgo , Contaminantes Ambientales/orina , Contaminantes Ambientales/sangre , Contaminantes Ambientales/efectos adversos , Adulto , Exposición Materna/efectos adversos , Exposición Materna/estadística & datos numéricos , Estudios de Cohortes , Cohorte de NacimientoRESUMEN
Neurosurgical intervention is the best available treatment for selected patients with drug resistant epilepsy. For these patients, surgical planning requires biomarkers that delineate the epileptogenic zone, the brain area that is indispensable for the generation of seizures. Interictal spikes recorded with electrophysiological techniques are considered key biomarkers of epilepsy. Yet, they lack specificity, mostly because they propagate across brain areas forming networks. Understanding the relationship between interictal spike propagation and functional connections among the involved brain areas may help develop novel biomarkers that can delineate the epileptogenic zone with high precision. Here, we reveal the relationship between spike propagation and effective connectivity among onset and areas of spread and assess the prognostic value of resecting these areas. We analysed intracranial EEG data from 43 children with drug resistant epilepsy who underwent invasive monitoring for neurosurgical planning. Using electric source imaging, we mapped spike propagation in the source domain and identified three zones: onset, early-spread and late-spread. For each zone, we calculated the overlap and distance from surgical resection. We then estimated a virtual sensor for each zone and the direction of information flow among them via Granger causality. Finally, we compared the prognostic value of resecting these zones, the clinically-defined seizure onset zone and the spike onset on intracranial EEG channels by estimating their overlap with resection. We observed a spike propagation in source space for 37 patients with a median duration of 95 ms (interquartile range: 34-206), a spatial displacement of 14 cm (7.5-22 cm) and a velocity of 0.5 m/s (0.3-0.8 m/s). In patients with good surgical outcome (25 patients, Engel I), the onset had higher overlap with resection [96% (40-100%)] than early-spread [86% (34-100%), P = 0.01] and late-spread [59% (12-100%), P = 0.002], and it was also closer to resection than late-spread [5 mm versus 9 mm, P = 0.007]. We found an information flow from onset to early-spread in 66% of patients with good outcomes, and from early-spread to onset in 50% of patients with poor outcome. Finally, resection of spike onset, but not area of spike spread or the seizure onset zone, predicted outcome with positive predictive value of 79% and negative predictive value of 56% (P = 0.04). Spatiotemporal mapping of spike propagation reveals information flow from onset to areas of spread in epilepsy brain. Surgical resection of the spike onset disrupts the epileptogenic network and may render patients with drug resistant epilepsy seizure-free without having to wait for a seizure to occur during intracranial monitoring.
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Epilepsia Refractaria , Epilepsia , Niño , Humanos , Epilepsia Refractaria/diagnóstico por imagen , Epilepsia Refractaria/cirugía , Electroencefalografía/métodos , Epilepsia/cirugía , Convulsiones , Resultado del TratamientoRESUMEN
BACKGROUND: Individuals are exposed to environmental pollutants with endocrine disrupting activity (endocrine disruptors, EDCs) and the early stages of life are particularly susceptible to these exposures. Previous studies have focused on identifying molecular signatures associated with EDCs, but none have used repeated sampling strategy and integrated multiple omics. We aimed to identify multi-omic signatures associated with childhood exposure to non-persistent EDCs. METHODS: We used data from the HELIX Child Panel Study, which included 156 children aged 6 to 11. Children were followed for one week, in two time periods. Twenty-two non-persistent EDCs (10 phthalate, 7 phenol, and 5 organophosphate pesticide metabolites) were measured in two weekly pools of 15 urine samples each. Multi-omic profiles (methylome, serum and urinary metabolome, proteome) were measured in blood and in a pool urine samples. We developed visit-specific Gaussian Graphical Models based on pairwise partial correlations. The visit-specific networks were then merged to identify reproducible associations. Independent biological evidence was systematically sought to confirm some of these associations and assess their potential health implications. RESULTS: 950 reproducible associations were found among which 23 were direct associations between EDCs and omics. For 9 of them, we were able to find corroborating evidence from previous literature: DEP - serotonin, OXBE - cg27466129, OXBE - dimethylamine, triclosan - leptin, triclosan - serotonin, MBzP - Neu5AC, MEHP - cg20080548, oh-MiNP - kynurenine, oxo-MiNP - 5-oxoproline. We used these associations to explore possible mechanisms between EDCs and health outcomes, and found links to health outcomes for 3 analytes: serotonin and kynurenine in relation to neuro-behavioural development, and leptin in relation to obesity and insulin resistance. CONCLUSIONS: This multi-omics network analysis at two time points identified biologically relevant molecular signatures related to non-persistent EDC exposure in childhood, suggesting pathways related to neurological and metabolic outcomes.
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Disruptores Endocrinos , Contaminantes Ambientales , Triclosán , Niño , Humanos , Disruptores Endocrinos/efectos adversos , Leptina , Quinurenina , Multiómica , SerotoninaRESUMEN
The presence of various heavy metal ions in the industrial waste waters has recently been a challenging issue for human health. Since heavy metals are highly soluble in the aquatic environments and they can be absorbed easily by living organisms, their removal is essential from the environmental point of view. Many studies have been devoted to investigating the environmental behaviour of graphene-based nanomaterials as sorbent agents to remove metals from wastewaters arising by galvanic industries. Among the graphene derivates, especially graphene oxide (GO), due to its abundant oxygen functional groups, high specific area and hydrophilicity, is a high-efficient adsorbent for the removal of heavy and precious metals in aquatic environment. This paper reviews the main graphene, GO, functionalized GO and their composites and its applications in the metals removal process. The influencing factors, adsorption capacities and reuse capability are highlighted for the most extensively used heavy metals, including copper, zinc, nickel, chromium, cobalt and precious metals (i.e., gold, silver, platinum, palladium, rhodium, and ruthenium) in the electroplating process.
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Grafito , Metales Pesados , Nanoestructuras , Contaminantes Químicos del Agua , Adsorción , Galvanoplastia , Humanos , Aguas Residuales , Contaminantes Químicos del Agua/análisisRESUMEN
Interictal epileptiform discharges (IEDs) serve as sensitive but not specific biomarkers of epilepsy that can delineate the epileptogenic zone (EZ) in patients with drug resistant epilepsy (DRE) undergoing surgery. Intracranial EEG (icEEG) studies have shown that IEDs propagate in time across large areas of the brain. The onset of this propagation is regarded as a more specific biomarker of epilepsy than areas of spread. Yet, the limited spatial resolution of icEEG does not allow to identify the onset of this activity with high precision. Here, we propose a new method of mapping the spatiotemporal propagation of IEDs (and identify its onset) by using Electrical Source Imaging (ESI) on icEEG bypassing the spatial limitations of icEEG. We validated our method on icEEG recordings from 8 children with DRE who underwent surgery with good outcome (Engel score =1). On each icEEG channel, we detected IEDs and identified the propagation onset using an automated algorithm. We localized the propagation of IEDs with dynamic Statistical Parametric Mapping (dSPM) using a time-sliding window approach. We defined two brain regions: the ESI-onset and ESI-spread zone. We estimated the overlap of these regions with resection volume (in percentage), which served as the gold-standard of the EZ. We also estimated the mean distance of these regions from resection and clinically defined seizure onset zone (SOZ). We observed spatio-temporal propagation of IEDs in all patients across several channels (98 [85-102]) with a mean duration of 155 ms [96-186 ms]. A higher overlap with resection was seen for the ESI-onset zone compared to spread (73.3 % [ 47.4-100 %], 36.5 % [20.3-59.9 %], p = 0.008). The distance of the ESI-onset from resection was shorter compared to the ESI-spread zone (4.3 mm [3.4-5.5 mm], 7.4 mm [6.0-20.6 mm], p = 0.008) and the same trend was observed for the distance from the SOZ (11.9 mm [7.2-15.1 mm], 20.6 mm [15.4-27.2 mm], p = 0.02). These findings show that our method can map the spatiotemporal propagation of IEDs and de-lineate its onset, which is a reliable and focal biomarker of the EZ in children with DRE.Clinical Relevance - ESI on icEEG recordings of children with DRE can localize the spikes propagation phenomenon and help in the delineation of the EZ.
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Epilepsia Refractaria , Epilepsia , Mapeo Encefálico , Niño , Epilepsia Refractaria/cirugía , Electrocorticografía , Humanos , ConvulsionesRESUMEN
Drug-induced toxicity is a significant problem in clinical care. A key problem here is a general understanding of the molecular mechanisms accompanying the transition from desired drug effects to adverse events following administration of either therapeutic or toxic doses, in particular within a patient context. Here, a comparative toxicity analysis was performed for fifteen hepatotoxic drugs by evaluating toxic changes reflecting the transition from therapeutic drug responses to toxic reactions at the cellular level. By use of physiologically-based pharmacokinetic modeling, in vitro toxicity data were first contextualized to quantitatively describe time-resolved drug responses within a patient context. Comparatively studying toxic changes across the considered hepatotoxicants allowed the identification of subsets of drugs sharing similar perturbations on key cellular processes, functional classes of genes, and individual genes. The identified subsets of drugs were next analyzed with regard to drug-related characteristics and their physicochemical properties. Toxic changes were finally evaluated to predict both molecular biomarkers and potential drug-drug interactions. The results may facilitate the early diagnosis of adverse drug events in clinical application.