Prediction of factor VIII inhibitor development in the SIPPET cohort by mutational analysis and factor VIII antigen measurement
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
Authors: Spena, S.; Garagiola, I.; Cannavo, A.; Mortarino, M.; Mannucci, P. M.; Rosendaal, F. R.; Peyvandi, F.
Abstract
Background: The type of F8 mutation is the main predictor of inhibitor development in patients with severe hemophilia A. Mutations expected to allow residual synthesis of factor VIII are likely to play a protective role against alloantibody development by inducing immune tolerance. According to the expected full or partial impairment of FVIII synthesis, F8 variants are commonly classified as null and non-null. Objectives: To explore the mutation type-inhibitor risk association in a cohort of 231 patients with severe hemophilia A enrolled in the Survey of Inhibitors in Plasma-Product Exposed Toddlers (SIPPET) randomized trial. Methods: The genetic defects in these patients, consisting of inversions of intron 22 (n = 110) and intron 1 (n = 6), large deletions (n = 16), and nonsense (n = 38), frameshift (n = 28), missense (n = 19) and splicing (n = 14) variants, of which 34 have been previously unreported, were reclassified according to two additional criteria: the functional effects of missense and splicing alterations as predicted by multiple in silico analyses, and the levels of FVIII antigen in patient plasma. Results: A two-fold increase in inhibitor development for in silico null mutations as compared with in silico non-null mutations (hazard ratio [HR] 2.08, 95% confidence interval [CI] 0.84-5.17) and a 3.5-fold increase in inhibitor development for antigen-negative mutations as compared with antigen-positive mutations (HR 3.61, 95% CI 0.89-14.74] were found. Conclusions: Our findings confirm an association between the synthesis of minute amounts of FVIII and inhibitor protection, and underline the importance of investigating the residual FVIII antigen levels associated with causative variants in order to understand their clinical relevance.
EEG Patterns in Early Childhood Differ Between Children Prone To Reward "Bad" or "Good" Actors
PSYCHOLOGY IN RUSSIA-STATE OF THE ART
Authors: Orekhova, Liliia S.; Makhin, Sergey A.; Mikhailova, Anna A.; Pavlenko, Vladimir B.
Abstract
Background. Early childhood is a critically important period of development for the formation of personality. Many studies provide convincing proof that elements of moral behavior are observable already in the early stages of ontogenesis. Of particular interest for psychophysiologists is the question of whether the capacity for moral evaluation in younger children can be reflected in specific EEG patterns characteristic of them. Objective. To establish specific patterns of EEG oscillations, including the frontal alpha-rhythm asymmetry, in young children who are prone to evaluate differently the behaviors of "helping" and "hindering" puppets. Design. Fifty-six children aged 16 to 42 months participated in the study. To measure the level of moral evaluation in children, we used the method designed by B. Kenward and M. Dahl, with some modifications. The EEG was recorded when children distributed resources among the puppet-actors. Results. When deciding how to distribute resources among the puppets, the children with a higher moral evaluation index demonstrated an overall higher alpha rhythm amplitude, as well as a specific pattern of theta rhythm amplitude. The moral evaluation indices correlated with alpha asymmetry in the EEC loci F7 and F8. Conclusions. 1. Significant differences in EEG patterns were found between the children who showed different levels of moral evaluation. Children with higher indices of moral evaluation showed a higher alpha rhythm amplitude when deciding how to distribute resources among the puppets, depending on the puppets' "helping" or "hindering" behavior. 2. The theta rhythm oscillation patterns differed significantly between the samples of children with different moral evaluation indices. 3. Alpha asymmetry in the dorsolateral prefrontal cortex (loci F7, F8) was correlated with the moral evaluation indices, indicating an increased activation in the prefrontal regions of the left hemisphere in children with a more developed understanding of moral behavior.