The association of food insecurity with mental health in preschool-aged children and their parents.

BACKGROUND: Household food insecurity (HFI) is associated with poor general and mental health. Prior studies assessed parent and child mental health separately and did not assess other social risks. OBJECTIVE: To assess the relationship between HFI and both parental and child mental health. METHODS: Parents of 3-5-year-old children completed validated measures of food insecurity and mental health. Separate linear regression models were used for unadjusted analysis for each mental health outcome (parent depression, anxiety, and stress, and child mental health). Multivariable analysis was performed using hierarchical regression to adjust for relevant covariates. RESULTS: Children (n = 335) were racially and socioeconomically diverse. HFI was reported in 10% of participants. HFI was associated with worse parent depression and stress in unadjusted analyses; however, after adjusting for covariates, the associations became insignificant. HFI was significantly associated with worse child mental health in unadjusted and multivariable analysis (aß 2.24, 95% CI 0.59-3.88) compared to those without HFI. CONCLUSION: HFI was not associated with parental mental health outcomes when other social risks were included in the analyses; however, HFI was significantly associated with worse childhood mental health in all analyses. Pediatric providers should screen for and develop interventions to target both HFI and mental health. IMPACT: Household food insecurity was associated with worse parent depression and stress in unadjusted analyses; however, after adjusting for other social risks, the associations became insignificant. Household food insecurity was significantly associated with worse child mental health, even after adjusting for demographics, other social risks, and parent mental health. Social risks are differentially associated with parent and child mental health. Understanding the complexities of family stressors can help better support parents and children struggling with mental health problems and social risks.

Pharmacologic Recruitment of Endogenous Neural Stem/Progenitor Cells for the Treatment of Spinal Cord Injury.

STUDY DESIGN: Laboratory study using a rat T9 contusion model of spinal cord injury. OBJECTIVE: This study aims to examine whether a combinatory treatment of Pioglitazone (PGZ) and granulocyte colony-stimulating factor (GCSF) can support neural stem/progenitor cells (NSPCs) directly and provide a sustainable microenvironment through immunomodulatory mechanisms. SUMMARY OF BACKGROUND DATA: Neuroinflammation plays a crucial role in the progression of spinal cord injury (SCI) and hinders NSPC-mediated repair and regeneration. Broad acting drugs that mitigate inflammation and support NSPC proliferation have not been tested together in SCI research models. METHODS: Isolated NSPCs were treated with vehicle control, PGZ, GCSF, or both PGZ and GSCF for 24 hours and stained with proliferation marker Ki67. Adult female Sprague-Dawley rats sustained moderate-to-severe contusion-based SCI at T9 and were administered either vehicle control, PGZ, GCSF, or both PGZ and GCSF treatments. RESULTS: Immunocytochemistry revealed that cultured NSPCs treated with both drugs produced higher numbers of actively proliferating cells and total cell numbers. ELISA on spinal cord tissue lysates at 1, 3, and 7 days post-injury (DPI) demonstrated that animals treated with PGZ, GCSF, or combination therapy showed significantly higher doublecortin levels at 7 DPI compared to control animals (P < 0.05). Immunohistochemistry of injured tissue at 3, 7, and 14 DPI revealed no difference of ependymal NSPC proliferation between groups, but showed a significant decrease in lesion size with combination therapy compared to controls. Functional recovery was assessed by the Basso, Beattie, Bresnahan locomotor rating scale. Animals treated with both drugs had significantly higher levels of function at 1 (P < 0.001), 3 (P < 0.001), 7 (P < 0.05), and 14 (P < 0.05) DPI compared to controls. CONCLUSION: These results indicate that PGZ and GCSF treatment synergistically enhance NSPCs numbers and improve functional recovery after SCI. Our findings support an immunomodulatory strategy to recruit native NSPCs as a potential acute care intervention for SCI.Level of Evidence: N/A.

Keratin Biomaterials Improve Functional Recovery in a Rat Spinal Cord Injury Model.

STUDY DESIGN: Laboratory study using a rat T9 contusion model of spinal cord injury (SCI). OBJECTIVE: The purpose of this study was to evaluate which method of delivery of soluble keratin biomaterials would best support functional restoration through the macrophage polarization paradigm. SUMMARY OF BACKGROUND DATA: SCI is a devastating neurologic event with complex pathophysiological mechanisms that currently has no cure. After injury, macrophages and resident microglia are key regulators of inflammation and tissue repair exhibiting phenotypic and functional plasticity. Keratin biomaterials have been demonstrated to influence macrophage polarization and promote the M2 anti-inflammatory phenotype that attenuates inflammatory responses. METHODS: Anesthetized female Lewis rats were subjected to moderate T9 contusion SCI and randomly divided into: no therapy (control group), an intrathecally injected keratin group, and a keratin-soaked sponge group (n = 11 in all groups). Functional recovery assessments were obtained at 3- and 6-weeks post-injury (WPI) using gait analysis performed with the DigiGait Imaging System treadmill and at 1, 3, 7, 14, 21, 28, 35, and 42 days post-injury by the Basso, Beattie, Bresnahan (BBB) locomotor rating scale. Histology and immunohistochemistry of serial spinal cord sections were performed to assess injury severity and treatment efficacy. RESULTS: Compared to control rats, applying keratin materials after injury improved functional recovery in certain gait parameters and overall trended toward significance in BBB scores; however, no significant differences were observed with tissue analysis between groups at 6 WPI. CONCLUSION: Results suggest that keratin biomaterials support some locomotor functional recovery and may alter the acute inflammatory response by inducing macrophage polarization following SCI. This therapy warrants further investigation into treatment of SCI.Level of Evidence: N/A.