Faculty Bibliography

The placenta adapts to maternal environment and its alterations may have a lasting impact on child's temperament development. Prenatal stress has been linked to both a downregulation of monoamine oxidase A (MAOA) gene expression in the placenta and to difficult temperament. Capitalizing on an ongoing longitudinal study, we analysed data from 95 mother-child dyads to investigate whether MAOA mediates the association between prenatal stress and infant temperament. Prenatal stress was defined as exposure to Superstorm Sandy (Sandy) during pregnancy. Infant temperament was measured by Infant Behaviour Questionnaire-Revised. MAOA gene expression was quantified in placenta tissue. The Smiling and Laughter subscale score was independently associated with Sandy exposure and MAOA placental gene expression. Mediation analysis confirmed that MAOA expression partially mediated the relationship between Sandy and Smiling and Laughter subscale, suggesting that in utero exposure to Sandy could induce lower frequency of smiling and laughter via downregulation of placental MAOA gene expression. These effects could compromise optimal temperamental trajectory and contribute to risk for psychological problems. Placental epigenetic markers can contribute to a multidimensional model of early intervention for high-risk children.

Background: Chronic illness in children has adverse effects on family members besides the patient and can impact the integrity and function of the family unit. Most previous studies have examined a single disease entity. However, there has been limited assessment comparing the effect of different illnesses on family function.
Method(s): Established patients treated in the pediatric ambulatory Nephrology or DM clinics were included in the study. Their parents were asked to complete the 2-page Pediatric Quality-of-Life Family Impact Module (PedsQL-FIM), version 2.0, a validated survey instrument. Clinical and laboratory data were retrieved from the electronic health record. Data were summarized as mean+/-SD. Disease group and child age were entered as predictors in linear regression analyses with FIM total and subscale scores as outcome variables. Comparisons between groups were assessed using paired t-tests.
Result(s): 96 patients (43 F: 53 M) were evaluated in the Nephrology Clinic and 55 (30 F: 25 M) in the DM Clinic. The mean age of the patients was 13.0+/-3.9 and 10.4+/- 6.3 yr, respectively. Within the KD sample, older age was significantly associated with lower scores on all FIM subscale scores. Gender was not a significant predicator for FIM scores in either disease group. Controlling for age, chronic illness group was a significant predictor of the FIM total and subscale scores. Parents of D patients endorsed significantly lower total FIM scores compared to the KD patients (D 58+/-16; KD 79+/-17 p <0.001) as well as on subscales of physical, emotional, social, and cognitive functioning, communication, worry, daily activities, family relationships, and reports of health-related quality of life (P<0.01).
Conclusion(s): Our findings confirm that chronic illness in childhood adversely affects a wide range of aspects of family function. The impact is greater in older children with KD and varies depending on the disease context. Families with children who have DM manifested greater disturbances than those with children who have isolated KD. Further study is warranted to assess the effects of the underlying renal disease and intensity of medical care and whether there are specific features can be used to identify vulnerable families

Although both infancy and artificial intelligence (AI) researchers are interested in developing systems that produce adaptive, functional behavior, the two disciplines rarely capitalize on their complementary expertise. Here, we used soccer-playing robots to test a central question about the development of infant walking. During natural activity, infants' locomotor paths are immensely varied. They walk along curved, multi-directional paths with frequent starts and stops. Is the variability observed in spontaneous infant walking a "feature" or a "bug?" In other words, is variability beneficial for functional walking performance? To address this question, we trained soccer-playing robots on walking paths generated by infants during free play and tested them in simulated games of "RoboCup." In Tournament 1, we compared the functional performance of a simulated robot soccer team trained on infants' natural paths with teams trained on less varied, geometric paths-straight lines, circles, and squares. Across 1,000 head-to-head simulated soccer matches, the infant-trained team consistently beat all teams trained with less varied walking paths. In Tournament 2, we compared teams trained on different clusters of infant walking paths. The team trained with the most varied combination of path shape, step direction, number of steps, and number of starts and stops outperformed teams trained with less varied paths. This evidence indicates that variety is a crucial feature supporting functional walking performance. More generally, we propose that robotics provides a fruitful avenue for testing hypotheses about infant development; reciprocally, observations of infant behavior may inform research on artificial intelligence.

Estimates of the prevalence of Parkinson's disease in North America have varied widely and many estimates are based on small numbers of cases and from small regional subpopulations. We sought to estimate the prevalence of Parkinson's disease in North America by combining data from a multi-study sampling strategy in diverse geographic regions and/or data sources. Five separate cohort studies in California (2), Minnesota (1), Hawaii USA (1), and Ontario, Canada (1) estimated the prevalence of PD from health-care records (3), active ascertainment through facilities, large group, and neurology practices (1), and longitudinal follow-up of a population cohort (1). US Medicare program data provided complementary estimates for the corresponding regions. Using our age- and sex-specific meta-estimates from California, Minnesota, and Ontario and the US population structure from 2010, we estimate the overall prevalence of PD among those aged ≥45 years to be 572 per 100,000 (95% confidence interval 537-614) that there were 680,000 individuals in the US aged ≥45 years with PD in 2010 and that that number will rise to approximately 930,000 in 2020 and 1,238,000 in 2030 based on the US Census Bureau population projections. Regional variations in prevalence were also observed in both the project results and the Medicare-based calculations with which they were compared. The estimates generated by the Hawaiian study were lower across age categories. These estimates can guide health-care planning but should be considered minimum estimates. Some heterogeneity exists that remains to be understood.