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Background: A large body of data shows that fetal brain development is vulnerable to disruption by air pollution experienced by the mother during pregnancy, adversely affecting cognitive and psychomotor capabilities during childhood (De Asis-Cruz et al., Biol Psychiatry 7:480-90, 2022; Morgan ZEM et al., Environ Health 22:11, 2023). This study has sought to identify gestational windows of susceptibility to prenatal exposure to air pollution., Methods: 470 African American and Latina mother/child pairs participated in a prospective cohort study based in the low-income communities of Northern Manhattan and the South Bronx, New York City. Gestational exposure to respirable particulate matter (PM 2.5 ) and nitrogen dioxide (NO 2 ) was assessed through validated models in relation to cognitive and motor development assessed at ages 1, 2, and 3 years using the Bayley-II Scales. Multiple linear regression models and distributed lag models (DLM) were used to identify critical windows of exposure by trimester and week of pregnancy., Results: By linear regression, average exposures to NO 2 during the first and second trimesters and the entire pregnancy were significantly and negatively associated with the mental developmental index (MDI) at age 1. Average exposures to PM 2.5 during the second trimester and the entire pregnancy were also significantly, inversely associated with age 1 MDI. No significant associations were found between these exposures and MDI at age 2. NO 2 exposure during the first trimester was significantly negatively associated with MDI at age 3. Using DLM, exposures to NO 2 at lags 29-30 weeks (within the first trimester) and PM 2.5 at lags 17-18 weeks (second trimester) were significantly and inversely associated with MDI at age 1. Significant, inverse associations were found between exposures to NO 2 at lag 29 weeks and PM 2.5 at lags 27-29 weeks and children's MDI at age 3. No significant associations were found between psychomotor index (PDI) and prenatal exposures to NO 2 or PM 2.5 at ages 1, 2 or 3., Conclusions: Our finding that prenatal exposure to air pollution in the first and second trimesters was associated with lower scores for cognitive development at ages 1 and 3 is of concern because of the potential consequences of these outcomes for long-term functioning. They underscore the need for stronger policies to protect pregnant individuals and offspring, particularly during vulnerable, early life-stage of development., (© 2024. The Author(s).)

Introduction: Air pollution poses serious health risks to humans, with particular harm to children., Objectives: To address the gap in understanding the efficacy of policies to reduce exposure to air pollution, we sought to assess the temporal relationship between the enactment of major air pollution and climate policies in NYC and trends in air quality during the period 1998-2021. We used previously available data from citywide monitoring and new data from the Columbia Center for Children's Environmental Health (CCCEH) longitudinal cohort studies of mothers and children living in communities in Northern Manhattan and the South Bronx., Methods: We utilized publicly available citywide air monitoring data for particulate matter (PM 2.5 ) and nitrogen dioxide (NO 2 ) from 2009 to 2021 from the New York City Community Air Survey (NYCCAS) database and CCCEH cohort data on residential exposure to PM 2.5 and NO 2 and personal exposure to polycyclic aromatic hydrocarbons (PAH) during pregnancies occurring from 1998-2016 and 1998-2021, respectively. We compared annual and overall reductions in PM 2.5 and NO 2 citywide and reductions in PAH concentrations in the cohort studies., Results: As previously reported, annual average concentrations of pollutants in NYC dropped significantly over time. Between 1998 and 2021, PM 2.5 and NO 2 concentrations were reduced citywide by 37 and 31%, respectively. In our CCCEH cohorts, between 1998 and 2016, the annual average PM 2.5 and NO 2 concentrations also decreased significantly by 51 and 48%, respectively. Between 1998 and 2020, PAH concentrations decreased significantly by 66%., Discussion/conclusion: While it is not possible to link improved air quality to a single policy, our analysis provides evidence of a cumulative beneficial effect of clean air and climate policies enacted between 1998 and 2021 both city-wide and in our cohorts residing in communities that have been disproportionately affected by air pollution. There are important implications for health benefits, particularly for children, who are known to be especially vulnerable to these exposures. The results support further environmental and social policy changes to prevent the serious health impacts of air pollution from fossil fuel emissions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lau, Guo, Miao, Ross, Riley, Wang, Herbstman and Perera.)

Background: Low mitochondria DNA copy number (mtDNAcn) has been linked to cognitive decline. However, the role of mtDNAcn in healthy cognitive development is unclear. We hypothesized early-life mtDNAcn would be associated with children's learning and memory., Methods: We quantified mtDNAcn in umbilical cord blood and child blood at ages 5-7 from participants in a prospective birth cohort. We administered the Children's Memory Scale (CMS) at ages 9-14 (N = 342) and the Wechsler Intelligence Scale for Children (WISC-IV) at ages 7 and 9 (N = 457). Associations between mtDNAcn tertiles and CMS and WISC were evaluated with linear regression and linear mixed-effects models, respectively. We examined non-linear associations using generalized additive mixed models., Results: Relative to the middle tertile of mtDNAcn, lower childhood mtDNAcn was associated with lower WISC Working Memory (β = -2.65, 95% CI [-5.24, -0.06]) and Full-Scale IQ (β = -3.71 [-6.42, -1.00]), and higher CMS Visual Memory (β = 4.70 [0.47, 8.93]). Higher childhood mtDNAcn was linked to higher CMS Verbal Memory (β = 7.75 [2.50, 13.01]). In non-linear models, higher childhood mtDNAcn was associated with lower WISC Verbal Comprehension., Conclusions: Our study provides novel evidence that mtDNAcn measured in childhood is associated with children's neurocognitive performance. mtDNAcn may be a marker of healthy child development., Impact: Mitochondrial DNA copy number (mtDNAcn) may serve as a biomarker for early-life neurocognitive performances in the children's population. Both low and high mtDNAcn may contribute to poorer neurocognition, reflected through learning and memory abilities. This research elucidated the importance of investigating mitochondrial biomarkers in healthy populations and facilitated advancements of future studies to better understand the associations between mitochondrial markers and adverse children's health outcomes., (© 2024. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.)

Purpose: Previous studies suggest that external-beam partial breast irradiation (PBI) delivered twice a day can lead to increased adverse cosmesis (AC). The objective of our trial was to determine whether two regimens for PBI given once daily over 1 week resulted in acceptable AC to inform a phase III trial., Methods: Patients age ≥50 years with invasive breast cancer or ductal carcinoma in situ, ≤3 cm in size treated by lumpectomy with negative axillary nodes were randomly assigned to external-beam PBI of 30 Gy or 27.5 Gy, each given in five fractions once daily. The primary outcome was AC (fair or poor) by photographic assessment at 2 years. Secondary outcomes included AC assessed by nurse at 2 years, by patient self-assessment at 3 years, and late toxicity. On the basis of a 17% risk of AC with whole-breast irradiation, the upper bound of a two-sided 90% CI, 23% was set as the tolerance margin (OPAR, ClinicalTrials.gov identifier: NCT02637024)., Results: In total, 142 patients were randomly assigned to 30 Gy and 139 to 27.5 Gy. The median follow-up was 5 years. The mean age was 65 years, and the mean tumor size was 1.2 cm. Both schedules met acceptability criteria by photographic assessment (AC, 12.1% [90% CI, 8.2 to 17.6] for 30 Gy and 15.2% [90% CI, 10.8 to 21.1] for 27.5 Gy) and by nurse assessment. AC by patient self-assessment exceeded the 90% CI for the 30 Gy regimen. At 5 years, 16 (11.3%, 90% CI, 7.6 to 16.4) patients treated with 30 Gy and eight (5.8%, 90% CI, 3.3 to 9.9) patients treated with 27.5 Gy were observed to have grade 2 or more late toxicity., Conclusion: According to the study design, 30 Gy and 27.5 Gy resulted in acceptable cosmetic outcomes. In light of recent studies, a lower dose was chosen for the phase III trial.

Photodynamic therapy (PDT) has been used to treat cancers. It has also been used to treat infectious diseases and inflammatory conditions. PDT promotes wound healing, while clinical use of PDT for wound healing is uncommon and not thoroughly investigated. We report a 75-year-old female with a radiation-induced non-healing ulcer for five years on the chest wall postmastectomy radiotherapy. Biopsy showed epidermal erosion with dermal inflammation but no recurrent cancer. She was referred from the wound care clinic after multiple unsuccessful attempts to manage wound healing for two years involving daily home nursing visits. PDT was discussed with the patient who consented to PDT instead of hyperbaric oxygen therapy (HBOT) for fear of its side effects. Her wound improved after a total of three treatments and the process of wound healing continued for 14 months since her first treatment session. The presented case supports the beneficial effects of PDT on chronic ulceration impeding healing of a postmastectomy radiotherapy wound. To our knowledge, this report is unique in documenting details of PDT healing a chronic refractory ulcer of five years, which developed after cancer therapy (mastectomy and radiotherapy). Further clinical study of PDT is needed on wound healing post-surgery and radiation in cancer patients. An overview of HBOT in comparison with PDT for wound healing is presented., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yu et al.)

This study aimed to assess a four-marker protein panel (4MP)'s performance, including the precursor form of surfactant protein B, cancer antigen 125, carcinoembryonic antigen, and cytokeratin-19, for predicting lung cancer in a cohort enriched with never- and ever-smokers. Blinded pre-diagnostic plasma samples collected within 2 years prior to a lung cancer diagnosis from 25 cases and 100 sex-, age-, and smoking-matched controls were obtained from the Physicians' Health Study (PHS). The 4MP yielded AUC performance estimates of 0.76 (95% CI: 0.61-0.92) and 0.69 (95% CI: 0.56-0.82) for predicting lung cancer within one year and within two years of diagnosis, respectively. When stratifying into ever-smokers and never-smokers, the 4MP had respective AUCs of 0.77 (95% CI: 0.63-0.92) and 0.72 (95% CI: 0.17-1.00) for a 1-year risk of lung cancer. The AUCs of the 4MP for predicting metastatic lung cancer within one year and two years of the blood draw were 0.95 (95% CI: 0.87-1.00) and 0.78 (95% CI: 0.62-0.94), respectively. Our findings indicate that a blood-based biomarker panel may be useful in identifying ever- and never-smokers at high risk of a diagnosis of lung cancer within one-to-two years.

Background: Obesity disproportionately affects marginalized and low-income populations. Birth parent obesity from the prenatal period and childhood has been associated with child obesity. It is unknown whether prenatal or postnatal birth parent obesity has differential effects on subsequent changes in adiposity and metabolic health in children., Objectives: We evaluated how birth parent obesity 7 y after delivery was associated with child body composition changes and cardiometabolic health in midchildhood and further assessed the influence of the perinatal and postpartum period on associations., Methods: Black and Dominican pregnant individuals were enrolled, and dyads ( n = 319) were followed up at child age 7 and 9 y. Measures included, height, weight, waist circumference (WC), and percent body fat (BF%). Multiple linear regression was used to relate postpartum weight status with child outcomes accounting for attrition, and a series of secondary analyses were conducted with additional adjustment for perinatal weight status, gestational weight gain (GWG), and/or long-term weight retention to evaluate how these factors influenced associations., Results: Almost one-quarter (23%) of birth parents and 24.1% children were classified with obesity at child age 7 y, while at 9 y, 30% of children had obesity. Birth parent obesity at child age 7 y was associated with greater changes, from ages 7 to 9 y, in child BMI z -score (β: 0.13; 95% CI: 0.02, 0.24) and BF% (β: 1.15; 95% CI: 0.22, 2.09) but not obesity at age 9 y. All observed associations crossed the null after additional adjustment for prenatal factors., Conclusions: Birth parent obesity at 7-y postpartum is associated with greater gains in child BMI z -score and BF% in midchildhood. These associations diminish after accounting for prenatal size, suggesting a lasting impact of the perinatal environment and that interventions supporting families from the prenatal period through childhood are needed., (© 2024 The Author(s).)