Lifetime residential data collection protocol for the Adolescent Brain Cognitive Development (ABCD) Study

Understanding the impacts of environmental exposures on health outcomes during development is an important area of research for plenty of reasons. Collecting retrospective and prospective residential history can enrich observational studies through eventual linkages to external sources. Augmenting participant health outcome data with environmental data can better inform on the role of the environment, thereby enhancing prevention and intervention efforts. However, collecting the geospatial information needed for this type of research can be difficult, especially when data are collected directly from participants. Participants' residential histories are unique and often complex. Collecting residential history data often involves capturing precise spatial locations along specific timeframes as well as contending with recall bias and unique, complex living arrangements. When trying to assess lifetime environmental exposures, researchers must consider the many changes in location a person goes through and the timeframes in which these changes occur, ultimately creating a multidimensional and dynamic dataset. Creating data collection protocols that are feasible to administer, result in accurate data, and minimize data missingness is a major challenge to undertake. Here, we provide an overview of the protocol developed to collect the lifetime residential address information of participants in the Adolescent Brain Cognitive Development (ABCD) Study.

Lifetime residential history collection and processing for environmental data linkages in the ABCD study

By using geospatial information such as participants' residential history along with external datasets of environmental exposures, ongoing studies can enrich their cohorts to investigate the role of the environment on brain-behavior health outcomes. However, challenges may arise if clear guidance and key quality control steps are not taken at the outset of data collection of residential information. Here, we detail the protocol development aimed at improving the collection of lifetime residential address information from the Adolescent Brain Cognitive Development (ABCD) Study. This protocol generates a workflow for minimizing gaps in residential information, improving data collection processes, and reducing misclassification error in exposure estimates.

Comparison of inhaled versus intravenous anesthesia for laryngoscopy and laryngeal electromyography in a rat model

Background

Propofol and remifentanil intravenous combination is one popular form of total intravenous anesthesia (TIVA) in mainstream clinical practice, but it has rarely been applied to a rat model for laryngoscopy and laryngeal electromyography (LEMG). Our objective was to establish a safe and reproducible general anesthetic protocol for laryngoscopy and endoscopic LEMG in a rat model. Our hypothesis is that TIVA allows a minimally morbid, and feasible laryngoscopy and LEMG.

Methods

Sprague Dawley rats were subjected to either inhalational anesthesia (IA) (isoflurane) or TIVA (propofol and remifentanil) and underwent laryngoscopy and LEMG. The primary outcome was a complete minimally interrupted rigid laryngoscopy and obtaining reproducible motor unit potentials from the posterior cricoarytenoid muscles. The secondary outcome was morbidity and mortality.

Results

Seventeen out of twenty-two rats underwent both TIVA and IA. Only two underwent IA only. All nineteen rats that underwent IA had a successful experiment. Seventeen rats underwent TIVA, however, only nine completed a successful experiment due to difficulty achieving a surgical plane, and respiratory events. Upon comparing the success of the two anaesthetic regimens, IA was superior to TIVA (P = 0.0008). There was no statistical difference between the amplitudes (p = 0.1985) or motor units burst duration (p = 0.82605) of both methods. Three mortalities were encountered, one of which was due to lidocaine toxicity and two were during anesthetic induction. Respiratory related morbidity was encountered in two rats, all seen with TIVA.

Conclusions

TIVA is not an ideal anesthetic regimen for laryngeal endoscopy and LEMG in rat models. Contrary to our hypothesis, IA did not affect the quality of the LEMG and allowed a seamless rigid endoscopy.

Electronic supplementary material

The online version of this article (10.1186/s40463-018-0312-9) contains supplementary material, which is available to authorized users.

3D collagen architecture induces a conserved migratory and transcriptional response linked to vasculogenic mimicry

The topographical organization of collagen within the tumor microenvironment has been implicated in modulating cancer cell migration and independently predicts progression to metastasis. Here, we show that collagen matrices with small pores and short fibers, but not Matrigel, trigger a conserved transcriptional response and subsequent motility switch in cancer cells resulting in the formation of multicellular network structures. The response is not mediated by hypoxia, matrix stiffness, or bulk matrix density, but rather by matrix architecture-induced β1-integrin upregulation. The transcriptional module associated with network formation is enriched for migration and vasculogenesis-associated genes that predict survival in patient data across nine distinct tumor types. Evidence of this gene module at the protein level is found in patient tumor slices displaying a vasculogenic mimicry (VM) phenotype. Our findings link a collagen-induced migration program to VM and suggest that this process may be broadly relevant to metastatic progression in solid human cancers.

Extracellular matrix plays a central role in driving cancer development. Here the authors using an in vitro approach show that confining collagen architectures induce fast and persistent cell migration and the formation of multicellular network structures linked to vascular mimicry observed in tumours from patients.

Identifying tools for capturing the overall experience of dyspnea in a lung cancer population: The patient’s perspective

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Background: Efficient methods of tracking dyspnea can improve quality of care. We asked lung cancer patients to assess five validated patient-reported outcome (PRO) tools and determine whether these tools captured different domains of their dyspnea experience. Methods: This cross-sectional study of adult lung cancer outpatients of all stages utilized touch screen tablets to administer five dyspnea tools (Borg severity (B), Reduced Cancer Dyspnea (R), Breathlessness intensity (I), breathlessness distress (D), and MRC breathlessness (M) scales) that focused on the severity, experience, intensity, extent, and functional impairment of dyspnea, respectively. Patients were then asked whether each tool captured their dyspnea experience. Results: Of 226 lung cancer patients, 120 reported some level of dyspnea, and their responses were analyzed. Median age (range) was 67 (30-97) years; 53% were males; 37% were stage I-II; 56%, were stage III-IV. All the tools except B were completed by over 90% of patients (R 95%, I 93%, D 91%, M 91%). 71% of patients thought that M captured functional impairment well, while 58-62% of patients thought that R, S, A captured experience, intensity and distress well. B had the lowest completion rate (83%) and the lowest patient perception that is captured severity of dyspnea well (49%). Qualitative analysis suggests that most dyspnea is activity-related in this population, which would be consistent with patients favoring M (functional assessment) over B (dyspnea at present in clinic). I+D+M takes under 5 minutes to complete, whilst R takes 5+ minutes alone to complete. Conclusions: In a sample of cancer patients with high prevalence of dyspnea, patients felt four of five tools were useful in capturing various domains of their dyspnea experience. The majority of patients felt that the questions were relevant to their circumstances. I, D, M are appropriate screening tools, whilst R may be useful under specific circumstances. Our next step is the application and evaluation of self management tools in the dyspnea setting using these four tools.

A survey of dietary supplement use during pregnancy at an academic medical center

OBJECTIVE

This study examined the usage patterns of dietary supplements during pregnancy, providing information about type of supplements used, prevalence of use, and rationale for use.

STUDY DESIGN

A survey was distributed to pregnant patients who were touring the University of California, San Francisco birthing center or who were receiving care at the University of California, San Francisco Women's Health Clinic between November 1999 and March 2000.

RESULTS

Of the 150 surveys completed, 20 women (13%) used dietary supplements during pregnancy. The most common products were echinacea (4/45, 8.9%), pregnancy tea (4/45, 8.9%), and ginger (3/45, 6.7%). The most common reasons for beginning or discontinuing use of dietary supplements were to relieve nausea and vomiting (5/20, 25%) and to avoid potential harm to the fetus (5/20, 25%). All side effects were mild and included gastrointestinal discomfort in a patient using elderberry, taste disturbance in a patient using echinacea, and intestinal gas in a patient using borage seed oil. Most patients informed their primary care provider of their use of dietary supplements (15/20, 75%).

CONCLUSION

The use of dietary supplements among pregnant women is low but is of concern because of the lack of safety data. Most patients use dietary supplements to relieve gastrointestinal symptoms and disclose such use to their primary care provider.

Assessment of arylamine N-acetyltransferase (NAT1) activity in mononuclear leukocytes of cystic fibrosis patients

The clearance of sulphamethoxazole (SMX), a compound metabolised primarily by the N-acetyltransferase NAT1, is increased in cystic fibrosis (CF) patients. We assessed the activity and kinetic properties of NAT1 in lysates of peripheral blood mononuclear leukocytes (MNL) from CF (n = 17) and control (n = 22) subjects using SMX and p-aminobenzoic acid (PABA) as test substrates. The Km and Vmax values of both substrates in MNL from CF patients and control subjects were not significantly different. The acetylation of PABA (100 microM) by intact MNL from CF patients (n = 4) was not different from the observed in intact MNL from controls (n = 9) (25 +/- 3 pmol h-1 per 10(6) MNL vs 27 +/- 4 pmol h-1 per 10(6) MNL). These results suggest that there are not systemic changes in this enzyme in CF. The increased metabolic clearance of SMX may therefore be related to factors other than alterations in the level of activity of the N-acetyltransferase NAT1.

Acetylator phenotyping: the urinary caffeine metabolite ratio in slow acetylators correlates with a marker of systemic NAT1 activity

Eighteen healthy Caucasians were evaluated for the systemic acetylation of a caffeine metabolite using the urinary caffeine metabolite ratio 5-acetylamino-6-formylamino-3-methyluracil (AFMU) to 1-methylaxanthine (1X) and for N-acetyltransferase activity in peripheral blood mononuclear leukocytes (MNL) using p-aminobenzoic acid (PABA). These are markers for systemic NAT2 and NAT1 N-acetyltransferase activities, respectively. Fourteen slow acetylators and four fast acetylators (the NAT2 polymorphism) were identified by the caffeine metabolite ratio. In slow acetylators who have decreased levels of hepatic NAT2, the AFMU/1X ratio was significantly correlated with PABA acetylation in MNL (r = 0.8; p = 0.0002). These results suggest that significant variation in the acetylation of arylamine substrates susceptible to the classical acetylator polymorphism is attributable to variation in NAT1 activity in the slow acetylator phenotype.

High-performance liquid chromatographic assay of diltiazem and six of its metabolites in plasma: application to a pharmacokinetic study in healthy volunteers

A sensitive and specific reversed-phase high-performance liquid chromatographic assay for simultaneous determination of plasma concentrations of diltiazem and six of its metabolites known to occur in humans is reported. Using 2 mL of plasma, the lower limit of quantitation of the assay was less than 10 ng/mL of diltiazem and each of the metabolites, with coefficients of variation of less than 10%. The assay was successfully applied to determine the kinetics of diltiazem and its major metabolites in four healthy volunteers after each received a single 90-mg oral dose of diltiazem. In addition to the previously reported two major metabolites in humans, deacetyl diltiazem (M1) and N-monodemethyl diltiazem (MA), another previously unreported major metabolite, deacetyl N-monodemethyl diltiazem (M2), was present at comparable concentrations to M1 and MA in all four volunteers. In addition, another metabolite, deacetyl diltiazem N-oxide (M1-NO), which was previously found most abundant in urine, was also estimated in the plasma of two volunteers. Two other known human metabolites, deacetyl O-demethyl diltiazem (M4) and deacetyl N,O-didimethyl diltiazem (M6), were not detected in any of the four study subjects. The average maximum plasma concentrations of M1, M2, MA, and M1-NO were 10, 15, 26, and 13%, respectively, of the mean maximum diltiazem concentrations.