Pre- and peri-natal hurricane exposure alters DNA methylation patterns in children.

Hurricane Maria was the worst recorded natural disaster to affect Puerto Rico. Increased stress in pregnant women during and in the aftermath of the hurricane may have induced epigenetic changes in their infants, which could affect gene expression. Stage of gestation at the time of the event was associated with significant differences in DNA methylation in the infants, especially those who were at around 20-25 weeks of gestation when the hurricane struck. Significant differences in DNA methylation were also associated with maternal mental status assessed after the hurricane, and with property damage. Hurricane Maria could have long lasting consequences to children who were exposed to this disaster during pregnancy.

Mental Well-being InSciEd Out: Health Partnerships with the Boys & Girls Clubs of Puerto Rico.

BACKGROUND: Mental health care is a top clinical concern for modern Puerto Rico, especially given a dramatically changing economic landscape paired with recurrent natural disasters. Youth are particularly at-risk due to long-term impacts of toxic stress and adverse childhood experiences on health and development. OBJECTIVES: Here we present a novel clinician-community-educator-scientist partnership to address Puerto Rican youth mental well-being and wellness. We deployed pilot health workshops within the Boys & Girls Clubs of Puerto Rico to build youth mental health conceptual understanding and competencies in stress recognition and management. The work in progress herein evaluates acceptability and feasibility of our curricular model. METHODS: Dialogue with community stakeholders guided curricular design of workshops for youth ages 6 to 13 and older. Prior to implementation, educators and volunteers attended a 1-day training on educational strategies. Workshop success was evaluated using qualitative approaches (i.e., narrative feedback, educator and volunteer reflections, youth Talking Drawings) to assess youth engagement, youth conceptual health understanding, and educator/volunteer impressions of feasibility and impact. RESULTS: Initial findings indicate high acceptability and feasibility of our curricular model. Youth engagement and enthusiasm were noted in educator feedback and continue to be sustained post-workshop. Preliminary analysis shows accompanying increases in youth conceptual mental health understanding, particularly for 6- to 12-year-olds in recognition of stress and healthy coping mechanisms. Reciprocal gains were observed for volunteers. CONCLUSIONS: Activities have evolved into a formal partnership called Semilla, which features expanded analysis of mental well-being and wellness outcomes. Our collaborative model continues to engage Puerto Rican youth in the science of their well-being.

Decreased CSTB, RAGE, and Axl Receptor Are Associated with Zika Infection in the Human Placenta.

Zika virus (ZIKV) compromises placental integrity, infecting the fetus. However, the mechanisms associated with ZIKV penetration into the placenta leading to fetal infection are unknown. Cystatin B (CSTB), the receptor for advanced glycation end products (RAGE), and tyrosine-protein kinase receptor UFO (AXL) have been implicated in ZIKV infection and inflammation. This work investigates CSTB, RAGE, and AXL receptor expression and activation pathways in ZIKV-infected placental tissues at term. The hypothesis is that there is overexpression of CSTB and increased inflammation affecting RAGE and AXL receptor expression in ZIKV-infected placentas. Pathological analyses of 22 placentas were performed to determine changes caused by ZIKV infection. Quantitative proteomics, immunofluorescence, and western blot were performed to analyze proteins and pathways affected by ZIKV infection in frozen placentas. The pathological analysis confirmed decreased size of capillaries, hyperplasia of Hofbauer cells, disruption in the trophoblast layer, cell agglutination, and ZIKV localization to the trophoblast layer. In addition, there was a significant decrease in CSTB, RAGE, and AXL expression and upregulation of caspase 1, tubulin beta, and heat shock protein 27. Modulation of these proteins and activation of inflammasome and pyroptosis pathways suggest targets for modulation of ZIKV infection in the placenta.

Naturalization of the microbiota developmental trajectory of Cesarean-born neonates after vaginal seeding.

BACKGROUND: Early microbiota perturbations are associated with disorders that involve immunological underpinnings. Cesarean section (CS)-born babies show altered microbiota development in relation to babies born vaginally. Here we present the first statistically powered longitudinal study to determine the effect of restoring exposure to maternal vaginal fluids after CS birth. METHODS: Using 16S rRNA gene sequencing, we followed the microbial trajectories of multiple body sites in 177 babies over the first year of life; 98 were born vaginally, and 79 were born by CS, of whom 30 were swabbed with a maternal vaginal gauze right after birth. FINDINGS: Compositional tensor factorization analysis confirmed that microbiota trajectories of exposed CS-born babies aligned more closely with that of vaginally born babies. Interestingly, the majority of amplicon sequence variants from maternal vaginal microbiomes on the day of birth were shared with other maternal sites, in contrast to non-pregnant women from the Human Microbiome Project (HMP) study. CONCLUSIONS: The results of this observational study prompt urgent randomized clinical trials to test whether microbial restoration reduces the increased disease risk associated with CS birth and the underlying mechanisms. It also provides evidence of the pluripotential nature of maternal vaginal fluids to provide pioneer bacterial colonizers for the newborn body sites. This is the first study showing long-term naturalization of the microbiota of CS-born infants by restoring microbial exposure at birth. FUNDING: C&D, Emch Fund, CIFAR, Chilean CONICYT and SOCHIPE, Norwegian Institute of Public Health, Emerald Foundation, NIH, National Institute of Justice, Janssen.

Habilidades pre-escolares de los niños nacidos prematuramente y con bajo peso / Preschool abilities of children born preterm and low weight

El objetivo de este estudio fue conocer el nivel de desarrollo en la etapa pre-escolar de un grupo de niños nacidos prematuramente y con bajo peso. Se evaluó un grupo 20 niños de cuatro años nacidos prematuramente y con bajo peso y un grupo de 20 niños nacidos luego de gestación completada y peso deseado utilizando la prueba de integración visual-motora Beery-Buktenica. Además, se administró el cuestionario del desarrollo Ages and Stages (ASQ-3) a las 40 madres. El análisis estadístico se llevó a cabo mediante una prueba t de studentpara grupos independientes. El grupo de niños nacidos prematuramente obtuvo puntuaciones significativamente inferiores en las pruebas que medían las habilidades de percepción visual (µ1 83.65 ; µ2 93.7) (p=0.0001), integración visual-motora (µ1 93.6 ; µ2 104.8) (p=0.001) y motor fina (µ1 36.00 ; µ2 44.25) (p=0.033) al ser comparados con el grupo de niños nacidos luego de una gestacióncompletada.El estudio sugiere que los niños nacidos prematuramente y con bajo peso presentan menor ejecución en el desarrollo sensorio-motor durante la etapa pre-escolar. Estas desventajas pasan desapercibidas y pueden representar rezago en las tareas escolares futuras que requieren de dichas habilidades. Es importante fomentar la evaluación y estimulación ambiental temprana en esta población aún en ausencia de indicadores de riesgo.

The purpose of this study was to evaluate the development among a group of pre-school children born premature and with low weight. We evaluated a group of four years old children; 20 children born prematurely and 20 children born after a full gestation and desired weight, using the Beery-Buktenica visual-motor integration test. We also administered the Ages and Stages Questionnaire (ASQ-3) development test to all 40 mothers. Statistical analysis was performed using student t test for independent groups. The group of children born prematurely scored significantly lower on tests measuring visual perception skills (µ1 83.65 ; µ2 93.7) (p = 0.0001), visual-motor integration (µ1 93.6 ; µ2 104.8) (p = 0.001) and fine motor (µ1 36.00 ; µ2 44.25) (p=0.033) (p = 0.033), when compared to the group of children born after a full term. This study suggests that premature low weight born children have lower performance in the sensory-motor development during the preschool years. These disadvantages go unnoticed and may represent future delays on school tasks that require these skills. It is important to promote an early assessment and environmental stimulation among this population even in the absence of risk indicators