Genetic and phenotypic characterization of NKX6-2-related spastic ataxia and hypomyelination.

BACKGROUND AND PURPOSE: Hypomyelinating leukodystrophies are a heterogeneous group of genetic disorders with a wide spectrum of phenotypes and a high rate of genetically unsolved cases. Bi-allelic mutations in NKX6-2 were recently linked to spastic ataxia 8 with hypomyelinating leukodystrophy. METHODS: Using a combination of homozygosity mapping, exome sequencing, and detailed clinical and neuroimaging assessment a series of new NKX6-2 mutations in a multicentre setting is described. Then, all reported NKX6-2 mutations and those identified in this study were combined and an in-depth analysis of NKX6-2-related disease spectrum was provided. RESULTS: Eleven new cases from eight families of different ethnic backgrounds carrying compound heterozygous and homozygous pathogenic variants in NKX6-2 were identified, evidencing a high NKX6-2 mutation burden in the hypomyelinating leukodystrophy disease spectrum. Our data reveal a phenotype spectrum with neonatal onset, global psychomotor delay and worse prognosis at the severe end and a childhood onset with mainly motor phenotype at the milder end. The phenotypic and neuroimaging expression in NKX6-2 is described and it is shown that phenotypes with epilepsy in the absence of overt hypomyelination and diffuse hypomyelination without seizures can occur. CONCLUSIONS: NKX6-2 mutations should be considered in patients with autosomal recessive, very early onset of nystagmus, cerebellar ataxia with hypotonia that rapidly progresses to spasticity, particularly when associated with neuroimaging signs of hypomyelination. Therefore, it is recommended that NXK6-2 should be included in hypomyelinating leukodystrophy and spastic ataxia diagnostic panels.

Birth weight to placenta weight ratio and its relationship to ultrasonic measurements, maternal and neonatal morbidity: A prospective cohort study of nulliparous women.

INTRODUCTION: Birth weight to placenta weight (BWPW)-ratio is an indicator of the ability of the placenta to maintain adequate nutrient supply to the fetus. We sought to investigate the relationship between BWPW-ratio with fetal growth, utero-placental Doppler and neonatal and maternal morbidity. METHODS: We studied a group of 3311 women recruited to a prospective cohort study of nulliparous women (Rosie Hospital, Cambridge, UK) who delivered a live born infant at term and whose placental weight and birth weight were known. Ultrasonic indices and BWPW ratio were converted to gestational age adjusted z scores. Analysis of continuous variables was by multivariable linear regression. BWPW ratio was also categorized (lowest or highest quintile, both referent to quintiles 2 to 4) and associations with adverse outcomes analyzed using multivariable logistic regression. RESULTS: Lowest quintile of BWPW-ratio was associated (adjusted odds ratio [95% CI], P) with both neonatal morbidity (1.55 [1.12-2.14], 0.007) and maternal diabetes (1.75 [1.18-2.59], 0.005). Highest quintile of BWPW ratio was associated with a reduced risk of maternal obesity (0.71 [0.53 to 0.95], 0.02) and preeclampsia (0.51 [0.31 to 0.84], 0.008), but higher (adjusted z score [95% CI], P) uterine artery Doppler mean pulsatility index (PI) at 20 weeks of gestation (0.09 [0.01-0.18], 0.04) and umbilical artery Doppler PI at 36 weeks of gestation (0.16 [0.07-0.25], <0.001). CONCLUSION: BWPW-ratio is related to ultrasonic measurements and both neonatal and maternal morbidity. Therefore, this ratio may be an indicative marker of immediate and longer term health risks for an individual.

Silica decorated TiO2 for virus inactivation in drinking water--simple synthesis method and mechanisms of enhanced inactivation kinetics.

A new method of modifying TiO2 photocatalysts with SiO2 is developed in which SiO2 nanoparticles are simply mixed with TiO2 in water under ambient conditions. This method does not require the use of toxic solvents or significant energy input. Although the SiO2 modification slightly reduces hydroxyl free radical production, the composite SiO2-TiO2 nanomaterials have markedly higher photocatalytic inactivation rates for a common surrogate virus, bacteriophage MS2 (up to 270% compared to the unmodified TiO2), due to the greatly improved adsorptive density and dark inactivation of MS2. The Langmuir isotherm describes the adsorption data well and shows that the TiO2 modified with 5% SiO2 has a maximum adsorption density qmax 37 times that of the unmodified TiO2. The Langmuir-Hinshelwood model fits the photocatalytic inactivation kinetic data well. The SiO2-TiO2 material produces a greater maximum initial inactivation rate yet a lower intrinsic surface reaction rate constant, consistent with the reduced hydroxyl radical production and enhanced adsorption. These results suggest that modifying photocatalyst surface to increase contaminant adsorption is an important strategy to improve photocatalytic reaction efficiency. Simple and cheap synthesis methods such as that used in this study bring photocatalysis closer to being a viable water treatment option.

3D nanoporous nanowire current collectors for thin film microbatteries.

Conventional thin film batteries are fabricated based on planar current collector designs where the high contact resistance between the current collector and electrodes impedes overall battery performance. Hence, current collectors based on 3D architectures and nanoscale roughness has been proposed to dramatically increase the electrode-current collector surface contact areas and hence significantly reduce interfacial resistance. The nanorod-based current collector configuration is one of several 3D designs which has shown high potential for the development of high energy and high power microbatteries in this regard. Herein we fabricate a nanoporous nanorod based current collector, which provides increased surface area for electrode deposition arising from the porosity of each nanorods, yet keeping an ordered spacing between nanorods for the deposition of subsequent electrolyte and electrode layers. The new nanostructured 3D current collector is demonstrated with a polyaniline (PANI)-based electrode system and is shown to deliver improved rate capability characteristics compared to planar configurations. We have been able to achieve stable capacities of ~32 µAh/cm(2) up to 75 cycles of charge/discharge even at a current rate of ~0.04 mA/cm(2) and have observed good rate capability even at high current rates of ~0.8 mA/cm(2).

Simple route to enhanced photocatalytic activity of p25 titanium dioxide nanoparticles by silica addition.

Silica doped TiO2(P25) nanoparticles are tested for its photocatalytic activity in the degradation of bacteriophage MS2. During our studies it was found that treatment of TiO2(P25) in the glass flasks sealed with silicone grease resulted in a significant improvement in the catalytic activity of the titania. Further improvement can be made by the purposeful reaction of TiO2(P25) with 2.5 wt % silica. This non in situ method of incorporating silica to TiO2(P25) nanoparticles is tested for their role in killing of viruses, and it is found that the rate constant is three times higher to kill viruses with the addition of silica. BET measurements show no significant change/increase in the surface area of silica doped TiO2(P25)-SiO2, compared to the undoped TiO2(P25). Further studies show that the addition of silica increases the adsorption of viruses onto the catalyst. There is a significant difference in the activity of the TiO2(P25)-SiO2 samples in the presence of methanol, supporting the notion that hydroxide radical (HO·) is responsible for the antiviral action. The TiO2(P25)-SiO2 either produces more HO· than non silica-doped material, or the enhanced adsorption of MS2 to the catalyst results in greater exposure to the HO·, or both mechanisms may work in concert. XPS studies suggest the formation of silica species on the surface of the TiO2(P25), while UV-visible spectroscopy suggests that the presence of the silica results in a small increase in the measured band gap. We suggest that the enhanced catalytic activity is a result of increased adsorption and/or band bending which can occur at the interface within TiO2(P25)-SiO2. One result of this would be a reduction of the electron-hole recombination, the formation of a greater concentration of OH·, and hence an improved catalytic performance.

Personal experiences of women with diabetes who do not attend pre-pregnancy care.

AIMS: To explore the views of women who did not attend pre-pregnancy care (PPC), in particular their accounts of contraception, previous pregnancies and the influence of healthcare advice. METHODS: We conducted semi-structured interviews with 29 pregnant women (21 with Type 1 diabetes, eight with Type 2 diabetes) at three UK specialist diabetes antenatal clinics. Interviews explored women's journeys to becoming pregnant, including use of contraception, their views regarding diabetes and pregnancy and the factors which encouraged and discouraged them from attending PPC. RESULTS: All women had some understanding of the issues concerning diabetes during pregnancy, predominantly regarding the benefits of PPC (90%) and optimal glycaemic control (80%) and risks of malformation (48%) and macrosomia (35%). Most were not regularly using contraception (70%), having stopped deliberately (45%), become unintentionally less rigorous (28%) or experienced side effects/contraindications (14%). Knowledge concerning the risks of pregnancy (90%) and past pre-conception counselling (38%) did not encourage women to attend PPC, and neither did personal experience of miscarriage, malformation or stillbirth in women with previous poor pregnancy outcome (41%). Barriers included conceiving faster than anticipated (45%), fertility concerns (31%), negative experiences with health professionals (21%), desire for a 'normal' pregnancy (17%) and the logistics of attending (10%). CONCLUSIONS: More integrated diabetes and reproductive health/contraceptive advice, increased awareness of the potentially short time between stopping contraception and conception and more intensive support between pregnancies are required, particularly for women with previously poor outcomes. Research is also needed into how communication between health professionals and women with diabetes can be improved.