The correlation between obesity and severity of obstructive sleep apnea (OSA) is well established in adults, but data are inconsistent in children. We hypothesized that there is a significant ...correlation between the degree of obesity and the severity of OSA in children.
We retrospectively reviewed records of weight, height, history, and polysomnography of all 1-to 15-year-old children referred to our sleep laboratory. Children with known anomalies and repeated polysomnography were excluded from this study. Obesity was defined as body mass index z score (BMI Z score) > 1.96. The correlation between BMI Z score and apnea-hypopnea index (AHI) was assessed. Possible confounding factors, ie, age, gender, and tonsil size, were adjusted by multiple linear regression.
Four hundred eighty-two children were included in this study. Obese children had a significantly higher AHI (median, 1.5; interquartile range IQR, 0.2 to 7.0) than the AHI of nonobese children (median, 0.7; IQR, 0.0 to 2.5). BMI Z score was significantly correlated with log-transformed AHI (LnAHI) r = 0.156, p = 0.003. BMI Z score and tonsil size were still correlated with Ln(AHI) even after adjusted for other confounding factors (p = 0.001).
Degree of obesity as measured by BMI Z score and tonsil size are significantly related to severity of OSA as reflected by the AHI, although the correlation is mild.
Chromosome 14 was transferred into tumorigenic nasopharyngeal carcinoma and esophageal carcinoma cell lines by a microcell-mediated chromosome transfer approach. Functional complementation of defects ...present in the cancer cells suppressed tumor formation. A candidate tumor-suppressor gene, cysteine-rich intestinal protein 2 (CRIP2), located in the hot spot for chromosomal loss at 14q32.3, was identified as an important candidate gene capable of functionally suppressing tumor formation. Previous studies have shown that CRIP2 is associated with development. To date, no report has provided functional evidence supporting a role for CRIP2 in tumor development. The present study provides unequivocal evidence that CRIP2 can functionally suppress tumorigenesis. CRIP2 is significantly down-regulated in nasopharyngeal carcinoma cell lines and tumors. CRIP2 reexpression functionally suppresses in vivo tumorigenesis and angiogenesis; these effects are induced by its transcription-repressor capability. It interacts with the NF-κB/p65 to inhibit its DNA-binding ability to the promoter regions of the major proangiogenesis cytokines critical for tumor progression, including IL6, IL8, and VEGF. In condusion, we provide compelling evidence that CRIP2 acts as a transcription repressor of the NF-κB—mediated proangiogenic cytokine expression and thus functionally inhibits tumor formation and angiogenesis.
Purpose
This study aimed to develop and validate a new Chinese reading chart for children. The characteristics of reading profiles among Hong Kong children were also investigated.
Methods
A new ...reading chart was developed using the design principles of the MNREAD chart. Children (N = 169) aged seven to 11 years with normal vision and no developmental or reading difficulties were recruited from four local Hong Kong primary schools located in four different districts. Reading performance was measured using three versions of the new Chinese reading chart for children as well as six short passages. Repeated reading measures were conducted for 79 participants 4–8 weeks later. A linear mixed‐model analysis was performed for the reading measures to identify the contribution of each source of variation (individual participant, among‐charts within‐session and between‐sessions, and error) to the total variance.
Results
Three reading parameters were derived from the Chinese reading chart for children – maximum reading speed (MRS), critical print size (CPS) and reading acuity (RA). Results from the linear mixed‐model and Bland and Altman analyses revealed that all three versions of the chart were reproducible, with little variability among‐charts and between‐sessions (p < 0.001). The coefficient of repeatability for the MRS, CPS and RA was 0.08 logWPM, 0.16 logMAR and 0.14 logMAR respectively. The strong correlation between reading speed measured by the chart and ordinary children's reading passages confirmed the usefulness of the chart for assessing children's reading performance (Rc = 0.67, 95% CI of 0.60–0.73).
Conclusions
We developed and validated a new Chinese reading chart for children for quantifying reading performance in Chinese children with normal reading ability. This standardised clinical test can be reliably used to measure the MRS, CPS and RA in Chinese‐speaking children. Further research is needed to evaluate the validity of this chart for assessing reading performance in Chinese children with reading difficulties, dyslexia or low vision.
Objective:
To quantify stress and the psychological impact of severe acute respiratory syndrome (SARS) on high-risk health care workers (HCWs).
Method:
We evaluated 271 HCWs from SARS units and 342 ...healthy control subjects, using the Perceived Stress Scale (PSS) to assess stress levels and a structured list of putative psychological effects of SARS to assess its psychological effects. Healthy control subjects were balanced for age, sex, education, parenthood, living circumstances, and lack of health care experience.
Results:
Stress levels were raised in both groups (PSS = 18) but were not relatively increased in the HCWs. HCWs reported significantly more positive (94%, n = 256) and more negative psychological effects (89%, n = 241) from SARS than did control subjects. HCWs declared confidence in infection-control measures.
Conclusions:
In HCWs, adaptive responses to stress and the positive effects of infection control training may be protective in future outbreaks. Elevated stress in the population may be an important indicator of future psychiatric morbidity.
Abstract
Introduction
Nasopharyngeal carcinoma (NPC) is a unique epithelial malignancy with a high prevalence in Southeast Asia. To date, the genomic abnormalities leading to the pathogenesis of NPC ...remain unclear. Thus, we sought to characterize the mutational landscape in NPC tumors using next-generation sequencing approaches and to identify significantly mutated genes and pathways.
Methods
124 NPC primary tumors were examined to define the mutational landscape with whole-exome sequencing (WES) and targeted re-sequencing. Mean target coverage of tumor and blood samples was 70X and 49X in WES, and 190X and 68X in targeted resequencing, respectively. Somatic SNPs and INDELs were called with MuTect and VarScan2, respectively. MutSigCV was applied to identify potential driver events in tumorigenesis. Verification rate for somatic mutations was 95%. The functional consequences of mutations in candidate genes were evaluated by the luciferase promoter, cell proliferation, and colony formation assays.
Results
The mutation rate of NPC is relatively low, with a median of 0.9 somatic mutations per megabase. Mutational signature analysis revealed two signatures in NPC, the ubiquitous signature in cancer characterized by C>T transitions predominantly occurring at NpCpG trinucleotides and the APOBEC-related signature characterized by C>G and C>T mutations at TpCpN trinucleotides, which is related to the innate immune APOBEC family of cytidine deaminases.
MutSigCV analysis identified significantly mutated genes, NFKBIA, TP53, CYLD, KMT2D, DMXL1, KMT2C, GPR144, RYR2, BOD1L1, AKAP9, and CEP192, with q values less than 0.1. Pathway and gene ontology analysis identified several pathways/terms with enriched somatic mutations including cell cycle phase transition, chromatin modification, cell death, immune response, p53 pathway, viral carcinogenesis, and the canonical NF-κB signaling pathways. TP53 is the most frequently mutated gene (7.3%, 9/124). Almost all somatic mutations fall into the DNA binding domain of TP53, including well-known hotspot and gain-of-function mutations.
Multiple loss-of-function (LOF) mutations were detected in NF-kB negative regulators, including NFKBIA (encodes IκBα protein), CYLD, and TNFAIP3. Mutations in NFKBIA were shown to alter the tumor suppressive function of IκBα.
Conclusions
In this study we detected an APOBEC-related signature in NPC. Several NF-kB negative regulators, including NFKBIA and CYLD, were mutated in a subset of NPC primary tumors, which may contribute to pathogenesis of NPC through NF-kB signaling pathway. These data provide an enhanced road map for understanding the molecular basis underlying NPC and also provide insight for exploring new therapies.
Acknowledgement
This work was supported by the Research Grants Council of the Hong Kong Special Administrative Region, People's Republic of China Grant number AoE/M006/08 to MLL.
Citation Format: Hong Zheng, Wei Dai, Arthur KL Cheung, Josephine MY Ko, Rebecca Kan, Bonnie WY Wong, Merrin ML Leong, Maria L. Lung. Whole-exome sequencing identifies NF-kappaB pathway regulators frequently mutated in nasopharyngeal carcinoma. abstract. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 125.
Abstract
Purpose
This study aimed to develop and validate a new Chinese reading chart for children. The characteristics of reading profiles among Hong Kong children were also investigated.
Methods
A ...new reading chart was developed using the design principles of the
MNREAD
chart. Children (
N
= 169) aged seven to 11 years with normal vision and no developmental or reading difficulties were recruited from four local Hong Kong primary schools located in four different districts. Reading performance was measured using three versions of the new Chinese reading chart for children as well as six short passages. Repeated reading measures were conducted for 79 participants 4–8 weeks later. A linear mixed‐model analysis was performed for the reading measures to identify the contribution of each source of variation (individual participant, among‐charts within‐session and between‐sessions, and error) to the total variance.
Results
Three reading parameters were derived from the Chinese reading chart for children – maximum reading speed (
MRS
), critical print size (
CPS
) and reading acuity (
RA
). Results from the linear mixed‐model and Bland and Altman analyses revealed that all three versions of the chart were reproducible, with little variability among‐charts and between‐sessions (
p
< 0.001). The coefficient of repeatability for the
MRS
,
CPS
and
RA
was 0.08 log
WPM
, 0.16 log
MAR
and 0.14 log
MAR
respectively. The strong correlation between reading speed measured by the chart and ordinary children's reading passages confirmed the usefulness of the chart for assessing children's reading performance (Rc = 0.67, 95%
CI
of 0.60–0.73).
Conclusions
We developed and validated a new Chinese reading chart for children for quantifying reading performance in Chinese children with normal reading ability. This standardised clinical test can be reliably used to measure the
MRS
,
CPS
and
RA
in Chinese‐speaking children. Further research is needed to evaluate the validity of this chart for assessing reading performance in Chinese children with reading difficulties, dyslexia or low vision.
The World Health Organization (2001, 2017) recommends exclusive breastfeeding for 6 months and breastfeeding for up to 2 years with complementary food. Efforts are underway in Hong Kong to increase ...exclusive breastfeeding rates and sustain breastfeeding practices among mothers, but when mothers return to work after maternity leave, many discontinue the practice. Research has shown work-family role conflict to be one reason why breastfeeding working mothers have difficulty sustaining breastfeeding and that workplace support is a possible way to ease these conflicts. Work-family role conflict, workplace support, and the duration of breastfeeding for Hong Kong working mothers in a breastfeeding community were examined in the present study. A total of 95 breastfeeding working mothers completed the Work-Family Role Conflict Scale (adapted to Breastfeeding Mother Role; WFRC-BMR), Employee Perceptions of Breastfeeding Questionnaire (EPBS-Q), and gave demographic information, including work background and personal breastfeeding experience. Pearson’s correlation analyses showed marginal but nonsignificant negative correlations between the duration of breastfeeding and overall work-family role conflict and between the duration of breastfeeding and time-based conflict. There were no statistically significant relationships between workplace support and the duration of breastfeeding. A hierarchical multiple regression was also employed. Results showed that after controlling for the effects of background and demographic variables, including education, child’s check-up location, mother’s health issues, obtaining breastfeeding information at child’s check-up location, and time-based conflict, the WFRC-BMR itself did not predict the duration of breastfeeding and also did not predict the duration of breastfeeding over and above the effects of other background and demographic variables. These findings may be due to the small sample size, and as well as the characteristics of the current sample. Many of the participants were recruited through a nonprofit organization, the Hong Kong Breastfeeding Mothers’ Association, which advocates for breastfeeding practices in Hong Kong. It is possible that these participants might have been so keen on breastfeeding due to the support and advocacy of this organization that they continued to breastfeed despite facing obstacles and conflicts in doing so. As such, these findings depict a unique group of women whose breastfeeding practices meet international professional recommendations for healthy breastfeeding, and surpass local practices, which tends towards low rates of breastfeeding. Further studies on workplace support, work-family role conflict, and duration of breastfeeding with a larger, more representative sample are recommended.
Obstructive sleep apnea syndrome (OSAS) is a known risk factor for hypertension in adults. This relationship is less clear in childhood OSAS.
This study examined the relationship between OSAS and ...24-h ambulatory BP (ABP), a more accurate assessment than casual BP, in children with snoring.
Snoring children aged 6 to 15 years who underwent polysomnography in the sleep laboratory were recruited.
Twenty-four–hour ABP monitoring was initiated a few hours before polysomnography. The children were classified into two groups: a high apnea-hypopnea index (AHI) group (obstructive AHI > 5/h), and a low-AHI group (AHI ≤ 5/h). Mean sleep, wake, and 24-h systolic BP (SBP) and diastolic BP (DBP) were recorded. A child was considered a “nondipper” if his or her mean SBP and DBP did not decrease by ≥ 10% during sleep.
Ninety-six children (mean age ± SD, 9.4 ± 2.8 years) were recruited. Forty-one children were obese. When awake, the high-AHI group children had a significantly higher SBP. When asleep, both SBP and DBP were higher in the high-AHI group. Age, body mass index (BMI) z score, and desaturation index (DI) were significant predictors for elevated sleep DBP. BMI z score was the only significant predictor for wake and sleep SBP. Sixteen children (17%) had hypertension, and all were nondippers. Obese children in the high-AHI group had a significantly higher prevalence of hypertension than obese children in the low-AHI group. This relationship was not found in nonobese children.
The current study shows that increased DI contributed to the elevation of sleep DBP elevation.
Objective:
To examine stress and psychological impact in severe acute respiratory syndrome (SARS) patients during the 2003 outbreak. SARS is a novel, highly infectious pneumonia, and its ...psychological impact is still unclear.
Method:
At the peak of the outbreak, SARS patients (n = 79) and healthy control subjects (n = 145) completed the Perceived Stress Scale (PSS) and documented a range of psychological responses. Groups were balanced for age, sex, education, and living circumstances.
Results:
Stress was significantly higher in SARS patients than in healthy control subjects. Stress correlated significantly with negative psychological effects. Of SARS patients, 39% (n = 30) were infected health care workers; these individuals reported significantly more fatigue and worries about health than did other patients. Of patients, 25% (n = 20) requested psychological follow-up.
Conclusions:
General stress and negative psychological effects are increased in SARS patients, particularly among infected health care workers. This may increase the risk of mood and stress-related disorders. Functional impairment is apparent in the postrecovery phase.
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