1 4182 152 MESOAMERICAN NEPHROPATHY (MEN): WHAT WE KNOW SO FAR. IN 2002, A REPORT FROM EL SALVADOR DESCRIBED A HIGH INCIDENCE OF CHRONIC KIDNEY DISEASE (CKD) OF UNKNOWN CAUSE, MOSTLY IN YOUNG MALES FROM SPECIFIC COASTAL AREAS. SIMILAR SITUATIONS WERE OBSERVED ALONG THE PACIFIC OCEAN COASTLINE OF OTHER CENTRAL AMERICAN COUNTRIES AND SOUTHERN MEXICO (MESOAMERICA). THIS NEW FORM OF CKD HAS BEEN DENOMINATED MESOAMERICAN ENDEMIC NEPHROPATHY (MEN). THE TYPICAL PRESENTATION OF MEN IS A YOUNG MALE FROM AN ENDEMIC AREA WITH A FAMILY HISTORY OF CKD, LOW EGFR, HIGH SERUM CREATININE, LOW LEVEL OF ALBUMINURIA, HYPOKALEMIA, HYPERURICEMIA, AND URINE URATE CRYSTALS. KIDNEY BIOPSY DEMONSTRATING TUBULOINTERSTITIAL NEPHRITIS REMAINS THE GOLD STANDARD FOR DIAGNOSIS BUT IS AVAILABLE ONLY FOR A MINORITY. COMMONLY PROPOSED CAUSES INCLUDE THERMAL STRESS/DEHYDRATION AND/OR EXPOSURE TO ENVIRONMENTAL POLLUTANTS. HOWEVER, LIKELY, A THIRD FACTOR, WHICH COULD BE GENETIC OR EPIGENETIC, COULD CONTRIBUTE TO THE CAUSE AND DEVELOPMENT OF THE DISEASE, ALONG WITH SOCIAL DETERMINANTS. CURRENTLY, PREVENTIVE MEASURES FOCUS ON MINIMIZING WORKERS EXPOSURE TO THERMAL STRESS/DEHYDRATION. THERE ARE MANY RESEARCH OPPORTUNITIES AND PRIORITIES SHOULD INCLUDE CLINICAL TRIALS TO EVALUATE THE EFFICACY AND SAFETY OF THE CURRENT TREATMENT PROTOCOLS, ALONG WITH ETIOLOGICAL AND GENETIC STUDIES, AND THE DEVELOPMENT OF KIDNEY DISEASE DATA SYSTEMS. ALTHOUGH THERE IS SCANT AND CONTROVERSIAL LITERATURE WITH REGARD S TO THE ETIOLOGY, DIAGNOSIS AND MANAGEMENT OF THE DISEASE, OUR AIM IS TO PROVIDE THE READER A VISION OF THE DISEASE BASED ON OUR EXPERIENCE. 2020 2 1957 27 EPIGENETIC AGE PREDICTORS IN COMMUNITY-DWELLING ADULTS WITH HIGH IMPACT KNEE PAIN. GERONTOLOGICAL RESEARCH REVEALS CONSIDERABLE INTERINDIVIDUAL VARIABILITY IN AGING PHENOTYPES, AND EMERGING EVIDENCE SUGGESTS THAT HIGH IMPACT CHRONIC PAIN MAY BE ASSOCIATED WITH VARIOUS ACCELERATED BIOLOGICAL AGING PROCESSES. IN PARTICULAR, EPIGENETIC AGING IS A ROBUST PREDICTOR OF HEALTH-SPAN AND DISABILITY COMPARED TO CHRONOLOGICAL AGE ALONE. THE CURRENT STUDY AIMED TO DETERMINE WHETHER SEVERAL EPIGENETIC AGING BIOMARKERS WERE ASSOCIATED WITH HIGH IMPACT CHRONIC PAIN IN MIDDLE TO OLDER AGE ADULTS (44-78 YEARS OLD). PARTICIPANTS (N = 213) UNDERWENT A BLOOD DRAW, DEMOGRAPHIC, PSYCHOSOCIAL, PAIN AND FUNCTIONAL ASSESSMENTS. WE ESTIMATED FIVE EPIGENETIC CLOCKS AND CALCULATED THE DIFFERENCE BETWEEN EPIGENETIC AGE AND CHRONOLOGICAL AGE, WHICH HAS BEEN PREVIOUSLY REPORTED TO PREDICT OVERALL MORTALITY RISK, AS WELL AS INCLUDED ADDITIONAL DERIVED VARIABLES OF EPIGENETIC AGE PREVIOUSLY ASSOCIATED WITH PAIN. THERE WERE SIGNIFICANT DIFFERENCES ACROSS PAIN IMPACT GROUPS IN THREE OUT OF THE FIVE EPIGENETIC CLOCKS EXAMINED (DNAMAGE, DNAMPHENOAGE AND DNAMGRIMAGE), INDICATING THAT PAIN-RELATED DISABILITY DURING THE PAST 6 MONTHS WAS ASSOCIATED WITH MARKERS OF EPIGENETIC AGING. ONLY DNAMPHENOAGE AND DNAMGRIMAGE WERE ASSOCIATED WITH HIGHER KNEE PAIN INTENSITY DURING THE PAST 48 H. FINALLY, PAIN CATASTROPHIZING, DEPRESSIVE SYMPTOMATOLOGY AND MORE NEUROPATHIC PAIN SYMPTOMS WERE SIGNIFICANTLY ASSOCIATED WITH AN OLDER EPIGENOME IN ONLY ONE OF THE FIVE EPIGENETIC CLOCKS (I.E. DNAMGRIMAGE) AFTER CORRECTING FOR MULTIPLE COMPARISONS (CORRECTED P'S < 0.05). GIVEN THE SCANT LITERATURE IN RELATION TO EPIGENETIC AGING AND THE COMPLEX EXPERIENCE OF PAIN, ADDITIONAL RESEARCH IS NEEDED TO UNDERSTAND WHETHER EPIGENETIC AGING MAY HELP IDENTIFY PEOPLE WITH CHRONIC PAIN AT GREATER RISK OF FUNCTIONAL DECLINE AND POORER HEALTH OUTCOMES. 2022 3 4006 24 LOST AMONG THE TREES? THE AUTONOMIC NERVOUS SYSTEM AND PAEDIATRICS. THE AUTONOMIC NERVOUS SYSTEM (ANS) HAS BEEN STRIKINGLY NEGLECTED IN WESTERN MEDICINE. DESPITE ITS PROFOUND IMPORTANCE FOR REGULATION, ADJUSTMENT AND COORDINATION OF BODY SYSTEMS, IT LACKS PRIORITY IN TRAINING AND PRACTICE AND RECEIVES SCANT ATTENTION IN NUMEROUS MAJOR TEXTBOOKS. THE ANS IS INTEGRAL TO MANIFESTATIONS OF ILLNESS, UNDERLYING FAMILIAR PHYSICAL AND PSYCHOLOGICAL SYMPTOMS. WHEN ANS ACTIVITY IS ITSELF DYSFUNCTIONAL, USUAL INDICATORS OF ACUTE ILLNESS MAY PROVE DECEPTIVE. RECOGNISING THE RELEVANCE OF THE ANS CAN INVOLVE SEEING THE FAMILIAR THROUGH FRESH EYES, CHALLENGING ASSUMPTIONS IN CLINICAL ASSESSMENT AND IN APPROACHES TO PRACTICE. ITS IMPORTANCE EXTENDS FROM PHYSICAL AND PSYCHOLOGICAL WELL-BEING TO PARENTING AND SAFEGUARDING, PUBLIC SERVICES AND THE FUNCTIONING OF SOCIETY. EXPLORATION OF ITS ROLE IN CONDITIONS RANGING FROM NEUROLOGICAL, GASTROINTESTINAL AND CONNECTIVE TISSUE DISORDERS, DIABETES AND CHRONIC FATIGUE SYNDROME, TO AUTISM, BEHAVIOURAL AND MENTAL HEALTH DIFFICULTIES MAY OPEN THERAPEUTIC AVENUES. THE ANS OFFERS A MECHANISM FOR SO-CALLED FUNCTIONAL ILLNESSES AND ILLUSTRATES THE IMPORTANCE OF RECOGNISING THAT 'STRESS' TAKES MANY FORMS, PHYSICAL, PSYCHOLOGICAL AND ENVIRONMENTAL, DESIRABLE AND OTHERWISE. EVIDENCE OF INTRAUTERINE AND POST-NATAL PROGRAMMING OF ANS REACTIVITY SUGGESTS THAT NEONATAL CARE AND SAFEGUARDING PRACTICE MAY OFFER PREVENTIVE OPPORTUNITY, AS MAY GREATER UNDERSTANDING OF EPIGENETIC CHANGE OF ANS ACTIVITY THROUGH, FOR EXAMPLE, ACCIDENTAL OR PSYCHOLOGICAL TRAUMA OR INFECTION. THE AIM OF THIS ARTICLE IS TO ACCELERATE RECOGNITION OF THE IMPORTANCE OF THE ANS THROUGHOUT PAEDIATRICS, AND OF THE POTENTIAL PHYSICAL AND PSYCHOLOGICAL COST OF NEGLECTING IT. 2014 4 3472 24 IDENTIFICATION AND MANAGEMENT OF PAIN MEDICATION ABUSE AND MISUSE: CURRENT STATE AND FUTURE DIRECTIONS. LONG-TERM OPIOID THERAPY POSES A RISK FOR ABUSE AND MISUSE IN SOME PATIENTS. IDENTIFYING WHICH PATIENTS MAY POTENTIALLY BE AT RISK PRIOR TO INITIATION OF THERAPY, AND IDENTIFYING PATIENTS IN WHOM THESE PROBLEMS DEVELOP DURING THERAPY, ARE SIGNIFICANT CHALLENGES. OUTCOME PREDICTION IS IMPEDED BY THE COMPLEXITY OF THE PROBLEM, WHERE CONSIDERABLE HETEROGENEITY RESULTS FROM PSYCHOLOGICAL AND SOCIOECONOMIC FACTORS, AS WELL AS INTERINDIVIDUAL VARIATION IN BIOLOGICAL PATHWAYS DUE TO GENETIC AND EPIGENETIC FACTORS. SCREENING TOOLS DESIGNED TO DETECT OPIOID MISUSE AND URINE DRUG TESTING ARE BOTH USED CLINICALLY; SCANT EVIDENCE CURRENTLY EXISTS TO ALLOW THE FORMULATION OF AN ALGORITHM FOR JUDICIOUS USE OF THESE TOOLS. MOREOVER, THESE TOOLS MAY NOT BE ADDRESSING THE UNDERLYING ALTERATIONS IN BIOLOGICAL PATHWAYS THAT OCCUR OWING TO THE DEVELOPMENT OF CHRONIC PAIN OR IN RESPONSE TO CHRONIC OPIOID ADMINISTRATION. AN EVIDENCE-BASED ALGORITHMIC APPROACH TO RISK MITIGATION THAT CAN BE APPLIED IN A COST-EFFECTIVE MANNER TO GUIDE THERAPY IS URGENTLY NEEDED. 2012 5 180 26 ACCELERATED EPIGENETIC AGING IN OLDER ADULTS WITH HIV DISEASE: ASSOCIATIONS WITH SEROSTATUS, HIV CLINICAL FACTORS, AND HEALTH LITERACY. THE PREVALENCE OF OLDER PERSONS WITH HIV (PWH) DISEASE HAS INCREASED CONSIDERABLY IN THE LAST 20 YEARS, BUT OUR UNDERSTANDING OF BIOLOGICAL FACTORS OF AGING AND THEIR CLINICAL CORRELATES AMONG PWH REMAINS LIMITED. STUDY PARTICIPANTS WERE 149 PERSONS AGED 50 AND OLDER, INCLUDING 107 PWH AND 42 SERONEGATIVES. ALL PARTICIPANTS COMPLETED A BLOOD DRAW, RESEARCH MEDICAL EVALUATION, STRUCTURED PSYCHIATRIC INTERVIEW, NEUROCOGNITIVE ASSESSMENT, QUESTIONNAIRES, AND MEASURES OF HEALTH LITERACY. FOUR EPIGENETIC CLOCKS WERE GENERATED FROM STORED BLOOD SAMPLES USING STANDARDIZED LABORATORY METHODS. IN REGRESSION MODELS ADJUSTING FOR SEX AND SMOKING STATUS, PWH HAD SIGNIFICANTLY HIGHER EPIGENETIC AGING ACCELERATION VALUES THAN SERONEGATIVES ON ALL FOUR INDICATORS. WITHIN THE PWH SAMPLE, HIGHER LEVELS OF EPIGENETIC AGING ACCELERATION WERE MODERATELY ASSOCIATED WITH LOWER CURRENT CD4 COUNT, AIDS DIAGNOSES, HIGHER SCORES ON THE VETERANS AGING COHORT STUDY INDEX, AND LOWER TELOMERE VALUES. HIGHER EPIGENETIC AGING ACCELERATION INDICES WERE ALSO ASSOCIATED WITH LOWER HEALTH LITERACY AMONG PWH. PWH EXPERIENCE ACCELERATED AGING AS MEASURED BY A SERIES OF EPIGENETIC CLOCKS, WHICH MAY BE LINKED TO IMMUNE COMPROMISE AND RISK OF ALL-CAUSE MORTALITY. HEALTH LITERACY MAY BE A MODIFIABLE TARGET FOR MITIGATING THE RISK OF ACCELERATED AGING AMONG OLDER PWH. 2023 6 1535 27 DNA METHYLATION DYSFUNCTION IN CHRONIC KIDNEY DISEASE. RENAL DISEASE IS THE COMMON DENOMINATOR OF A NUMBER OF UNDERLYING DISEASE CONDITIONS, WHOSE PREVALENCE HAS BEEN DRAMATICALLY INCREASING OVER THE LAST TWO DECADES. TWO ASPECTS ARE PARTICULARLY RELEVANT TO THE SUBJECT OF THIS REVIEW: (I) MOST CASES ARE GATHERED UNDER THE UMBRELLA OF CHRONIC KIDNEY DISEASE SINCE THEY REQUIRE-PREDICTABLY FOR SEVERAL LUSTRUMS-CONTINUOUS CLINICAL MONITORING AND TREATMENT TO SLOW DOWN DISEASE PROGRESSION AND PREVENT COMPLICATIONS; (II) CARDIOVASCULAR DISEASE IS A TERRIBLE BURDEN IN THIS POPULATION OF PATIENTS, IN THAT IT CLAIMS MANY LIVES YEARLY, WHILE ONLY A SCANT MINORITY REACH THE RENAL DISEASE END STAGE. WHY INDEED A REVIEW ON DNA METHYLATION AND RENAL DISEASE? AS WE HOPE TO CONVINCE YOU, THE PRESENT EVIDENCE SUPPORTS THE ROLE OF THE EXISTENCE OF VARIOUS DERANGEMENTS OF THE EPIGENETIC CONTROL OF GENE EXPRESSION IN RENAL DISEASE, WHICH HOLD THE POTENTIAL TO IMPROVE OUR ABILITY, IN THE FUTURE, TO MORE EFFECTIVELY ACT TOWARD DISEASE PROGRESSION, PREDICT OUTCOMES AND OFFER NOVEL THERAPEUTIC APPROACHES. 2020 7 5470 45 RESOLVING THE ENIGMA OF THE MESOAMERICAN NEPHROPATHY: A RESEARCH WORKSHOP SUMMARY. THE FIRST INTERNATIONAL RESEARCH WORKSHOP ON MESOAMERICAN NEPHROPATHY (MEN) MET IN COSTA RICA IN NOVEMBER 2012 TO DISCUSS HOW TO ESTABLISH THE EXTENT AND DEGREE OF MEN, EXAMINE RELEVANT CAUSAL HYPOTHESES, AND FOCUS EFFORTS TO CONTROL OR ELIMINATE THE DISEASE BURDEN. MEN DESCRIBES A DEVASTATING EPIDEMIC OF CHRONIC KIDNEY DISEASE OF UNKNOWN ORIGIN PREDOMINANTLY OBSERVED AMONG YOUNG MALE SUGARCANE CUTTERS. THE CAUSE OF MEN REMAINS UNCERTAIN; HOWEVER, THE STRONGEST HYPOTHESIS PURSUED TO DATE IS REPEATED EPISODES OF OCCUPATIONAL HEAT STRESS AND WATER AND SOLUTE LOSS, PROBABLY IN COMBINATION WITH OTHER POTENTIAL RISK FACTOR(S), SUCH AS NONSTEROIDAL ANTI-INFLAMMATORY DRUG AND OTHER NEPHROTOXIC MEDICATION USE, INORGANIC ARSENIC, LEPTOSPIROSIS, OR PESTICIDES. AT THE RESEARCH WORKSHOP, CLINICAL AND EPIDEMIOLOGIC CASE DEFINITIONS WERE PROPOSED IN ORDER TO FACILITATE BOTH PUBLIC HEALTH AND RESEARCH EFFORTS. RECOMMENDATIONS EMANATING FROM THE WORKSHOP INCLUDED MEASURING WORKLOAD, HEAT, AND WATER AND SOLUTE LOSS AMONG WORKERS; QUANTIFYING NEPHROTOXIC AGENTS IN DRINKING WATER AND FOOD; USING BIOMARKERS OF EARLY KIDNEY INJURY TO EXPLORE POTENTIAL CAUSES OF MEN; AND CHARACTERIZING SOCIAL AND WORKING CONDITIONS TOGETHER WITH METHODS FOR VALID DATA COLLECTION OF EXPOSURES AND PERSONAL RISK FACTORS. ADVANTAGES AND DISADVANTAGES OF DIFFERENT POPULATION STUDY DESIGNS WERE DETAILED. TO ELUCIDATE THE ETIOLOGY OF MEN, MULTICOUNTRY STUDIES WITH PROSPECTIVE COHORT DESIGN, PREFERABLY INTEGRATING AN ECOSYSTEM HEALTH APPROACH, WERE CONSIDERED THE MOST PROMISING. IN ADDITION, GENETIC, EXPERIMENTAL, AND MECHANISTIC METHODS AND DESIGNS WERE ADDRESSED, SPECIFICALLY THE NEED FOR KIDNEY BIOPSY ANALYSIS, STUDIES IN ANIMAL MODELS, ADVANCES IN BIOMARKERS, GENETIC AND EPIGENETIC STUDIES, A COMMON REGISTRY AND REPOSITORY OF BIOLOGICAL AND DEMOGRAPHIC DATA AND/OR SPECIMENS, AND OTHER AREAS OF POTENTIAL CHRONIC KIDNEY DISEASE EXPERIMENTAL RESEARCH. FINALLY, IN ORDER TO IMPROVE INTERNATIONAL COLLABORATION ON MEN, WORKSHOP PARTICIPANTS AGREED TO ESTABLISH A RESEARCH CONSORTIUM TO LINK THESE MESOAMERICAN EFFORTS TO OTHER EFFORTS WORLDWIDE. 2014 8 2485 24 EPIGENETIC-BASED AGE ACCELERATION IN A REPRESENTATIVE SAMPLE OF OLDER AMERICANS: ASSOCIATIONS WITH AGING-RELATED MORBIDITY AND MORTALITY. BIOMARKERS DEVELOPED FROM DNA METHYLATION (DNAM) DATA ARE OF GROWING INTEREST AS PREDICTORS OF HEALTH OUTCOMES AND MORTALITY IN OLDER POPULATIONS. HOWEVER, IT IS UNKNOWN HOW EPIGENETIC AGING FITS WITHIN THE CONTEXT OF KNOWN SOCIOECONOMIC AND BEHAVIORAL ASSOCIATIONS WITH AGING-RELATED HEALTH OUTCOMES IN A LARGE, POPULATION-BASED, AND DIVERSE SAMPLE. THIS STUDY USES DATA FROM A REPRESENTATIVE, PANEL STUDY OF US OLDER ADULTS TO EXAMINE THE RELATIONSHIP BETWEEN DNAM-BASED AGE ACCELERATION MEASURES IN THE PREDICTION OF CROSS-SECTIONAL AND LONGITUDINAL HEALTH OUTCOMES AND MORTALITY. WE EXAMINE WHETHER RECENT IMPROVEMENTS TO THESE SCORES, USING PRINCIPAL COMPONENT (PC)-BASED MEASURES DESIGNED TO REMOVE SOME OF THE TECHNICAL NOISE AND UNRELIABILITY IN MEASUREMENT, IMPROVE THE PREDICTIVE CAPABILITY OF THESE MEASURES. WE ALSO EXAMINE HOW WELL DNAM-BASED MEASURES PERFORM AGAINST WELL-KNOWN PREDICTORS OF HEALTH OUTCOMES SUCH AS DEMOGRAPHICS, SES, AND HEALTH BEHAVIORS. IN OUR SAMPLE, AGE ACCELERATION CALCULATED USING "SECOND AND THIRD GENERATION CLOCKS," PHENOAGE, GRIMAGE, AND DUNEDINPACE, IS CONSISTENTLY A SIGNIFICANT PREDICTOR OF HEALTH OUTCOMES INCLUDING CROSS-SECTIONAL COGNITIVE DYSFUNCTION, FUNCTIONAL LIMITATIONS AND CHRONIC CONDITIONS ASSESSED 2 Y AFTER DNAM MEASUREMENT, AND 4-Y MORTALITY. PC-BASED EPIGENETIC AGE ACCELERATION MEASURES DO NOT SIGNIFICANTLY CHANGE THE RELATIONSHIP OF DNAM-BASED AGE ACCELERATION MEASURES TO HEALTH OUTCOMES OR MORTALITY COMPARED TO EARLIER VERSIONS OF THESE MEASURES. WHILE THE USEFULNESS OF DNAM-BASED AGE ACCELERATION AS A PREDICTOR OF LATER LIFE HEALTH OUTCOMES IS QUITE CLEAR, OTHER FACTORS SUCH AS DEMOGRAPHICS, SES, MENTAL HEALTH, AND HEALTH BEHAVIORS REMAIN EQUALLY, IF NOT MORE ROBUST, PREDICTORS OF LATER LIFE OUTCOMES. 2023 9 648 25 BIRTH WEIGHT AND MATERNAL ENERGY STATUS DURING PREGNANCY AS PREDICTORS OF EPIGENETIC AGE ACCELERATION IN YOUNG ADULTS FROM METROPOLITAN CEBU, PHILIPPINES. EPIGENETIC CLOCKS QUANTIFY REGULAR CHANGES IN DNA METHYLATION THAT OCCUR WITH AGE, OR IN RELATION TO BIOMARKERS OF AGEING, AND ARE STRONG PREDICTORS OF MORBIDITY AND MORTALITY. HERE, WE ASSESS WHETHER MEASURES OF FETAL NUTRITION AND GROWTH THAT PREDICT ADULT CHRONIC DISEASE ALSO PREDICT ACCELERATED BIOLOGICAL AGEING IN YOUNG ADULTHOOD USING A SUITE OF COMMONLY USED EPIGENETIC CLOCKS. DATA COME FROM THE CEBU LONGITUDINAL HEALTH AND NUTRITION SURVEY (CLHNS), A LONG-RUNNING COHORT FOLLOWED SINCE BIRTH IN METROPOLITAN CEBU, PHILIPPINES. PAST WORK HAS SHOWN THAT BIRTH WEIGHT (BW) AND THE MOTHER'S ARM FAT DURING PREGNANCY (A MEASURE OF PREGNANCY ENERGY STATUS) RELATE INVERSELY TO HEALTH OUTCOMES IN THE CLHNS BUT PRIMARILY IN MALES. GENOME-WIDE DNA METHYLATION WAS ASSESSED IN WHOLE BLOOD USING THE INFINIUM EPIC ARRAY. PARTICIPANTS INCLUDED MALES (N=895) AND FEMALES (N=803) MEASURED IN 2005 (20.8-22.5 YEARS). CLOCKS INCLUDED THE HANNUM AND HORVATH CLOCKS TRAINED ON CHRONOLOGICAL AGE, THE DNAMPHENOAGE AND DNAMGRIMAGE CLOCKS TRAINED ON CLINICAL BIOMARKERS, THE DUNEDIN PACE OF AGEING (DUNEDINPACE) CLOCK TRAINED ON LONGITUDINAL CHANGES IN AGEING BIOMARKERS, AND THE DNAMTL CLOCK TRAINED ON LEUKOCYTE TELOMERE LENGTH. IN MALES, LOWER BW PREDICTED ADVANCED BIOLOGICAL AGEING USING THE HANNUM, DNAMPHENOAGE, DUNEDINPOAM, AND DNAMTL CLOCKS. IN CONTRAST, BW DID NOT PREDICT ANY CLOCK IN FEMALE PARTICIPANTS. PARTICIPANTS' MOTHERS' PREGNANCY ARM FAT ONLY PREDICTED DNAMTL IN MALES. THESE FINDINGS SUGGEST THAT EPIGENETIC CLOCKS ARE A USEFUL TOOL FOR GAUGING LONG-TERM OUTCOMES PREDICTED BY FETAL GROWTH, AND ADD TO EXISTING EVIDENCE IN THE CLHNS FOR SEX DIFFERENCES IN THESE RELATIONSHIPS. 2022 10 1962 26 EPIGENETIC AGING IS ASSOCIATED WITH CLINICAL AND EXPERIMENTAL PAIN IN COMMUNITY-DWELLING OLDER ADULTS. GERONTOLOGICAL RESEARCH REVEALS CONSIDERABLE INTERINDIVIDUAL VARIABILITY IN AGING PHENOTYPES, WHICH HAS MOTIVATED RESEARCH EFFORTS TO IDENTIFY "AGING BIOMARKERS." AGING BIOMARKERS ARE USED TO CALCULATE BIOLOGICAL AGE, WHICH ARE BETTER PREDICTORS OF DISEASE RISK AND RESIDUAL LIFESPAN WHEN COMPARED TO CHRONOLOGICAL AGE ALONE. EMERGING EVIDENCE USING THE EPIGENETIC CLOCK AS AN AGING BIOMARKER SUPPORTS HIGHLY RELIABLE INDIVIDUALIZED PREDICTIONS ABOUT FUTURE HEALTH. THIS STUDY AIMED TO DETERMINE WHETHER AN EPIGENETIC AGING BIOMARKER WAS ASSOCIATED WITH CHRONIC PAIN IN OLDER ADULTS (60-83 YEARS OLD). A SUBSET OF PARTICIPANTS (N = 29) IN THE NEUROMODULATORY EXAMINATION OF PAIN AND MOBILITY ACROSS THE LIFESPAN STUDY UNDERWENT A BLOOD DRAW, DEMOGRAPHIC, PSYCHOLOGICAL, COGNITIVE, AND PAIN ASSESSMENTS. WE ESTIMATED HORVATH'S EPIGENETIC CLOCK AND CALCULATED THE DIFFERENCE BETWEEN EPIGENETIC AGE AND CHRONOLOGICAL AGE THAT HAS BEEN PREVIOUSLY REPORTED TO PREDICT OVERALL MORTALITY RISK. OLDER INDIVIDUALS WITHOUT CHRONIC PAIN (N = 9) HAD SIGNIFICANTLY "YOUNGER" EPIGENETIC AGE COMPARED TO THOSE WITH CHRONIC PAIN (N = 20, P < 0.05). OLDER EPIGENETIC AGE WAS ASSOCIATED WITH GREATER PAIN DURING DAILY ACTIVITIES (R = 0.494, P = 0.010) AND ANATOMICAL PAIN SITES (R = 0.741, P < 0.001) BUT NOT PAIN FREQUENCY/DURATION. AN OLDER EPIGENETIC AGE WAS ALSO ASSOCIATED WITH HIGHER VIBRATORY DETECTION THRESHOLDS (R = 0.490, P = 0.021), HEAT PAIN THRESHOLDS (R = -0.478, P = 0.028), AND PRESSURE PAIN THRESHOLDS AT THE TRAPEZIUS (R = -0.571, P = 0.006) BUT NOT THERMAL DETECTION, PRESSURE PAIN AT THE QUADRICEPS OR PAIN INHIBITION (P'S > 0.05). EPIGENETIC AGING WAS ASSOCIATED WITH GREATER EMOTIONAL STABILITY (R = -0.461, P = 0.027), CONSCIENTIOUSNESS (R = -0.549, P = 0.007), AND LOWER EXTRAVERSION (R = 0.414, P = 0.049) BUT NOT DEPRESSION OR AFFECT (P'S > 0.05). EPIGENETIC AGING WAS ALSO ASSOCIATED WITH LOWER EPISODIC (R = -0.698, P = 0.001) AND WORKING MEMORY (R = -0.760, P < 0.001). OUR FINDINGS SUGGEST THAT CHRONIC PAIN IS ASSOCIATED WITH ACCELERATED EPIGENETIC AGING IN HEALTHY, COMMUNITY-DWELLING OLDER INDIVIDUALS, AND FUTURE STUDIES WITH LARGER SAMPLES ARE NEEDED TO CONFIRM OUR FINDINGS. AN AGING BIOMARKER SUCH AS THE EPIGENETIC CLOCK MAY HELP IDENTIFY PEOPLE WITH CHRONIC PAIN AT GREATER RISK OF FUNCTIONAL DECLINE AND POORER HEALTH OUTCOMES. 2019 11 3664 26 INFANT NEUROBEHAVIORAL DEVELOPMENT. THE TREND TOWARD SINGLE-ROOM NEONATAL INTENSIVE CARE UNITS (NICUS) IS INCREASING; HOWEVER SCIENTIFIC EVIDENCE IS, AT THIS POINT, MOSTLY ANECDOTAL. THIS IS A CRITICAL TIME TO ASSESS THE IMPACT OF THE SINGLE-ROOM NICU ON IMPROVING MEDICAL AND NEUROBEHAVIORAL OUTCOMES OF THE PRETERM INFANT. WE HAVE DEVELOPED A THEORETICAL MODEL THAT MAY BE USEFUL IN STUDYING HOW THE CHANGE FROM AN OPEN-BAY NICU TO A SINGLE-ROOM NICU COULD AFFECT INFANT MEDICAL AND NEUROBEHAVIORAL OUTCOME. THE MODEL IDENTIFIES MEDIATING FACTORS THAT ARE LIKELY TO ACCOMPANY THE CHANGE TO A SINGLE-ROOM NICU. THESE MEDIATING FACTORS INCLUDE FAMILY CENTERED CARE, DEVELOPMENTAL CARE, PARENTING AND FAMILY FACTORS, STAFF BEHAVIOR AND ATTITUDES, AND MEDICAL PRACTICES. MEDICAL OUTCOMES THAT PLAN TO BE MEASURED ARE SEPSIS, LENGTH OF STAY, GESTATIONAL AGE AT DISCHARGE, WEIGHT GAIN, ILLNESS SEVERITY, GESTATIONAL AGE AT ENTERAL FEEDING, AND NECROTIZING ENTEROCOLITIS (NEC). NEUROBEHAVIORAL OUTCOMES INCLUDE THE NICU NETWORK NEUROBEHAVIORAL SCALE (NNNS) SCORES, SLEEP STATE ORGANIZATION AND SLEEP PHYSIOLOGY, INFANT MOTHER FEEDING INTERACTION SCORES, AND PAIN SCORES. PRELIMINARY FINDINGS ON THE SAMPLE OF 150 PATIENTS IN THE OPEN-BAY NICU SHOWED A "BASELINE" OF EFFECTS OF FAMILY CENTERED CARE, DEVELOPMENTAL CARE, PARENT SATISFACTION, MATERNAL DEPRESSION, AND PARENTING STRESS ON THE NEUROBEHAVIORAL OUTCOMES OF THE NEWBORN. THE SINGLE-ROOM NICU HAS THE POTENTIAL TO IMPROVE THE NEUROBEHAVIORAL STATUS OF THE INFANT AT DISCHARGE. NEUROBEHAVIORAL ASSESSMENT CAN ASSIST WITH EARLY DETECTION AND THEREFORE PREVENTATIVE INTERVENTION TO MAXIMIZE DEVELOPMENTAL OUTCOME. WE ALSO PRESENT AN EPIGENETIC MODEL OF THE POTENTIAL EFFECTS OF MATERNAL CARE ON IMPROVING INFANT NEUROBEHAVIORAL STATUS. 2011 12 5746 24 SMOKING-RELATED DNA METHYLATION IS ASSOCIATED WITH DNA METHYLATION PHENOTYPIC AGE ACCELERATION: THE VETERANS AFFAIRS NORMATIVE AGING STUDY. DNA METHYLATION MAY PLAY A CRITICAL ROLE IN AGING AND AGE-RELATED DISEASES. DNA METHYLATION PHENOTYPIC AGE (DNAMPHENOAGE) IS A NEW AGING BIOMARKER AND PREDICTOR OF CHRONIC DISEASE RISK. WHILE SMOKING IS A STRONG RISK FACTOR FOR CHRONIC DISEASES AND INFLUENCES METHYLATION, ITS INFLUENCE ON DNAMPHENOAGE IS UNKNOWN. WE INVESTIGATED ASSOCIATIONS OF SELF-REPORTED AND EPIGENETIC SMOKING INDICATORS WITH DNAMPHENOAGE ACCELERATION IN A LONGITUDINAL AGING STUDY IN EASTERN MASSACHUSETTS. DNA METHYLATION WAS MEASURED IN WHOLE BLOOD SAMPLES FROM MULTIPLE VISITS FOR 692 MALE PARTICIPANTS IN THE VETERANS AFFAIRS NORMATIVE AGING STUDY DURING 1999-2013. ACCELERATION WAS DEFINED USING RESIDUALS FROM LINEAR REGRESSION OF THE DNAMPHENOAGE ON THE CHRONOLOGICAL AGE. CUMULATIVE SMOKING (PACK-YEARS) WAS SIGNIFICANTLY ASSOCIATED WITH DNAMPHENOAGE ACCELERATION, WHEREAS SELF-REPORTED SMOKING STATUS WAS NOT. WE OBSERVED SIGNIFICANT VALIDATED ASSOCIATIONS BETWEEN SMOKING-RELATED LOCI AND DNAMPHENOAGE ACCELERATION FOR 52 CPG SITES, WHERE 18 WERE HYPOMETHYLATED AND 34 WERE HYPERMETHYLATED, MAPPED TO 16 GENES. THE AHRR GENE HAD THE MOST LOCI (N = 8) AMONG THE 16 GENES. WE GENERATED A SMOKING AGING INDEX BASED ON THESE 52 LOCI, WHICH SHOWED POSITIVE SIGNIFICANT ASSOCIATIONS WITH DNAMPHENOAGE ACCELERATION. THESE EPIGENETIC BIOMARKERS MAY HELP TO PREDICT AGE-RELATED RISKS DRIVEN BY SMOKING. 2019 13 1746 23 EARLY LIFE ADVERSITY, PUBERTAL TIMING, AND EPIGENETIC AGE ACCELERATION IN ADULTHOOD. BACKGROUND: GIVEN ASSOCIATIONS LINKING EARLY LIFE ADVERSITY, PUBERTAL TIMING, AND BIOLOGICAL AGING, WE EXAMINED THE DIRECT AND INDIRECT EFFECTS OF EARLY LIFE TRAUMA ON ADULT BIOLOGICAL AGING (VIA AGE OF MENARCHE). METHODS: PARTICIPANTS WERE PREMENOPAUSAL WOMEN (N = 183). PATH MODELS EVALUATED WHETHER EARLY LIFE TRAUMA PREDICTED EARLY PUBERTAL TIMING AND THEREBY, ADULT EPIGENETIC AGE ACCELERATION (INDEXED VIA FOUR EPIGENETIC CLOCKS: HORVATH DNAM AGE, HANNUM DNAM AGE, DNAM PHENOAGE, AND DNAM GRIMAGE). SECONDARY ANALYSES EXPLORED THE EFFECTS OF TYPE OF TRAUMA (ABUSE AND NEGLECT) AND ADULT CHRONIC STRESS STATUS (CAREGIVER OF CHILD WITH AUTISM AND NON-CAREGIVER). RESULTS: EARLY LIFE TRAUMA AND EARLIER AGE AT MENARCHE INDEPENDENTLY PREDICTED ACCELERATED AGING BASED ON ONE OF THE FOUR EPIGENETIC CLOCKS, DNAM GRIMAGE, THOUGH EARLY LIFE TRAUMA WAS NOT ASSOCIATED WITH AGE OF MENARCHE. CHILDHOOD ABUSE, BUT NOT NEGLECT, PREDICTED FASTER EPIGENETIC AGING; RESULTS DID NOT DIFFER BY CHRONIC STRESS STATUS. CONCLUSIONS: EARLY TRAUMA AND EARLY MENARCHE APPEAR TO EXERT INDEPENDENT EFFECTS ON DNAM GRIMAGE, WHICH HAS BEEN SHOWN TO BE THE STRONGEST EPIGENETIC PREDICTOR OF MORTALITY RISK. THIS STUDY IDENTIFIES A POTENTIAL CORRELATE OR DETERMINANT OF ACCELERATED EPIGENETIC AGING-MENARCHEAL AGE. FUTURE RESEARCH SHOULD ADDRESS THE LIMITATIONS OF THIS STUDY BY USING RACIALLY DIVERSE SAMPLES. 2021 14 415 29 ANALYSIS OF RETROTRANSPOSON SUBFAMILY DNA METHYLATION REVEALS NOVEL EARLY EPIGENETIC CHANGES IN CHRONIC LYMPHOCYTIC LEUKEMIA. RETROTRANSPOSONS SUCH AS LINE-1 AND ALU COMPRISE >25% OF THE HUMAN GENOME. WHILE GLOBAL HYPOMETHYLATION OF THESE ELEMENTS HAS BEEN WIDELY REPORTED IN SOLID TUMOURS, THEIR EPIGENETIC DYSREGULATION IS YET TO BE CHARACTERISED IN CHRONIC LYMPHOCYTIC LEUKAEMIA, AND THERE HAS BEEN SCANT CONSIDERATION OF THEIR EVOLUTIONARY HISTORY THAT MEDIATES SENSITIVITY TO HYPOMETHYLATION. HERE, WE DEVELOPED AN APPROACH FOR LOCUS- AND EVOLUTIONARY SUBFAMILY-SPECIFIC ANALYSIS OF RETROTRANSPOSONS USING THE ILLUMINA INFINIUM HUMAN METHYLATION 450K MICROARRAY PLATFORM, WHICH WE APPLIED TO PUBLICLY-AVAILABLE DATASETS FROM CHRONIC LYMPHOCYTIC LEUKAEMIA AND OTHER HAEMATOLOGICAL MALIGNANCIES. WE IDENTIFIED 9,797 MICROARRAY PROBES MAPPING TO 117 LINE-1 SUBFAMILIES AND 13,130 MAPPING TO 37 ALU SUBFAMILIES. OF THESE, 10,782 WERE DIFFERENTIALLY METHYLATED (PFDR<0.05) IN CHRONIC LYMPHOCYTIC LEUKAEMIA PATIENTS (N=139) COMPARED WITH HEALTHY INDIVIDUALS (N=14), WITH ENRICHMENT AT ENHANCERS (P=0.002). DIFFERENTIAL METHYLATION WAS ASSOCIATED WITH EVOLUTIONARY AGE OF LINE-1 (R2=0.31, P=0.003) AND ALU (R2=0.74, P=0.002) ELEMENTS, WITH GREATER HYPOMETHYLATION OF OLDER SUBFAMILIES (L1M, ALUJ). LOCUS-SPECIFIC HYPOMETHYLATION WAS ASSOCIATED WITH DIFFERENTIAL EXPRESSION OF PROXIMAL GENES, INCLUDING DCLK2, HK1, ILRUN, TANK, TBCD, TNFRSF1B AND TXNRD2, WITH HIGHER EXPRESSION OF DCLK2 AND TNFRSF1B ASSOCIATED WITH REDUCED PATIENT SURVIVAL. HYPOMETHYLATION AT NINE LOCI WAS HIGHLY FREQUENT IN CHRONIC LYMPHOCYTIC LEUKAEMIA (>90% PATIENTS) BUT NOT OBSERVED IN HEALTHY INDIVIDUALS OR OTHER LEUKAEMIAS, AND WAS DETECTABLE IN BLOOD SAMPLES TAKEN PRIOR TO CHRONIC LYMPHOCYTIC LEUKAEMIA DIAGNOSIS IN 9 OF 82 INDIVIDUALS FROM THE MELBOURNE COLLABORATIVE COHORT STUDY. OUR RESULTS DEMONSTRATE DIFFERENTIAL METHYLATION OF RETROTRANSPOSONS IN CHRONIC LYMPHOCYTIC LEUKAEMIA BY THEIR EVOLUTIONARY HERITAGE THAT MODULATES EXPRESSION OF PROXIMAL GENES. 2021 15 5757 21 SOCIOECONOMIC STATUS, KNEE PAIN, AND EPIGENETIC AGING IN COMMUNITY-DWELLING MIDDLE-TO-OLDER AGE ADULTS. CHRONIC MUSCULOSKELETAL PAIN IS OFTEN ASSOCIATED WITH LOWER SOCIOECONOMIC STATUS (SES). SES CORRELATES WITH PSYCHOLOGICAL AND ENVIRONMENTAL CONDITIONS THAT COULD CONTRIBUTE TO THE DISPROPORTIONATE BURDEN OF CHRONIC STRESS. CHRONIC STRESS CAN INDUCE CHANGES IN GLOBAL DNA METHYLATION AND GENE EXPRESSION, WHICH INCREASES RISK OF CHRONIC PAIN. WE AIMED TO EXPLORE THE ASSOCIATION OF EPIGENETIC AGING AND SES IN MIDDLE-TO-OLDER AGE INDIVIDUALS WITH VARYING DEGREES OF KNEE PAIN. PARTICIPANTS COMPLETED SELF-REPORTED PAIN, A BLOOD DRAW, AND ANSWERED DEMOGRAPHIC QUESTIONS PERTAINING TO SES. WE USED AN EPIGENETIC CLOCK PREVIOUSLY ASSOCIATED WITH KNEE PAIN (DNAMGRIMAGE) AND THE SUBSEQUENT DIFFERENCE OF PREDICTED EPIGENETIC AGE (DNAMGRIMAGE-DIFF). OVERALL, THE MEAN DNAMGRIMAGE WAS 60.3 (+/-7.6), AND THE AVERAGE DNAMGRIMAGE-DIFF WAS 2.4 YEARS (+/-5.6 YEARS). THOSE EXPERIENCING HIGH-IMPACT PAIN EARNED LESS INCOME AND HAD LOWER EDUCATION LEVELS COMPARED TO BOTH LOW-IMPACT AND NO PAIN GROUPS. DIFFERENCES IN DNAMGRIMAGE-DIFF ACROSS PAIN GROUPS WERE FOUND, WHEREBY INDIVIDUALS WITH HIGH-IMPACT PAIN HAD ACCELERATED EPIGENETIC AGING ( APPROXIMATELY 5 YEARS) COMPARED TO LOW-IMPACT PAIN AND NO PAIN CONTROL GROUPS (BOTH APPROXIMATELY 1 YEAR). OUR MAIN FINDING WAS THAT EPIGENETIC AGING MEDIATED THE ASSOCIATIONS OF INCOME AND EDUCATION WITH PAIN IMPACT, AS SUCH THE RELATIONSHIP BETWEEN SES AND PAIN OUTCOMES MAY OCCUR THROUGH POTENTIAL INTERACTIONS WITH THE EPIGENOME REFLECTIVE OF ACCELERATED CELLULAR AGING. PERSPECTIVE: SOCIOECONOMIC STATUS (SES) HAS PREVIOUSLY BEEN IMPLICATED IN THE PAIN EXPERIENCE. THE PRESENT MANUSCRIPT AIMS TO PRESENT A POTENTIAL SOCIAL-BIOLOGICAL LINK BETWEEN SES AND PAIN VIA ACCELERATED EPIGENETIC AGING. 2023 16 6548 25 TRANSCULTURAL DIABETES CARE IN THE UNITED STATES - A POSITION STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS. THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS (AACE) HAS CREATED A TRANSCULTURALIZED DIABETES CHRONIC DISEASE CARE MODEL THAT IS ADAPTED FOR PATIENTS ACROSS A SPECTRUM OF ETHNICITIES AND CULTURES. AACE HAS CONDUCTED SEVERAL TRANSCULTURAL ACTIVITIES ON GLOBAL ISSUES IN CLINICAL ENDOCRINOLOGY AND COMPLETED A 3-CITY SERIES OF CONFERENCES IN DECEMBER 2017 THAT FOCUSED ON DIABETES CARE FOR ETHNIC MINORITIES IN THE U.S. PROCEEDINGS FROM THE "DIABETES CARE ACROSS AMERICA" SERIES OF TRANSCULTURAL SUMMITS ARE PRESENTED HERE. INFORMATION FROM COMMUNITY LEADERS, PRACTICING HEALTH CARE PROFESSIONALS, AND OTHER STAKEHOLDERS IN DIABETES CARE IS ANALYZED ACCORDING TO BIOLOGICAL AND ENVIRONMENTAL FACTORS. FOUR SPECIFIC U.S. ETHNICITIES ARE DETAILED: AFRICAN AMERICANS, LATINO/HISPANICS, ASIAN AMERICANS, AND NATIVE AMERICANS. A CORE SET OF RECOMMENDATIONS TO CULTURALLY ADAPT DIABETES CARE IS PRESENTED THAT EMPHASIZES CULTURALLY APPROPRIATE TERMINOLOGY, TRANSCULTURALIZATION OF WHITE PAPERS, CULTURALLY ADAPTING CLINIC INFRASTRUCTURE, FLEXIBLE OFFICE HOURS, BEHAVIORAL MEDICINE-ESPECIALLY MOTIVATIONAL INTERVIEWING AND BUILDING TRUST-CULTURALLY COMPETENT NUTRITIONAL MESSAGING AND HEALTH LITERACY, COMMUNITY PARTNERSHIPS FOR CARE DELIVERY, TECHNOLOGY INNOVATION, CLINICAL TRIAL RECRUITMENT AND RETENTION OF ETHNIC MINORITIES, AND MORE FUNDING FOR SCIENTIFIC STUDIES ON EPIGENETIC MECHANISMS OF CULTURAL IMPACT ON DISEASE EXPRESSION. IT IS HOPED THAT THROUGH EDUCATION, RESEARCH, AND CLINICAL PRACTICE ENHANCEMENTS, DIABETES CARE CAN BE OPTIMIZED IN TERMS OF PRECISION AND CLINICAL OUTCOMES FOR THE INDIVIDUAL AND U.S. POPULATION AS A WHOLE. 2019 17 3559 34 IMPACT OF CHRONIC CONDITIONS AND DEMENTIA IN RURAL WEST TEXAS: A HEALTHY AGING STUDY. ALZHEIMER'S DISEASE (AD) IS A DEVASTATING ILLNESS IN ELDERLY INDIVIDUALS, THAT CURRENTLY HAS NO KNOWN CURE. CAUSAL GENETIC FACTORS ONLY ACCOUNT FOR 1-2% OF AD PATIENTS. HOWEVER, OTHER CAUSAL FACTORS ARE STILL UNKNOWN FOR A MAJORITY OF AD PATIENTS. CURRENTLY, MULTIPLE FACTORS ARE IMPLICATED IN LATE-ONSET AD, INCLUDING UNHEALTHY DIET, PHYSICAL INACTIVITY, TRAUMATIC BRAIN INJURY, CHRONIC CONDITIONS, EPIGENETIC FACTORS, AND ENVIRONMENTAL EXPOSURES. ALTHOUGH CLINICAL SYMPTOMS OF DEMENTIA ARE COMMON TO ALL RACES AND ETHNIC GROUPS, CONDITIONS THAT LEAD TO DEMENTIA ARE DIFFERENT IN TERMS OF LIFESTYLE, GENETIC PROFILE, AND SOCIO-ECONOMIC CONDITIONS. INCREASING EVIDENCE ALSO SUGGESTS THAT SOME ELDERLY INDIVIDUALS AGE WITHOUT COGNITIVE IMPAIRMENTS IN THEIR 60-90S AS SEEN IN RURAL WEST TEXAS, WHILE SOME INDIVIDUALS PROGRESS WITH CHRONIC CONDITIONS AND COGNITIVE IMPAIRMENTS INTO THEIR 60S. TO UNDERSTAND THESE DISCRIMINATIONS, WE ASSESSED CURRENT LITERATURE ON DEMOGRAPHIC FEATURES OF HEALTH IN RURAL WEST TEXAS. THIS PAPER ALSO OUTLINES OUR INITIATED CLINICAL STUDY WITH A PURPOSE OF UNDERSTANDING THE FACTORS THAT ALLOW SOME INDIVIDUALS TO LIVE WITHOUT COGNITIVE IMPAIRMENTS AT THE AGE OF 60-90 YEARS, WHEREAS OTHERS DEVELOP DEFICITS IN COGNITIVE FUNCTION AROUND OR ABOVE 60 YEARS. OUR ONGOING STUDY HOPES TO DETERMINE THE FACTORS THAT DELAY AGING IN SOME INDIVIDUALS BY INVESTIGATING VARIOUS ASPECTS INCLUDING GENETICS, EPIGENETICS, ETHNICITY, BIOLOGY, CULTURE, AND LIFESTYLE. THIS WILL BE ACHIEVED BY GATHERING INFORMATION ABOUT PARTICIPANTS' ETHNOGRAPHIC PROFILES, COGNITIVE ASSESSMENTS, BLOOD-PROFILES, BRAIN SCANS, AND BLOOD-BASED GENOMIC ANALYSES IN RELATION TO LIFESTYLE. THE OUTCOMES OF OUR STUDY WILL PROVIDE INSIGHTS INTO HEALTHY AGING IN RURAL WEST TEXAS. 2022 18 1256 31 CURRENT STUDIES AND FUTURE DIRECTIONS FOR MEDULLOBLASTOMA: A REVIEW FROM THE PACIFIC PEDIATRIC NEURO-ONCOLOGY CONSORTIUM (PNOC) DISEASE WORKING GROUP. MEDULLOBLASTOMA (MB) IS THE MOST COMMON MALIGNANT CENTRAL NERVOUS SYSTEM TUMOR OF CHILDHOOD, COMPRISING A HETEROGENOUS GROUP OF TUMORS EACH WITH DISTINCT BIOLOGY, CLINICAL BEHAVIOR, AND PROGNOSIS. LONG-TERM SURVIVAL REMAINS UNACCEPTABLE, AND THOSE WHO DO SURVIVE FACE HIGH LATE MORTALITY RISK, NEW CHRONIC TREATMENT-RELATED MEDICAL CONDITIONS, NEUROCOGNITIVE IMPAIRMENTS, AND POOR HEALTH-RELATED QUALITY OF LIFE. UP-FRONT TREATMENT STRATEGIES NOW INTEGRATE MOLECULAR SUBGROUPING WITH STANDARD CLINICO-RADIOLOGICAL FACTORS TO MORE ACTUALLY RISK STRATIFY NEWLY-DIAGNOSED PATIENTS. TO WHAT EXTENT THIS NEW STRATIFICATION WILL LEAD TO IMPROVEMENTS IN TREATMENT OUTCOME WILL BE DETERMINED IN THE COMING YEARS. IN PARALLEL, DISCOVERY AND APPRECIATION FOR MEDULLOBLASTOMA'S INTER- AND INTRA-TUMORAL HETEROGENEITY CONTINUES GROWING. CLINICAL TRIALS TREATING RELAPSED DISEASE NOW ENCOMPASS PRECISION MEDICINE, EPIGENETIC MODIFICATION, AND IMMUNE THERAPY APPROACHES. THE PACIFIC PEDIATRIC NEURO-ONCOLOGY (PNOC) MEDULLOBLASTOMA WORKING GROUP IS COMMITTED TO DEVELOPING CLINICAL TRIALS BASED ON THESE EVOLVING THERAPEUTIC STRATEGIES AND SUPPORTS TRANSLATIONAL EFFORTS BY PNOC RESEARCHERS AND THE MULTI-STAKEHOLDER MEDULLOBLASTOMA COMMUNITY AT LARGE. 2023 19 6598 29 TWINSUK: THE UK ADULT TWIN REGISTRY UPDATE. TWINSUK IS THE LARGEST COHORT OF COMMUNITY-DWELLING ADULT TWINS IN THE UK. THE REGISTRY COMPRISES OVER 14,000 VOLUNTEER TWINS (14,838 INCLUDING MIXED, SINGLE AND TRIPLETS); IT IS PREDOMINANTLY FEMALE (82%) AND MIDDLE-AGED (MEAN AGE 59). IN ADDITION, OVER 1800 PARENTS AND SIBLINGS OF TWINS ARE REGISTERED VOLUNTEERS. DURING THE LAST 27 YEARS, TWINSUK HAS COLLECTED NUMEROUS QUESTIONNAIRE RESPONSES, PHYSICAL/COGNITIVE MEASURES AND BIOLOGICAL MEASURES ON OVER 8500 SUBJECTS. DATA WERE COLLECTED ALONGSIDE FOUR COMPREHENSIVE PHENOTYPING CLINICAL VISITS TO THE DEPARTMENT OF TWIN RESEARCH AND GENETIC EPIDEMIOLOGY, KING'S COLLEGE LONDON. SUCH COLLECTION METHODS HAVE RESULTED IN VERY DETAILED LONGITUDINAL CLINICAL, BIOCHEMICAL, BEHAVIORAL, DIETARY AND SOCIOECONOMIC COHORT CHARACTERIZATION; IT PROVIDES A MULTIDISCIPLINARY PLATFORM FOR THE STUDY OF COMPLEX DISEASE DURING THE ADULT LIFE COURSE, INCLUDING THE PROCESS OF HEALTHY AGING. THE MAJOR STRENGTH OF TWINSUK IS THE AVAILABILITY OF SEVERAL 'OMIC' TECHNOLOGIES FOR A RANGE OF SAMPLE TYPES FROM PARTICIPANTS, WHICH INCLUDES GENOMEWIDE SCANS OF SINGLE-NUCLEOTIDE VARIANTS, NEXT-GENERATION SEQUENCING, METABOLOMIC PROFILES, MICROBIOMICS, EXOME SEQUENCING, EPIGENETIC MARKERS, GENE EXPRESSION ARRAYS, RNA SEQUENCING AND TELOMERE LENGTH MEASURES. TWINSUK FACILITATES AND ACTIVELY ENCOURAGES SHARING THE 'TWINSUK' RESOURCE WITH THE SCIENTIFIC COMMUNITY - INTERESTED RESEARCHERS MAY REQUEST DATA VIA THE TWINSUK WEBSITE (HTTP://TWINSUK.AC.UK/RESOURCES-FOR-RESEARCHERS/ACCESS-OUR-DATA/) FOR THEIR OWN USE OR FUTURE COLLABORATION WITH THE STUDY TEAM. IN ADDITION, FURTHER COHORT DATA COLLECTION IS PLANNED VIA THE WELLCOME OPEN RESEARCH GATEWAY (HTTPS://WELLCOMEOPENRESEARCH.ORG/GATEWAYS). THE CURRENT ARTICLE PRESENTS AN UP-TO-DATE REPORT ON THE APPLICATION OF TECHNOLOGICAL ADVANCES, NEW STUDY PROCEDURES IN THE COHORT AND FUTURE DIRECTION OF TWINSUK. 2019 20 2096 29 EPIGENETIC EFFECTS OF CHILDHOOD ADVERSITY IN THE BRAIN AND SUICIDE RISK. WITH PREVALENCE ESTIMATES RANGING BETWEEN 6.4% AND 10.1% [-5], MAJOR DEPRESSION RANKS FIRST AMONG THE MOST SIGNIFICANT CAUSES OF DISABILITY AND PREMATURE DEATH, THUS IMPOSING A CONTINUAL ECONOMIC BURDEN ON SOCIETY. FOR INSTANCE, IN THE UNITED STATES, THE DIRECT AND INDIRECT COSTS ARE ESTIMATED AT U.S.$44 BILLION/YEAR [6]. THE GREATEST LOSS TO OUR SOCIETY, HOWEVER, IS THE ASSOCIATED MORTALITY BY SUICIDE RELATED TO MAJOR DEPRESSION. INDEED, IT HAS BEEN ESTIMATED THAT BETWEEN 50% AND 70% OF SUICIDE COMPLETERS WILL DIE DURING AN EPISODE OF MAJOR DEPRESSION [7,8] AND PROSPECTIVE FOLLOW-UP STUDIES OF MAJOR DEPRESSION SUGGEST THAT BETWEEN 7% AND 15% OF THESE PATIENTS WILL DIE BY SUICIDE [-12]. SUICIDE IS A COMPLEX PROBLEM, WHICH IS BELIEVED TO RESULT FROM THE INTERACTION OF SEVERAL DIFFERENT FACTORS [13,14]. INDEED, PSYCHOLOGICAL FACTORS AND PERSONALITY TRAITS SUCH AS IMPULSIVITY AND NEGATIVE AFFECT [14,15], SOCIAL FACTORS [16,17], ENVIRONMENTAL FACTORS SUCH AS EARLY-LIFE ADVERSITY [-20], GENETIC FACTORS [21], AND NEUROBIOLOGICAL FACTORS [22] HAVE BEEN PROPOSED TO INDUCE BEHAVIORAL ALTERATIONS, WHICH IN TURN MAY PREDISPOSE CERTAIN INDIVIDUALS TO DEVELOP DEPRESSIVE AND SUICIDAL BEHAVIORS. HOWEVER, SINCE THESE FACTORS ALONE ARE UNLIKELY TO EXPLAIN SUICIDE AND SUICIDE RISK, IT MAY BE MORE READILY EXPLAINED WHEN CONSIDERING THE INTERACTION BETWEEN THESE DIFFERENT SOURCES OF VARIATION [23,24]. AMONG THESE RISK FACTORS, EARLY-LIFE ADVERSITY, PARTICULARLY CHILDHOOD SEXUAL ABUSE (CSA) AND CHILDHOOD PHYSICAL ABUSE (CPA), IS ONE OF THE STRONGEST PREDICTORS OF MENTAL DISORDERS [25,26] AND SUICIDE [18,19]. FOR EXAMPLE, STUDIES HAVE SHOWN THAT CSA IS ASSOCIATED WITH EARLY ONSET OF DEPRESSION, CHRONIC COURSE, AND MORE SEVERE DEPRESSIVE OUTCOME [-29] BUT, MORE IMPORTANTLY, WITH 12 TIMES HIGHER ODDS OF SUICIDAL BEHAVIORS [26,30]. ALTHOUGH LESS CONSISTENTLY, CPA AND NEGLECT HAVE ALSO BEEN ASSOCIATED WITH SUICIDAL BEHAVIORS [19,31]. CSA AND CPA HAVE BEEN ASSOCIATED WITH HIGHER ODDS OF SELF-HARM [,,-34], SUICIDAL IDEATION [35,36], AND SUICIDE ATTEMPTS [,-39]. MOREOVER, THE PREVALENCE OF SUICIDAL IDEATION AND SUICIDE ATTEMPTS HAS BEEN SHOWN TO INCREASE WITH THE SEVERITY AND INTENSITY OF THE ABUSE [35,36,38]. 2012