Faculty Bibliography

OBJECTIVES/OBJECTIVE:To evaluate whether parents who assess their infants as more developmentally advanced are more likely to begin feeding their infants complementary foods before 6 months, and whether developmental readiness explains racial and ethnic differences in complementary food introduction. STUDY DESIGN/METHODS:In a cohort of mothers of 5475 infants from New York state, 9 markers of infant development and timing of initiating complementary feeding were assessed. Mixed effect models assessed associations between developmental markers and initiation of complementary feeding before 6 months term-corrected age. Direct and indirect effects of racial and ethnic differences in complementary feeding through a total development score were computed. RESULTS:In a fully adjusted model, infant sitting (adjusted odds ratio [aOR]:1.60, 95% CI:1.32, 1.93), head control (aOR:1.51, 95% CI:1.26, 1.81), reaching (aOR:1.19, 95% CI:1.04, 1.37), mouthing (aOR:1.26, 95%CI:1.08, 1.46), and having a good appetite (aOR:1.61, 95%CI:1.15, 2.24) were uniquely associated with complementary feeding before age 6 months. A 1-point increase in a total development score was also associated with higher odds of complementary feeding (aOR:1.26, 95% CI:1.19, 1.33). The development score explained some racial and ethnic differences in the odds of complementary feeding before 6 months. CONCLUSIONS:Results suggest that parents are using their children's developmental markers to decide when to begin complementary feeding. Furthermore, observations of racial and ethnic differences in the timing of complementary feeding may be explained by perceptions of developmental readiness, in line with recommendations. Future research on complementary feeding should incorporate assessments of infant developmental readiness.

BACKGROUND:The 2022-2023 global mpox outbreak predominantly affected sexual minority men, with notable racial/ethnic disparities in the USA. While the current literature has established the clinical predictors of severe mpox disease, little is known about the role of insurance status on clinical outcomes. We sought to characterize patients diagnosed with mpox in New York City (NYC) and examine associations between insurance status and mpox severity score (mpox-SS). METHODS:), prior vaccination with JYNNEOS or a smallpox vaccine, presence of a sexually transmitted infection (STI), and CDC Social Vulnerability Index. RESULTS:The mean age (SD) was 38.3 (10.2) years with 53 (37.1%) identifying as non-Hispanic White, 44 (30.8%) as Hispanic/Latino, and 30 (20.9%) as non-Hispanic Black. Over 90% were male sex at birth or identified as cisgender men and approximately 80% were sexual minority men. Ninety-six (67.1%) had private insurance, 6 (4.2%) Medicare, 35 (24.5%) Medicaid, and 4 were (2.8%) uninsured. Sixty-three (44.1%) had a confirmed HIV diagnosis, 25 (17.4%) patients had prior JYNNEOS vaccination, and 31 (21.7%) had a high-risk condition. Thirty-eight (26.6%) patients received tecovirimat; 21 (14.7%) patients were hospitalized, with 4 (2.8%) of those admitted to the ICU. The mean (SD) mpox-SS was 6.85 (3.36). In univariate analysis, lack of insurance or Medicaid status was associated significantly with more severe mpox-SS. Insurance status remained significant (p = 0.03) in multivariable models. CONCLUSIONS:Being uninsured or on Medicaid was significantly associated with a higher mpox-SS in this diverse cohort of predominantly cisgender sexual minority men in NYC. High-risk status and lack of prior vaccination were associated with higher mpox-SS. Further studies are needed to assess the relationship between insurance, delays in access to care, or other socioeconomic inequities with severe mpox to understand the inequities beyond insurance access to prevent disparities in future outbreaks.

Preterm birth can significantly impact cognitive development, particularly executive functions (EF). This study investigated hot (with emotional/motivational aspects) and cool (purely neutral/cognitive) EF trajectories in preterm and full-term children, examining brain-behavior relationships. It included 3508 participants aged 9-10 years (mean age 10.0 years) at baseline from the Adolescent Brain and Cognitive Development (ABCD®) study, evenly split between preterm and full-term births (54.36 % males; 1.05 % Asian American, 10.69 % Black, 15.68 % Hispanic, 61.57 % White, 11.09 % other). Participants were followed for 4 years, completing MRI scans and a cool EF task at baseline and at the 2-year follow-up, as well as hot/cool and hot EF tasks at the 1- and 3-year follow-ups. Linear mixed models showed varying effects of preterm birth across the different EF tasks. Specifically, preterm children showed persistent cool EF deficits and a catch-up pattern for hot EF, while performance on the hot/cool task showed no association with preterm birth. Brain-behavior bivariate latent change score analyses identified distinct bidirectional relationships in specific regions, suggesting altered cognitive-brain maturation interactions in preterm children. These findings highlight the complex nature of EF development following preterm birth: while cool EF deficits persist, hot EF shows catch-up growth in preterm children during early adolescence. This emphasizes the need for tailored interventions and long-term follow-up in this population.

This study examined the bidirectional associations among maternal depressive symptoms, child social skills, and child executive function between 3 (T1) and 4 years (T2) of child age. Participants included 1,292 families and children (49% girls; 41% Black) from the Family Life Project, living in rural, low-income areas of the United States. Using an autoregressive and cross-lagged latent change score model, we found significant bidirectional associations between maternal depressive symptoms and child social skills, such that lower maternal depressive symptoms at T1 predicted a greater increase in child social skills from T1 to T2 and higher social skills at T1 predicted a greater decline in maternal depressive symptoms from T1 to T2. In addition, we found bidirectional associations between child social skills and executive function. Specifically, higher social skills predicted a greater increase in executive function from T1 to T2 and higher executive function at T1 predicted a smaller increase in social skills from T1 to T2. However, we found no evidence for the bidirectional relation between maternal depressive symptoms and child executive function. Our findings support the bidirectional model of child development and suggest that interventions targeting early maternal depression in underserved families may foster the growth of children's social skills during the preschool years. Additionally, enhancing child social skills may reduce maternal depressive symptoms and boost the growth of child executive function. The results also highlight the interactive nature between the growth of social skills and executive function during early childhood. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

BACKGROUND:Plasma proteomic data can be used to discover breast cancer risk biomarkers beyond established risk factors. Discovery using a large-scale platform in a diverse population is needed. METHODS:We investigated 4,712 plasma proteins and breast cancer risk among post-menopausal women in a prospective cohort analysis in the Atherosclerosis Risk in Communities study. Proteins were measured by SomaScan® 5K Assay. Incident cases were ascertained primarily from state cancer registries. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox regression adjusting for risk factors, and applied the Benjamini-Hochberg method to control false discovery. We determined whether the statistically significant proteins were confirmed in a case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC). RESULTS:After median follow-up of 23.3 years, 340 of 4,403 women had an incident breast cancer. Two proteins were statistically significantly associated after p-value adjustmentper doubling, the HR of breast cancer was 1.45 (95% CI: 1.23-1.70, p = 7.47*10-6, padjusted=0.0370) for protein LEG1 homolog and 2.52 (95% CI: 1.66-3.83, p = 1.50*10-5, padjusted=0.0371) for ADP-dependent glucokinase. Results were consistent in a lagged analysis and among both Black (28.1%) and White women. In EPIC, both associations were confirmed (protein LEG1 homolog, HR = 1.24, 95% CI 1.14-1.35, p = 9.79*10-7, ADP-dependent glucokinase, HR = 1.13, 95% CI 1.03-1.23, p = .01). CONCLUSION/CONCLUSIONS:We identified two plasma proteins associated with increased breast cancer risk over the longer-term in post-menopausal women; both were confirmed in an independent cohort. If further validated, these plasma protein biomarkers could be considered for utility in current risk stratification tools.

BACKGROUND:Prenatal exposure to organophosphate esters (OPEs) has been linked to neurotoxic effects in children; however, epidemiological evidence remains inconclusive. We investigated associations of prenatal OPE exposure with child behaviors. METHODS:We analyzed data of 2948 mother-child dyads from 12 prospective cohorts of the Environmental influences on Child Health Outcomes (ECHO) Cohort. Nine OPE biomarkers quantified in prenatal maternal urine were modeled based on detection frequency. Child behaviors were assessed using the Child Behavior Checklist for Ages 1½-5. We used linear mixed effects models to examine associations between each OPE biomarker and composite T-scores. We evaluated child sex and social vulnerability as potential effect modifiers. RESULTS: = -0.89, 95% CI: -1.74, -0.04). Associations between high BCPP exposure and higher externalizing and total problem T-scores were stronger among children from highly vulnerable neighborhoods compared to those from less vulnerable neighborhoods (p-interaction < 0.1). Child sex modified associations for bis(1,3-dichloro-2-propyl) phosphate and high BCPP exposure, with males exhibiting greater adverse behaviors for all associations. DISCUSSION/CONCLUSIONS:Gestational exposure to several OPEs may be adversely associated with early behavioral development.