Recent Research Publications and Funding

Many pain assessment tools for preschool and school-aged children are based on facial expressions of pain. Despite broad use, their metrics are not rooted in the anatomic display of the facial pain expression. We aim to describe quantitatively the patterns of initiation and maintenance of the infant pain expression across an expressive cycle. We evaluated the trajectory of the pain expression of three newborns with the most intense facial display among 63 infants receiving a painful stimulus. A modified “point-pair” system was used to measure movement in key areas across the face by analyzing still pictures from video recording the procedure. Point-pairs were combined into “upper face” and “lower face” variables; duration and intensity of expression were standardized. Intensity and duration of expression varied among infants. Upper and lower face movement rose and overlapped in intensity about 30% into the expression. The expression reached plateau without major change for the duration of the expressive cycle. We conclude that there appears to be a shared pattern in the dynamic trajectory of the pain display among infants expressing extreme intensity. We speculate that these patterns are important in the communication of pain, and their incorporation in facial pain scales may improve current metrics.

Objective: The purpose of this study was to explore the extent to which neighborhood poverty was associated with the utilization of dental care by American adolescents.

Methods: To accomplish the study goals we conducted multilevel modeling analyses of two nationally representative data sets: National Longitudinal Study of Adolescent Health (Add Health) and the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K).

Results: As hypothesized, neighborhood poverty predicted frequency of dental care in both studies (t = 6.06; P < 0.001; t = 2.44; P < 0.05). Even after accounting for individual level predictors such as household income, health insurance, and parental education, adolescents living in poor neighborhoods are less likely than their counterparts in non-poor neighborhoods to utilize dental care.

Conclusions: The findings from this study indicate that neighborhoods influence dental care utilization patterns in adolescents.

Preeclampsia (PE) affects 8–10% of women in the US. Long-term consequences include development of maternal hypertension and hypertension in offspring. The familial risk of PE is well established, though underlying mechanisms are unknown. In this study, our goal was to identify differentially methylated genes common to both maternal peripheral blood cells (MPBCs) and placental tissue of fetal origin in order to determine potential epigenomic markers of heritable PE risk. Methylation quantification of individual CpG dinucleotides in MPBCs and placental tissue from women with and without PE was determined using the Illumina Infinium methylation array (n=6/group). Gain of methylation was seen in 218 CpG dinucleotides from MPBCs, and ~34% of these changes were also present in placenta. Significant methylation loss was observed in 123 CpG dinucleotides, and ~28% of changes were also present in placenta. Validation of methylation was determined by bisulfite sequencing. Differentially methylated loci were primarily located in non-CpG island regions of genes with known roles in angiogenesis, inflammation and metabolic regulation. This study provides novel evidence for the mechanisms underlying heritable risk for PE, implicating differential transgenerational DNA methylation in key genes associated with the etiology and consequences of PE and suggest that these may serve as novel biomarkers for PE screening.

We want to thank Dr. Wang and colleagues for their recently reported findings titled, “Mitigation of Radon and Thoron Decay Products by Filtration” in the November 2011 issue. Their experiments advanced what is known about the role of filtration in reducing exposure to ionizing radiation and broadened the discussion for mitigation alternatives when active soil depressurization is not feasible. In particular, the low-cost idea of using a fan with surgical mask material is a strategy to address risk reduction across socioeconomic strata.

In reading the results we wondered about two elements of interpretation made by Dr. Wang et al. First, in Fig. 3 they showed extremely significant reductions when the filter was operated at 0.8 h−1 rate, yet they used a less robust setting on the filter for their dose calculations. As reported in Table 2, using the lower filtration rate of 0.5 h−1 they achieved an overall dose reduction of 26%. We are interested to know what the dose with filtration reductions was with the higher filtration rate, since it is our understanding that room air purifiers are often sized at air exchange rates of 1 to 1.5.

Second, in the concluding statement of the manuscript the authors stated, “The small effect of filtration on the inhalation dose from radon decay products could be confirmed.” This statement seems modest when the data show a 26% reduction in the total radon decay products. Perhaps this statement was made relative to the greater reductions in the thoron decay products they achieved. In any case, we are interested to know if the 26% reduction in radon decay products, particularly in regions where radon is the primary concern rather than thoron, should be considered as both a statistically and clinically significant reduction in exposure.