Functional analysis of Ectodysplasin-A mutations causing selective tooth agenesis

Mutations of the Ectodysplasin-A (EDA) gene are generally associated with the syndrome hypohidrotic ectodermal dysplasia (MIM 305100), but they can also manifest as selective, non-syndromic tooth agenesis (MIM300606). We have performed an in vitro functional analysis of six selective tooth agenesis-causing EDA mutations (one novel and five known) that are located in the C-terminal tumor necrosis factor homology domain of the protein. Our study reveals that expression, receptor binding or signaling capability of the mutant EDA1 proteins is only impaired in contrast to syndrome-causing mutations, which we have previously shown to abolish EDA1 expression, receptor binding or signaling. Our results support a model in which the development of the human dentition, especially of anterior teeth, requires the highest level of EDA-receptor signaling, whereas other ectodermal appendages, including posterior teeth, have less stringent requirements and form normally in response to EDA mutations with reduced activity.     

Exposure to Human and Bovine Noroviruses in a Birth Cohort in Southern India from 2002 to 2006

Human and bovine norovirus virus-like particles were used to evaluate antibodies in Indian children at ages 6 and 36 months and their mothers. Antibodies to genogroup II viruses were acquired early and were more prevalent than antibodies to genogroup I. Low levels of IgG antibodies against bovine noroviruses indicate possible zoonotic transmission.     

Evaluating Barriers to Bystander CPR among Laypersons before and after Compression-only CPR Training

Objective: Bystander CPR is an essential part of out-of-hospital cardiac arrest (OHCA) survival. EMS and public safety jurisdictions have embraced initiatives to teach compression-only CPR to laypersons in order to increase rates of bystander CPR. We examined barriers to bystander CPR amongst laypersons participating in community compression-only CPR training and the ability of the training to alleviate these barriers. The barriers analyzed include fear of litigation, risk of disease transmission, fear of hurting someone as a result of doing CPR when unnecessary, and fear of hurting someone as a result of doing CPR incorrectly. Methods: Laypersons attending community compression-only CPR training were administered surveys before and after community CPR training. Data were analyzed via standard statistical analyses. Results: A total of 238 surveys were collected and analyzed between September 2015 and January 2016. The most common reported motivation for attending CPR training was “to be prepared/just in case” followed by “infant or child at home.” Respondents reported that they were significantly more likely to perform CPR on a family member than a stranger in both pre-and post-training responses. Nevertheless, reported self-confidence in and likelihood of doing CPR on both family and strangers increased from pre-training to post-training. There was a statistically significant decrease in reported likelihood of all four barriers to prevent respondents from performing bystander CPR when pre-training responses were compared to post-training responses. Previous CPR training and history of having witnessed a sudden cardiac arrest (SCA) were both associated with decreased barriers to CPR, but previous training had no effect on reported likelihood of or confidence in performing CPR. Conclusion: The training initiative studied significantly reduced the reported likelihood of all barriers studied to prevent respondents from performing bystander CPR and also increased the reported confidence in doing CPR and likelihood of doing CPR on both strangers and family. However, it did not alleviate the pre-training discrepancy between likelihood of performing CPR on strangers versus family. Previous CPR training or certification had no impact on likelihood of or confidence in performing CPR.     

Prophylactic Amnioinfusion During Labour Complicated by Meconium

EDITORIAL COMMENT: This study of amnioinfusion during labour complicated by the known passage of meconium shows that the technique seems clinically worthwhile, even in a centre without facilities for electronic fetal heart monitoring or scalp blood pH and blood gas analysis. The series is small and more data from larger studies is required to test the conclusions reported by the authors.
Summary: A prospective study to see the safety and efficacy of transcervical amnioinfusion in labour complicated by meconium-stained amniotic fluid (MSAF) was carried out in a teaching hospital with limited resources. Fifty patients in labour with meconium-stained amniotic fluid and fulfilling the inclusion criteria (vertex presentation, gestational age of 36 weeks or more, no medical or obstetrical complications and normal fetal heart rate at time of inclusion) were taken for the study; 25 patients received amnioinfusion. The control group received only supportive therapy. Labour outcome was compared in the 2 groups. The incidence of Caesarean section was seen to be decreased but neonatal parameters showed no significant difference in the amnioinfusion group.