1,209 results on '"Jacobson, Lisa P."'
Search Results
2. Integrative review of school integration support following pediatric cancer
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Parrillo, Elaina, Petchler, Claire, Jacobson, Lisa A., Ruble, Kathy, Paré-Blagoev, E. Juliana, and Nolan, Marie T.
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- 2024
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3. Applying earth system justice to phase out fossil fuels: learning from the injustice of adopting 1.5 °C over 1 °C
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Gupta, Joyeeta, Chen, Yang, Mckay, David I. Armstrong, Fezzigna, Paola, Gentile, Giuliana, Karg, Aljoscha, van Vliet, Luc, Lade, Steven J., and Jacobson, Lisa
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- 2024
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4. The Environmental Influences on Child Health Outcomes (ECHO)-Wide Cohort
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Knapp, Emily A, Kress, Amii M, Parker, Corette B, Page, Grier P, McArthur, Kristen, Gachigi, Kennedy K, Alshawabkeh, Akram N, Aschner, Judy L, Bastain, Theresa M, Breton, Carrie V, Bendixsen, Casper G, Brennan, Patricia A, Bush, Nicole R, Buss, Claudia, Camargo, Carlos A, Catellier, Diane, Cordero, José F, Croen, Lisa, Dabelea, Dana, Deoni, Sean, D’Sa, Viren, Duarte, Cristiane S, Dunlop, Anne L, Elliott, Amy J, Farzan, Shohreh F, Ferrara, Assiamira, Ganiban, Jody M, Gern, James E, Giardino, Angelo P, Towe-Goodman, Nissa R, Gold, Diane R, Habre, Rima, Hamra, Ghassan B, Hartert, Tina, Herbstman, Julie B, Hertz-Picciotto, Irva, Hipwell, Alison E, Karagas, Margaret R, Karr, Catherine J, Keenan, Kate, Kerver, Jean M, Koinis-Mitchell, Daphne, Lau, Bryan, Lester, Barry M, Leve, Leslie D, Leventhal, Bennett, LeWinn, Kaja Z, Lewis, Johnnye, Litonjua, Augusto A, Lyall, Kristen, Madan, Juliette C, McEvoy, Cindy T, McGrath, Monica, Meeker, John D, Miller, Rachel L, Morello-Frosch, Rachel, Neiderhiser, Jenae M, O’Connor, Thomas G, Oken, Emily, O’Shea, Michael, Paneth, Nigel, Porucznik, Christina A, Sathyanarayana, Sheela, Schantz, Susan L, Spindel, Eliot R, Stanford, Joseph B, Stroustrup, Annemarie, Teitelbaum, Susan L, Trasande, Leonardo, Volk, Heather, Wadhwa, Pathik D, Weiss, Scott T, Woodruff, Tracey J, Wright, Rosalind J, Zhao, Qi, Jacobson, Lisa P, and Outcomes, on behalf of program collaborators for Environmental Influences on Child Health
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Public Health ,Health Sciences ,Human Genome ,Prevention ,Nutrition ,Pediatric ,Behavioral and Social Science ,Genetics ,Clinical Research ,Pediatric Research Initiative ,2.2 Factors relating to the physical environment ,Aetiology ,Good Health and Well Being ,Child ,Humans ,United States ,Environmental Exposure ,Cohort Studies ,Child Health ,Air Pollution ,Outcome Assessment ,Health Care ,adolescent ,child ,child development ,child health ,child well-being ,cohort studies ,environmental exposure ,epidemiologic methods ,Mathematical Sciences ,Medical and Health Sciences ,Epidemiology - Abstract
The Environmental Influences on Child Health Outcomes (ECHO)-Wide Cohort Study (EWC), a collaborative research design comprising 69 cohorts in 31 consortia, was funded by the National Institutes of Health (NIH) in 2016 to improve children's health in the United States. The EWC harmonizes extant data and collects new data using a standardized protocol, the ECHO-Wide Cohort Data Collection Protocol (EWCP). EWCP visits occur at least once per life stage, but the frequency and timing of the visits vary across cohorts. As of March 4, 2022, the EWC cohorts contributed data from 60,553 children and consented 29,622 children for new EWCP data and biospecimen collection. The median (interquartile range) age of EWCP-enrolled children was 7.5 years (3.7-11.1). Surveys, interviews, standardized examinations, laboratory analyses, and medical record abstraction are used to obtain information in 5 main outcome areas: pre-, peri-, and postnatal outcomes; neurodevelopment; obesity; airways; and positive health. Exposures include factors at the level of place (e.g., air pollution, neighborhood socioeconomic status), family (e.g., parental mental health), and individuals (e.g., diet, genomics).
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- 2023
5. Living within the safe and just Earth system boundaries for blue water
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Stewart-Koster, Ben, Bunn, Stuart E., Green, Pamela, Ndehedehe, Christopher, Andersen, Lauren S., Armstrong McKay, David I., Bai, Xuemei, DeClerck, Fabrice, Ebi, Kristie L., Gordon, Christopher, Gupta, Joyeeta, Hasan, Syezlin, Jacobson, Lisa, Lade, Steven J., Liverman, Diana, Loriani, Sina, Mohamed, Awaz, Nakicenovic, Nebojsa, Obura, David, Qin, Dahe, Rammelt, Crelis, Rocha, Juan C., Rockström, Johan, Verburg, Peter H., and Zimm, Caroline
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- 2024
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6. No Association of IFNL4 Genotype With Opportunistic Infections and Cancers Among Men With Human Immunodeficiency Virus 1 Infection
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Fang, Michelle Z, Jackson, Sarah S, Pfeiffer, Ruth M, Kim, Eun-Young, Chen, Sabrina, Hussain, Shehnaz K, Jacobson, Lisa P, Martinson, Jeremy, Prokunina-Olsson, Ludmila, Thio, Chloe L, Duggal, Priya, Wolinsky, Steven, and O’Brien, Thomas R
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Medical Microbiology ,Biomedical and Clinical Sciences ,Immunology ,Infectious Diseases ,Digestive Diseases ,Cancer ,Emerging Infectious Diseases ,Genetics ,HIV/AIDS ,2.2 Factors relating to the physical environment ,2.1 Biological and endogenous factors ,Aetiology ,Infection ,Good Health and Well Being ,Male ,Humans ,HIV-1 ,Cohort Studies ,Sarcoma ,Kaposi ,Genotype ,HIV Infections ,Opportunistic Infections ,Herpes Simplex ,Cytomegalovirus Infections ,Interleukins ,Polymorphism ,Single Nucleotide ,cytomegalovirus ,genetics ,herpes simplex virus ,interferon lambda ,Kaposi sarcoma ,interferon λ ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundIFNL4 genetic variants that are strongly associated with clearance of hepatitis C virus have been linked to risk of certain opportunistic infections (OIs) and cancers, including Kaposi sarcoma, cytomegalovirus infection, and herpes simplex virus infection. As the interferon (IFN) λ family plays a role in response to viral, bacterial, and fungal infections, IFNL4 genotype might affect risk for a wide range of OIs/cancers.MethodsWe examined associations between genotype for the functional IFNL4 rs368234815 polymorphism and incidence of 16 OIs/cancers among 2310 men with human immunodeficiency virus (2038 white; 272 black) enrolled in the Multicenter AIDS Cohort Study during 1984-1990. Our primary analyses used Cox proportional hazards models adjusted for self-reported racial ancestry to estimate hazard ratios with 95% confidence intervals, comparing participants with the genotypes that generate IFN-λ4 and those with the genotype that abrogates IFN-λ4. We censored follow-up at the introduction of highly effective antiretroviral therapies.ResultsWe found no statistically significant association between IFNL4 genotype and the incidence of Kaposi sarcoma (hazard ratio, 0.92 [95% confidence interval, .76-1.11]), cytomegalovirus infection (0.94 [.71-1.24]), herpes simplex virus infection (1.37 [.68-2.93]), or any other OI/cancer. We observed consistent results using additive genetic models and after controlling for CD4 cell count through time-dependent adjustment or restriction to participants with a low CD4 cell count.ConclusionsThe absence of associations between IFNL4 genotype and these OIs/cancers provides evidence that this gene does not affect the risk of disease from opportunistic pathogens.
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- 2023
7. Opportunities for understanding the COVID-19 pandemic and child health in the United States: the Environmental influences on Child Health Outcomes (ECHO) program
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Bekelman, Traci A, Trasande, Leonardo, Law, Andrew, Blackwell, Courtney K, Jacobson, Lisa P, Bastain, Theresa M, Breton, Carrie V, Elliott, Amy J, Ferrara, Assiamira, Karagas, Margaret R, Aschner, Judy L, Bornkamp, Nicole, Camargo, Carlos A, Comstock, Sarah S, Dunlop, Anne L, Ganiban, Jody M, Gern, James E, Karr, Catherine J, Kelly, Rachel S, Lyall, Kristen, O’Shea, T Michael, Schweitzer, Julie B, and LeWinn, Kaja Z
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Paediatrics ,Biomedical and Clinical Sciences ,Neurosciences ,Prevention ,Pediatric ,Clinical Research ,Health Services ,American Indian or Alaska Native ,Pediatric Research Initiative ,2.4 Surveillance and distribution ,Aetiology ,Good Health and Well Being ,life course approach ,environmental exposures ,health disparities ,parent-child dyads ,pediatric health ,health behaviors ,Paediatrics and Reproductive Medicine ,Other Medical and Health Sciences - Abstract
ObjectiveOngoing pediatric cohort studies offer opportunities to investigate the impact of the COVID-19 pandemic on children's health. With well-characterized data from tens of thousands of US children, the Environmental influences on Child Health Outcomes (ECHO) Program offers such an opportunity.MethodsECHO enrolled children and their caregivers from community- and clinic-based pediatric cohort studies. Extant data from each of the cohorts were pooled and harmonized. In 2019, cohorts began collecting data under a common protocol, and data collection is ongoing with a focus on early life environmental exposures and five child health domains: birth outcomes, neurodevelopment, obesity, respiratory, and positive health. In April of 2020, ECHO began collecting a questionnaire designed to assess COVID-19 infection and the pandemic's impact on families. We describe and summarize the characteristics of children who participated in the ECHO Program during the COVID-19 pandemic and novel opportunities for scientific advancement.ResultsThis sample (n = 13,725) was diverse by child age (31% early childhood, 41% middle childhood, and 16% adolescence up to age 21), sex (49% female), race (64% White, 15% Black, 3% Asian, 2% American Indian or Alaska Native,
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- 2023
8. Characterizing changes in behaviors associated with chemical exposures during the COVID-19 pandemic
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Herbstman, Julie B, Romano, Megan E, Li, Xiuhong, Jacobson, Lisa P, Margolis, Amy E, Hamra, Ghassan B, Bennett, Deborah H, Braun, Joseph M, Buckley, Jessie P, Colburn, Trina, Deoni, Sean, Hoepner, Lori A, Morello-Frosch, Rachel, Riley, Kylie Wheelock, Sathyanarayana, Sheela, Schantz, Susan L, Trasande, Leonardo, Woodruff, Tracey J, Perera, Frederica P, Karagas, Margaret R, and Outcomes, on behalf of program collaborators for Environmental influences on Child Health
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Public Health ,Health Sciences ,Behavioral and Social Science ,Mental Health ,Basic Behavioral and Social Science ,Prevention ,Clinical Research ,2.2 Factors relating to the physical environment ,2.3 Psychological ,social and economic factors ,Aetiology ,Good Health and Well Being ,Child ,Humans ,COVID-19 ,Pandemics ,Soaps ,Stress ,Psychological ,Surveys and Questionnaires ,program collaborators for Environmental influences on Child Health Outcomes ,General Science & Technology - Abstract
The COVID-19 pandemic-and its associated restrictions-have changed many behaviors that can influence environmental exposures including chemicals found in commercial products, packaging and those resulting from pollution. The pandemic also constitutes a stressful life event, leading to symptoms of acute traumatic stress. Data indicate that the combination of environmental exposure and psychological stress jointly contribute to adverse child health outcomes. Within the Environmental influences on Child Health Outcomes (ECHO)-wide Cohort, a national consortium initiated to understand the effects of environmental exposures on child health and development, our objective was to assess whether there were pandemic-related changes in behavior that may be associated with environmental exposures. A total of 1535 participants from nine cohorts completed a survey via RedCap from December 2020 through May 2021. The questionnaire identified behavioral changes associated with the COVID-19 pandemic in expected directions, providing evidence of construct validity. Behavior changes reported by at least a quarter of the respondents include eating less fast food and using fewer ultra-processed foods, hair products, and cosmetics. At least a quarter of respondents reported eating more home cooked meals and using more antibacterial soaps, liquid soaps, hand sanitizers, antibacterial and bleach cleaners. Most frequent predictors of behavior change included Hispanic ethnicity and older age (35 years and older). Respondents experiencing greater COVID-related stress altered their behaviors more than those not reporting stress. These findings highlight that behavior change associated with the pandemic, and pandemic-related psychological stress often co-occur. Thus, prevention strategies and campaigns that limit environmental exposures, support stress reduction, and facilitate behavioral change may lead to the largest health benefits in the context of a pandemic. Analyzing biomarker data in these participants will be helpful to determine if behavior changes reported associate with measured changes in exposure.
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- 2023
9. Improving Assistive Technology Access for Students with Chronic and Complex Medical Conditions: Lessons Learned from Young Cancer Survivors
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Carey, Lisa B., Harkins-Brown, Andrea, Ruble, Kathy, Paré-Blagoev, E. Juliana, Milla, Kimberly, Thornton, Clifton P., and Jacobson, Lisa A.
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Students with chronic and complex medical conditions often require assistive technologies in order to accommodate both physical and cognitive needs. Survivors of childhood cancer who are eligible for special education offer a lens through which to examine barriers to assistive technology assessment, acquisition, use, and support for students with health impairments. In this article, we examine literature that suggests that special education students with a history of cancer are unlikely to gain access to assistive technology, despite clearly demonstrated needs. We discuss assistive technology literature to determine research-supported steps schools can take to increase and improve access to assistive technology for students with chronic and complex medical conditions.
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- 2023
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10. Will the 'Real' Theoretical Structure of the WISC-V Please Stand Up? Implications for Clinical Interpretation
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Dombrowski, Stefan C., McGill, Ryan J., Watkins, Marley W., Canivez, Gary L., Pritchard, Alison E., and Jacobson, Lisa A.
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The Wechsler Intelligence Scale for Children's (WISC) factorial\theoretical structure has undergone numerous substantive changes since it was first developed, and each of these changes has subsequently been questioned by assessment experts. Given remaining questions about the structure of the latest revision, the WISC-V, the present study used three different exploratory factor analytic techniques to investigate the factor structure of the 10 primary subtests in a large clinical sample (N = 5359). Results revealed that the WISC-V likely contains four factors (e.g., Gc, Gwm, Gs, and either Gv (via exploratory bifactor analysis) or a complexly determined perceptual reasoning factor (via the Schmid-Leiman procedure and oblique/higher-order factor analysis)), "not" the five factors proposed by the test publisher. Variance apportionment and omega estimates indicate that only secondary interpretive emphasis should be placed upon group factors, but only when there is structural validity support. This study suggests that the WISC-V measures four, not five, factors, although the four-factor configuration may be different than previously reported in the technical literature.
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- 2022
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11. Suboptimal HIV suppression is associated with progression of coronary artery stenosis: The Multicenter AIDS Cohort Study (MACS) longitudinal coronary CT angiography study
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Post, Wendy S, Haberlen, Sabina A, Witt, Mallory D, Zhang, Long, Jacobson, Lisa P, Brown, Todd T, Margolick, Joseph B, Kingsley, Lawrence, Palella, Frank J, and Budoff, Matthew
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Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Heart Disease ,HIV/AIDS ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Clinical Research ,Infectious Diseases ,Infection ,Good Health and Well Being ,Cohort Studies ,Computed Tomography Angiography ,Constriction ,Pathologic ,Coronary Angiography ,Coronary Artery Disease ,Coronary Stenosis ,HIV Infections ,Humans ,Male ,Middle Aged ,Viremia ,Atherosclerosis ,HIV ,Coronary artery disease ,Coronary CT angiography ,Epidemiology ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
Background and aimsPeople living with HIV (HIV+) are surviving longer due to effective antiretroviral therapy. Cardiovascular disease is a leading cause of non-AIDS related clinical events. We determined HIV-related factors associated with coronary artery stenosis progression.MethodsWe performed serial coronary CT angiography among HIV+ and HIV-uninfected (HIV-) men in the Multicenter AIDS Cohort Study. The median inter-scan interval was 4.5 years. Stenosis was graded as 0, 1-29, 30-49, 50-69 or ≥70%. Progression was defined as an increase ≥2 categories. Suppressed HIV infection was consistent viral loads 1 viral load >500 copies/ml demonstrated greatest stenosis progression (RR 3.01; 95% CI, 1.53-4.92, p = 0.001 compared with HIV- men). Suppressed HIV+ men with suboptimal antiretroviral adherence had greater stenosis progression (RR 1.91; 95% CI 1.12-3.24, p = 0.02) than HIV + suppressed men with optimal adherence.ConclusionsCoronary artery stenosis progression was associated with suboptimal HIV RNA suppression and antiretroviral therapy adherence. Effective ongoing HIV virologic suppression and antiretroviral therapy adherence may mitigate risk for coronary disease events among people living with HIV.
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- 2022
12. Associations between cord blood acetaminophen biomarkers and childhood asthma with and without allergic comorbidities
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Li, Yijun, Hong, Xiumei, Chandran, Aruna, Keet, Corinne A., Clish, Clary B., Liang, Liming, Jacobson, Lisa P., Wang, Xiaobin, and Ladd-Acosta, Christine
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- 2024
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13. Safe and just Earth system boundaries
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Rockström, Johan, Gupta, Joyeeta, Qin, Dahe, Lade, Steven J., Abrams, Jesse F., Andersen, Lauren S., Armstrong McKay, David I., Bai, Xuemei, Bala, Govindasamy, Bunn, Stuart E., Ciobanu, Daniel, DeClerck, Fabrice, Ebi, Kristie, Gifford, Lauren, Gordon, Christopher, Hasan, Syezlin, Kanie, Norichika, Lenton, Timothy M., Loriani, Sina, Liverman, Diana M., Mohamed, Awaz, Nakicenovic, Nebojsa, Obura, David, Ospina, Daniel, Prodani, Klaudia, Rammelt, Crelis, Sakschewski, Boris, Scholtens, Joeri, Stewart-Koster, Ben, Tharammal, Thejna, van Vuuren, Detlef, Verburg, Peter H., Winkelmann, Ricarda, Zimm, Caroline, Bennett, Elena M., Bringezu, Stefan, Broadgate, Wendy, Green, Pamela A., Huang, Lei, Jacobson, Lisa, Ndehedehe, Christopher, Pedde, Simona, Rocha, Juan, Scheffer, Marten, Schulte-Uebbing, Lena, de Vries, Wim, Xiao, Cunde, Xu, Chi, Xu, Xinwu, Zafra-Calvo, Noelia, and Zhang, Xin
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- 2023
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14. Earth system justice needed to identify and live within Earth system boundaries
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Gupta, Joyeeta, Liverman, Diana, Prodani, Klaudia, Aldunce, Paulina, Bai, Xuemei, Broadgate, Wendy, Ciobanu, Daniel, Gifford, Lauren, Gordon, Chris, Hurlbert, Margot, Inoue, Cristina Y. A., Jacobson, Lisa, Kanie, Norichika, Lade, Steven J., Lenton, Timothy M., Obura, David, Okereke, Chukwumerije, Otto, Ilona M., Pereira, Laura, Rockström, Johan, Scholtens, Joeri, Rocha, Juan, Stewart-Koster, Ben, David Tàbara, J., Rammelt, Crelis, and Verburg, Peter H.
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- 2023
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15. Impacts of meeting minimum access on critical earth systems amidst the Great Inequality
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Rammelt, Crelis F., Gupta, Joyeeta, Liverman, Diana, Scholtens, Joeri, Ciobanu, Daniel, Abrams, Jesse F., Bai, Xuemei, Gifford, Lauren, Gordon, Christopher, Hurlbert, Margot, Inoue, Cristina Y. A., Jacobson, Lisa, Lade, Steven J., Lenton, Timothy M., McKay, David I. Armstrong, Nakicenovic, Nebojsa, Okereke, Chukwumerije, Otto, Ilona M., Pereira, Laura M., Prodani, Klaudia, Rockström, Johan, Stewart-Koster, Ben, Verburg, Peter H., and Zimm, Caroline
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- 2023
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16. Will the Real Theoretical Structure of the WISC-V Please Stand Up? Implications for Clinical Interpretation
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Dombrowski, Stefan C., McGill, Ryan J., Watkins, Marley W., Canivez, Gary L., Pritchard, Alison E., and Jacobson, Lisa A.
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- 2022
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17. Effect of Statin Use on Inflammation and Immune Activation Biomarkers in HIV-Infected Persons on Effective Antiretroviral Therapy
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Hussain, Shehnaz K, Golozar, Asieh, Widney, Daniel P, Rappocciolo, Giovanna, Penugonda, Sudhir, Bream, Jay H, Martínez-Maza, Otoniel, and Jacobson, Lisa P
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Medical Microbiology ,Biomedical and Clinical Sciences ,Immunology ,HIV/AIDS ,Heart Disease ,Infectious Diseases ,Cardiovascular ,Clinical Research ,Cancer ,Evaluation of treatments and therapeutic interventions ,6.1 Pharmaceuticals ,Inflammatory and immune system ,Infection ,Good Health and Well Being ,Biomarkers ,Cohort Studies ,HIV Infections ,Humans ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Inflammation ,Longitudinal Studies ,Male ,statins ,inflammation ,immune activation ,HIV ,cytokine ,Clinical Sciences ,Virology ,Clinical sciences - Abstract
Immune activation and inflammation are hallmarks of chronic HIV infection and are etiologically linked to major causes of morbidity and mortality among HIV-infected persons, including coronary artery disease and cancer. Systemic immune activation is dampened, but not resolved, with use of combination antiretroviral therapy (cART). Statins are cardioprotective drugs that also appear to have immunomodulatory and anti-inflammatory properties. We sought to understand the association between statin use, cART, and levels of circulating immune markers in a longitudinal cohort study. From 2004 to 2009, statin use was ascertained in male participants of the Multicenter AIDS Cohort Study (MACS) using interviewer-administered questionnaires. Twenty-four circulating markers of immune activation and inflammation were measured in archived serial samples from a subset of cohort members using multiplex assays. Propensity-adjusted generalized gamma models were used to compare biomarkers' distributions by statin use, and multivariable linear regression models were used to assess the effect of initiating statin on these biomarkers. Overall, 1,031 cART-exposed individuals with HIV infection were included in this study. Statin use was reported by 31.5% of cART-exposed participants. Compared to nonstatin users on cART, statin users on cART had lower levels of IP-10, IL-10, and IL-12p70, and the effect of statin use was decreased in participants using lipophilic statins (atorvastatin, simvastatin, fluvastatin, or lovastatin); these results were statistically significant (p
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- 2021
18. Social inequalities contribute to racial/ethnic disparities in depressive symptomology among men who have sex with men
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Barrett, Benjamin W, Abraham, Alison G, Dean, Lorraine T, Plankey, Michael W, Friedman, M Reuel, Jacobson, Lisa P, Teplin, Linda A, Gorbach, Pamina M, and Surkan, Pamela J
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Epidemiology ,Public Health ,Health Sciences ,Depression ,Prevention ,Clinical Research ,Behavioral and Social Science ,Basic Behavioral and Social Science ,Mental Health ,Sexual and Gender Minorities (SGM/LGBT*) ,2.3 Psychological ,social and economic factors ,Aetiology ,Mental health ,Reduced Inequalities ,Baltimore ,Cohort Studies ,Ethnicity ,Hispanic or Latino ,Homosexuality ,Male ,Humans ,Los Angeles ,Male ,Prospective Studies ,Sexual and Gender Minorities ,Socioeconomic Factors ,United States ,Depressive symptoms ,Men who have sex with men ,Racial ,ethnic health disparities ,USA ,Racial/ethnic health disparities ,Clinical Sciences ,Psychology ,Cognitive Sciences ,Psychiatry ,Public health ,Clinical and health psychology - Abstract
PurposeRacial/ethnic minorities experience disproportionate rates of depressive symptoms in the United States. The magnitude that underlying factors-such as social inequalities-contribute to these symptoms is unknown. We sought to identify exposures that explain racial/ethnic differences in clinically significant depressive symptomology among men who have sex with men (MSM).MethodsData from the Multicenter AIDS Cohort Study (MACS), a prospective cohort study, were used to examine clinically significant symptoms of depression (Center for Epidemiologic Studies Depression Scale score ≥ 20) among non-Latinx White, non-Latinx Black, and Latinx MSM. We included 44,823 person-visits by 1729 MSM seen in the study sites of Baltimore/Washington, DC; Chicago; Pittsburgh/Columbus; and Los Angeles from 2000 to 2017. Regression models estimated the percentage of depressive symptom risk explained by social, treatment, and health-related variables related to race/ethnicity. Machine-learning methods were used to predict the impact of mitigating differences in determinants of depressive symptoms by race/ethnicity.ResultsAt the most recent non-missing MACS visit, 16% of non-Latinx White MSM reported clinically significant depressive symptoms, compared to 22% of non-Latinx Black and 25% of Latinx men. We found that income and social-environmental stress were the largest contributors to racial/ethnic disparities in risk for depressive symptoms. Similarly, setting the prevalence of these two exposures to be equal across racial/ethnic groups was estimated to be most effective at reducing levels of clinically significant depressive symptoms.ConclusionResults suggested that reducing socioeconomic inequalities and stressful experiences may be effective public health targets to decrease racial/ethnic disparities in depressive symptoms among MSM.
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- 2021
19. Sluggish cognitive tempo profiles in survivors of childhood cancer as compared to children with attention-deficit/hyperactivity disorder
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Peterson, Rachel K., Holingue, Calliope, and Jacobson, Lisa A.
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- 2022
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20. A novel density-volume calcium score by non-contrast CT predicts coronary plaque burden on coronary CT angiography: Results from the MACS (Multicenter AIDS cohort study)
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Nakanishi, Rine, Delaney, Joseph A, Post, Wendy S, Dailing, Christopher, Blaha, Michael J, Palella, Frank, Witt, Mallory, Brown, Todd T, Kingsley, Lawrence A, Osawa, Kazuhiro, Ceponiene, Indre, Nezarat, Negin, Rahmani, Sina, Kanisawa, Mitsuru, Jacobson, Lisa, and Budoff, Matthew J
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Atherosclerosis ,Cardiovascular ,Heart Disease ,Biomedical Imaging ,Heart Disease - Coronary Heart Disease ,Adult ,Aged ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Disease ,Humans ,Male ,Middle Aged ,Plaque ,Atherosclerotic ,Predictive Value of Tests ,Prospective Studies ,Reproducibility of Results ,Severity of Illness Index ,United States ,Vascular Calcification ,Calcium density ,Calcium volume ,Coronary artery calcium ,Coronary computed tomographic angiography ,Human immunodeficiency virus ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences ,Applied computing - Abstract
BackgroundThe purpose of this study is to determine if a new score calculated with coronary artery calcium (CAC) density and volume is associated with total coronary artery plaque burden and composition on coronary CT angiography (CCTA) compared to the Agatston score (AS).MethodsWe identified 347 men enrolled in the Multicenter AIDS cohort study who underwent contrast and non-contrast CCTs, and had CAC>0. CAC densities (mean Hounsfield Units [HU]) per plaque) and volumes on non-contrast CCT were measured. A Density-Volume Calcium score was calculated by multiplying the plaque volume by a factor based on the mean HU of the plaque (4, 3, 2 and 1 for 130-199, 200-299, 300-399, and ≥400HU). Total Density-Volume Calcium score was determined by the sum of these individual scores. The semi-quantitative partially calcified and total plaque scores (PCPS and TPS) on CCTA were calculated. The associations between Density-Volume Calcium score, PCPS and TPS were examined.ResultsOverall, 2879 CAC plaques were assessed. Multivariable linear regression models demonstrated a stronger association between the log Density-Volume Calcium score and both the PCPS (β 0.99, 95%CI 0.80-1.19) and TPS (β 2.15, 95%CI 1.88-2.42) compared to the log of AS (PCPS: β 0.77, 95%CI 0.61-0.94; TPS: β 1.70, 95%CI 1.48-1.94). Similar results were observed for numbers of PC or TP segments.ConclusionThe new CAC score weighted towards lower density demonstrated improved correlation with semi-quantitative PC and TP burden on CCTA compared to the traditional AS, which suggests it has utility as an alternative measure of atherosclerotic burden.
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- 2020
21. Association of Immunosuppression and Human Immunodeficiency Virus (HIV) Viremia With Anal Cancer Risk in Persons Living With HIV in the United States and Canada
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Hernández-Ramírez, Raúl U, Qin, Li, Lin, Haiqun, Leyden, Wendy, Neugebauer, Romain S, Althoff, Keri N, Hessol, Nancy A, Achenbach, Chad J, Brooks, John T, Gill, M John, Grover, Surbhi, Horberg, Michael A, Li, Jun, Mathews, W Christopher, Mayor, Angel M, Patel, Pragna, Rabkin, Charles S, Rachlis, Anita, Justice, Amy C, Moore, Richard D, Engels, Eric A, Silverberg, Michael J, Dubrow, Robert, Benson, Constance A, Bosch, Ronald J, Kirk, Gregory D, Mayer, Kenneth H, Grasso, Chris, Hogg, Robert S, Harrigan, P Richard, Montaner, Julio SG, Yip, Benita, Zhu, Julia, Salters, Kate, Gabler, Karyn, Buchacz, Kate, Gebo, Kelly A, Rodriguez, Benigno, Thorne, Jennifer E, Rabkin, Charles, Margolick, Joseph B, Jacobson, Lisa P, D’Souza, Gypsyamber, Klein, Marina B, Kroch, Abigail, Burchell, Ann, Betts, Adrian, Lindsay, Joanne, Hunter-Mellado, Robert F, Deeks, Steven G, Martin, Jeffrey N, Saag, Michael S, Mugavero, Michael J, Willig, James, Mathews, William C, Eron, Joseph J, Napravnik, Sonia, Kitahata, Mari M, Crane, Heidi M, Drozd, Daniel R, Sterling, Timothy R, Haas, David, Rebeiro, Peter, Turner, Megan, Fiellin, David, Gange, Stephen J, Anastos, Kathryn, McKaig, Rosemary G, Freeman, Aimee M, Van Rompaey, Stephen E, Morton, Liz, McReynolds, Justin, Lober, William B, Lee, Jennifer S, and You, Bin
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Medical Microbiology ,Biomedical and Clinical Sciences ,Immunology ,Digestive Diseases ,Prevention ,Sexually Transmitted Infections ,Cancer ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,2.1 Biological and endogenous factors ,Aetiology ,Infection ,Good Health and Well Being ,Anus Neoplasms ,CD4 Lymphocyte Count ,Canada ,HIV ,HIV Infections ,Humans ,Immunosuppression Therapy ,United States ,Viral Load ,Viremia ,HIV infection ,CD4+T-cell count ,HIV-1 RNA viral load ,anal cancer ,risk ,North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS ,CD4+ T-cell count ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundPeople living with human immunodeficiency virus (HIV; PLWH) have a markedly elevated anal cancer risk, largely due to loss of immunoregulatory control of oncogenic human papillomavirus infection. To better understand anal cancer development and prevention, we determined whether recent, past, cumulative, or nadir/peak CD4+ T-cell count (CD4) and/or HIV-1 RNA level (HIV RNA) best predict anal cancer risk.MethodsWe studied 102 777 PLWH during 1996-2014 from 21 cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. Using demographics-adjusted, cohort-stratified Cox models, we assessed associations between anal cancer risk and various time-updated CD4 and HIV RNA measures, including cumulative and nadir/peak measures during prespecified moving time windows. We compared models using the Akaike information criterion.ResultsCumulative and nadir/peak CD4 or HIV RNA measures from approximately 8.5 to 4.5 years in the past were generally better predictors for anal cancer risk than their corresponding more recent measures. However, the best model included CD4 nadir (ie, the lowest CD4) from approximately 8.5 years to 6 months in the past (hazard ratio [HR] for
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- 2020
22. Inflammation and Risk of Depression in HIV: Prospective Findings From the Multicenter AIDS Cohort Study.
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Lu, Haidong, Surkan, Pamela J, Irwin, Michael R, Treisman, Glenn J, Breen, Elizabeth C, Sacktor, Ned, Stall, Ron, Wolinsky, Steven M, Jacobson, Lisa P, and Abraham, Alison G
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Prevention ,Brain Disorders ,Depression ,HIV/AIDS ,Mental Health ,Clinical Research ,2.1 Biological and endogenous factors ,Aetiology ,Inflammatory and immune system ,HIV Infections ,Humans ,Inflammation ,Male ,Prevalence ,Prospective Studies ,Sexual and Gender Minorities ,United States ,biomarkers ,depression ,HIV ,immune activation ,inflammation ,Mathematical Sciences ,Medical and Health Sciences ,Epidemiology - Abstract
Studies suggest that inflammation might be involved in the pathogenesis of depression. Individuals with human immunodeficiency virus (HIV) have a higher risk of depression and elevated inflammatory profiles. Despite this, research on the link between inflammation and depression among this high-risk population is limited. We examined a sample of men who have sex with men from the Multicenter AIDS Cohort Study in prospective analyses of the association between inflammation and clinically relevant depression symptoms, defined as scores >20 on Center for Epidemiological Studies Depression Scale. We included 1,727 participants who contributed 9,287 person-visits from 1984 to 2010 (8,218 with HIV (HIV+) and 1,069 without (HIV-)). Exploratory factor analysis (EFA) was used to characterize underlying inflammatory processes from 19 immune markers. Logistic regression with generalized estimating equations was used to evaluate associations between inflammatory processes and depressive symptoms stratified by HIV serostatus. Three EFA-identified inflammatory processes (EIPs) were identified. EIP-1 scores-described by soluble tumor necrosis factor receptor 2 (sTNF-R2), soluble interleukin-2 receptor α (sIL-2Rα), sCD27, B-cell activating factor, interferon γ-induced protein 10 (IP-10), soluble interleukin-6 receptor (sIL-6R), sCD14, and sGP130-were significantly associated with 9% higher odds of depressive symptoms in HIV+ participants (odds ratio = 1.09; 95% confidence interval: 1.03, 1.16) and 33% higher odds in HIV- participants (odds ratio = 1.33; 95% confidence interval: 1.09, 1.61). Findings suggest that immune activation might be involved in depression risk among both HIV+ and HIV- men who have sex with men.
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- 2019
23. Association of High-Sensitivity Troponin with Cardiac CT Angiography Evidence of Myocardial and Coronary Disease in a Primary Prevention Cohort of Men: Results from MACS
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Rahman, Faisal, Zhang, Zhenyu, Zhao, Di, Budoff, Matthew J, Palella, Frank J, Witt, Mallory D, Evans, Rhobert W, Jacobson, Lisa P, Korley, Frederick K, Guallar, Eliseo, Post, Wendy S, and McEvoy, John W
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Medical Biochemistry and Metabolomics ,Biomedical and Clinical Sciences ,Clinical Sciences ,Infectious Diseases ,Cardiovascular ,Heart Disease - Coronary Heart Disease ,Atherosclerosis ,Clinical Research ,Prevention ,HIV/AIDS ,Heart Disease ,Aetiology ,2.1 Biological and endogenous factors ,Good Health and Well Being ,Aged ,Biomarkers ,Cardiomyopathies ,Comorbidity ,Computed Tomography Angiography ,Coronary Artery Disease ,HIV Infections ,Humans ,Male ,Middle Aged ,Odds Ratio ,Sensitivity and Specificity ,Troponin ,Troponin C ,Troponin T ,Clinical sciences ,Medical biochemistry and metabolomics - Abstract
BackgroundHigh-sensitivity cardiac troponin (hs-cTn) elevations are associated with incident cardiovascular disease events in primary prevention samples. However, the mechanisms underlying this association remain unclear.MethodsWe studied 458 men without known cardiovascular disease who participated in the cardiovascular disease substudy of the Multicenter AIDS Cohort Study and had cardiac CT angiography. We used multivariable linear and logistic regression models to examine the cross-sectional associations between coronary artery stenosis, coronary artery plaque, indexed left ventricular mass (LVMi), and the outcome of hs-cTnI. We also evaluated the associations between HIV serostatus or use of highly active antiretroviral therapy (HAART) and hs-cTnI.ResultsThe mean age was 54 years, 54% were white, and 61% were HIV infected. In multivariable-adjusted logistic models, comparing the highest quartile of LVMi with the lowest quartile, the odds ratio (OR) of hs-cTnI ≥75th percentile was 2.59 (95% CI, 1.20-5.75). There was no significant association between coronary stenosis severity or plaque type and hs-cTnI in linear models; however, in logistic regression models, coronary artery stenosis ≥70% (8% of sample) was marginally associated with a higher likelihood (OR, 2.75 [95% CI, 1.03, 7.27]) of having hs-cTnI ≥75th percentile. There were no associations between HIV serostatus or HAART use and hs-cTnI in either linear or logistic models.ConclusionAmong primary prevention men with or at risk for HIV, hs-cTnI concentrations were strongly associated with LVMi but were not associated with HIV infection or treatment status or with coronary plaque type or stenosis until the extremes of severity (≥70% stenosis).
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- 2019
24. Meta-analysis under imbalance in measurement of confounders in cohort studies using only summary-level data
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Ray, Debashree, Muñoz, Alvaro, Zhang, Mingyu, Li, Xiuhong, Chatterjee, Nilanjan, Jacobson, Lisa P., and Lau, Bryan
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- 2022
- Full Text
- View/download PDF
25. Measurement Invariance of the Wechsler Intelligence Scale for Children, Fifth Edition 10-Subtest Primary Battery: Can Index Scores Be Compared across Age, Sex, and Diagnostic Groups?
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Dombrowski, Stefan C., Watkins, Marley W., McGill, Ryan J., Canivez, Gary L., Holingue, Calliope, Pritchard, Alison E., and Jacobson, Lisa A.
- Abstract
Measurement invariance of the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V) 10 subtest primary battery was evaluated across sex, age (6-8, 9-11, 12-14, and 15-16 year-olds), and three diagnostic (attention-deficit/hyperactivity disorder, anxiety, and encephalopathy) groups within a large clinical sample (N = 5359) referred to a children's specialty hospital. Competing models were tested using confirmatory factor analysis (CFA), and a five-factor oblique model corresponding to the publisher's hypothesized first-order measurement model (e.g., verbal comprehension, fluid reasoning, visual-spatial, working memory, and processing speed) was found to have the best model fit. Multigroup CFA was subsequently used to evaluate progressively more restrictive constraints on the measurement model. Results indicated that full metric invariance was attained across the three groups studied. Full scalar invariance was attained for sex and diagnostic groups. Partial scalar invariance was attained for age-group. The results of this study provide support for the first-order scoring structure of the five WISC-V factors in the 10 subtest primary battery with this large clinical sample.
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- 2021
- Full Text
- View/download PDF
26. HIV Infection Is Associated with Greater Left Ventricular Mass in the Multicenter AIDS Cohort Study.
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Hutchins, Elizabeth, Wang, Ruibin, Rahmani, Sina, Nakanishi, Rine, Haberlen, Sabina, Kingsley, Lawrence, Witt, Mallory D, Palella, Frank Joseph, Jacobson, Lisa, Budoff, Matthew J, and Post, Wendy S
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Heart Ventricles ,Humans ,Acquired Immunodeficiency Syndrome ,Atrial Fibrillation ,Cardiomyopathies ,Anti-Retroviral Agents ,CD4 Lymphocyte Count ,Antiretroviral Therapy ,Highly Active ,Risk Factors ,Cross-Sectional Studies ,Ventricular Function ,Left ,Adult ,Aged ,Middle Aged ,Male ,Heart Failure ,AIDS ,HIV ,X-ray computed tomography ,cardiomyopathy ,diastolic ,heart failure ,Heart Disease ,HIV/AIDS ,Clinical Research ,Infectious Diseases ,Clinical Trials and Supportive Activities ,Prevention ,Cardiovascular ,Infection ,Good Health and Well Being ,tomography ,atrial fibrillation ,Clinical Sciences ,Virology - Abstract
HIV infection has been associated with diastolic heart failure and atrial fibrillation. The purpose of this study is to determine whether HIV infection is associated with differences in left ventricular mass (LVM), left ventricular end-diastolic volume (LVEDV), and left atrial volume (LAV) indexed to body surface area (left ventricular mass index, left ventricular end-diastolic volume index [LVEDVI], and left atrial volume index [LAVI], respectively). Cross-sectional study of 721 men [425 HIV-infected (HIV+), 296 HIV-uninfected (HIV-) enrolled in the cardiovascular substudy of the Multicenter AIDS Cohort Study (MACS). Participants underwent cardiac computed tomography imaging. A blinded reader measured LVM, LVEDV, and LAV. We used multivariable linear regression models to evaluate whether LVEDVI, left ventricular mass index (LVMI), and LAVI differed by HIV serostatus, adjusting for demographics and cardiovascular disease risk factors. LVMI was significantly greater in HIV+ compared with HIV- men, with adjusted difference of 2.65 g/m2 (95% confidence interval 0.53-4.77, p
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- 2019
27. Midlife adiposity predicts cognitive decline in the prospective Multicenter AIDS Cohort Study
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Rubin, Leah H, Gustafson, Deborah, Hawkins, Kellie L, Zhang, Long, Jacobson, Lisa P, Becker, James T, Munro, Cynthia A, Lake, Jordan E, Martin, Eileen, Levine, Andrew, Brown, Todd T, Sacktor, Ned, and Erlandson, Kristine M
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Clinical Trials and Supportive Activities ,Obesity ,Mental Health ,Clinical Research ,Prevention ,Neurosciences ,Infectious Diseases ,HIV/AIDS ,Nutrition ,Behavioral and Social Science ,Cardiovascular ,Adult ,Aged ,Aged ,80 and over ,Attention ,Body Mass Index ,Case-Control Studies ,Cognitive Dysfunction ,HIV Infections ,Humans ,Male ,Memory ,Short-Term ,Middle Aged ,Movement ,Obesity ,Abdominal ,Waist Circumference ,Clinical Sciences ,Cognitive Sciences ,Neurology & Neurosurgery - Abstract
ObjectiveObesity is a common, modifiable cardiovascular and cerebrovascular risk factor. Among people with HIV, obesity may contribute to multisystem dysregulation including cognitive impairment. We examined body mass index (BMI) and central obesity (waist circumference [WC]) in association with domain-specific cognitive function and 10-year cognitive decline in men with HIV infection (MWH) vs HIV-uninfected (HIV-) men.MethodsA total of 316 MWH and 656 HIV- Multicenter AIDS Cohort Study participants ≥40 years at baseline, with neuropsychological testing every 2 years and concurrent BMI and WC measurements, were included. MWH were included if taking ≥2 antiretroviral agents and had HIV-1 RNA 80% of visits. Mixed-effects models included all visits from 1996 to 2015, stratified by HIV serostatus, and adjusted for sociodemographic, behavioral, and clinical characteristics. At baseline and follow-up, 8% of MWH and 15% of HIV- men and 41% of MWH and 56% of HIV- men were ≥60 years, respectively.ResultsCross-sectionally, higher BMI was inversely associated with motor function in MWH and HIV- men, and attention/working memory in HIV- men. WC was inversely associated with motor function in MWH and HIV- men. Longitudinal associations indicated an obese BMI was associated with a less steep decline in motor function in MWH whereas in HIV- men, obesity was associated with a greater decline in motor function, learning, and memory. WC, or central obesity, showed similar patterns of associations.ConclusionHigher adiposity is associated with lower cognition cross-sectionally and greater cognitive decline, particularly in HIV- men. Overweight and obesity may be important predictors of neurologic outcomes and avenues for prevention and intervention.
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- 2019
28. Associations between lipids and subclinical coronary atherosclerosis
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Whelton, Seamus P, Deal, Jennifer A, Zikusoka, Michelle, Jacobson, Lisa P, Sarkar, Sudipa, Palella, Frank J, Kingsley, Lawrence, Budoff, Matthew, Witt, Mallory D, Brown, Todd T, and Post, Wendy S
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Cardiovascular ,Atherosclerosis ,Clinical Research ,HIV/AIDS ,Heart Disease ,Heart Disease - Coronary Heart Disease ,Aetiology ,2.1 Biological and endogenous factors ,Good Health and Well Being ,Adult ,Asymptomatic Diseases ,Cohort Studies ,Coronary Artery Disease ,Coronary Vessels ,HIV Infections ,Humans ,Lipids ,Male ,Middle Aged ,Prevalence ,Tomography ,X-Ray Computed ,atherosclerosis ,coronary artery disease ,HIV ,lipids ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectiveWhether HIV modifies the relationship of serum lipids with coronary atherosclerosis and coronary plaque subtypes is uncertain. We examined the associations between traditional lipids and coronary atherosclerosis among HIV-infected (HIV+) and HIV-uninfected (HIV-) men.DesignThe Multicenter AIDS Cohort Study is an observational cohort with a total of 429 HIV+ and 303 HIV- men who had non-contrast cardiac computed tomography performed to measure coronary artery calcium and coronary computed tomography angiography to measure coronary stenosis, coronary plaque presence, and composition.MethodsWe used multivariable adjusted prevalence ratios to examine the relationship between the SD difference in each lipid parameter and coronary atherosclerosis.ResultsTotal cholesterol (TC)/HDL-cholesterol had the strongest associations with coronary atherosclerosis regardless of HIV status. Overall, lipid parameters were most strongly associated with the presence of mixed plaque, stenosis more than 50%, and coronary artery calcium for both HIV+ and HIV- men. HIV+ men had similar, but weaker associations, between lipid parameters and coronary atherosclerosis compared with HIV- men. The strongest association was between the TC/HDL-cholesterol and stenosis more than 50% for both HIV+ [prevalence ratios 1.25 per SD (95% confidence interval 1.07-1.43)] and HIV- men [prevalence ratios 1.46 per SD (95% confidence interval 1.08-1.85)].ConclusionThe associations between lipids and coronary atherosclerosis tended to be weaker for HIV+ compared with HIV- men, although TC/HDL had the strongest association for both HIV+ and HIV- men. A weaker association between lipid levels and coronary atherosclerosis for HIV+ men may contribute to the decreased discrimination of cardiovascular disease risk observed in HIV+ individuals.
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- 2019
29. Optimal metrics for identifying long term patterns of depression in older HIV-infected and HIV-uninfected men who have sex with men
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Armstrong, Nicole M, Surkan, Pamela J, Treisman, Glenn J, Sacktor, Ned C, Irwin, Michael R, Teplin, Linda A, Stall, Ron C, Jacobson, Lisa P, and Abraham, Alison G
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Health Sciences ,Sexual and Gender Minorities (SGM/LGBT*) ,Mental Health ,HIV/AIDS ,Clinical Research ,Behavioral and Social Science ,Depression ,Infection ,Good Health and Well Being ,Aged ,Bisexuality ,Comorbidity ,Depressive Disorder ,Follow-Up Studies ,HIV Infections ,Homosexuality ,Male ,Humans ,Male ,Middle Aged ,Psychiatric Status Rating Scales ,Reproducibility of Results ,Sensitivity and Specificity ,Sexual and Gender Minorities ,HIV infection ,sensitivity ,specificity ,validity ,Medical and Health Sciences ,Studies in Human Society ,Psychology and Cognitive Sciences ,Geriatrics ,Health sciences ,Human society ,Psychology - Abstract
ObjectivesCenter of Epidemiologic Studies-Depression Scale (CES-D) provides a snapshot of symptom severity at a single point in time. However, the best way of using CES-D to classify long-term depression is unclear.MethodTo identify long-term depression among HIV-infected and HIV-uninfected 50+ year-old men who have sex with men (MSM) with at least 5 years of follow-up, we compared sensitivities and specificities of CES-D-based metrics (baseline CES-D; four consecutive CES-Ds; group-based trajectory models) thresholded at 16 and 20 to a clinician's evaluation of depression phenotype based on all available data including CES-D history, depression treatment history, drug use history, HIV disease factors, and demographic characteristics.ResultsA positive depressive phenotype prevalence was common among HIV-infected (prevalence = 33.1%) and HIV-uninfected MSM (prevalence = 23.2%). Compared to the depressive phenotype, trajectory models of CES-D≥20 provided highest specificities among HIV-infected (specificity = 99.9%, 95% Confidence Interval [CI]:99.4%-100.0%) and HIV-uninfected MSM (specificity = 99.0%, 95% CI:97.4%-99.7%). Highest sensitivities resulted from classifying baseline CES-D ≥ 16 among HIV-infected MSM (sensitivity = 75.0%, 95% CI:67.3%-81.7%) and four consecutive CES-Ds ≥ 16 among HIV-uninfected MSM (sensitivity = 81.0%, 95% CI:73.7%-87.0%).ConclusionChoice of method should vary, depending on importance of false positive or negative rate for long-term depression in HIV-infected and HIV-uninfected MSM.
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- 2019
30. Association of immunosuppression and HIV viraemia with non-Hodgkin lymphoma risk overall and by subtype in people living with HIV in Canada and the USA: a multicentre cohort study
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Hernández-Ramírez, Raúl U, Qin, Li, Lin, Haiqun, Leyden, Wendy, Neugebauer, Romain S, Althoff, Keri N, Achenbach, Chad J, Hessol, Nancy A, D'Souza, Gypsyamber, Gebo, Kelly A, Gill, M John, Grover, Surbhi, Horberg, Michael A, Li, Jun, Mathews, W Christopher, Mayor, Angel M, Park, Lesley S, Rabkin, Charles S, Salters, Kate, Justice, Amy C, Moore, Richard D, Engels, Eric A, Silverberg, Michael J, Dubrow, Robert, AIDS, North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate, Betts, Adrian, Brooks, John T, Freeman, Aimee M, Van Rompaey, Stephen E, Burchell, Ann, Yip, Benita, You, Bin, Hogan, Brenna, Grasso, Chris, Hogg, Robert S, Benson, Constance A, Drozd, Daniel R, Sterling, Timothy R, Haas, David, Humes, Elizabeth, Crane, Heidi M, Willig, James, Eron, Joseph J, Martin, Jeffrey N, Saag, Michael S, Jing, Jerry, Zhang, Jinbing, Lindsay, Joanne, Hunter-Mellado, Robert F, Deeks, Steven G, Zhu, Julia, Montaner, Julio SG, McReynolds, Justin, Gabler, Karyn, Buchacz, Kate, Rodriguez, Benigno, Thorne, Jennifer E, Margolick, Joseph B, Anastos, Kathryn, Jacobson, Lisa P, Klein, Marina B, Kroch, Abigail, Morton, Liz, Turner, Megan, Fiellin, David, Gange, Stephen J, Mugavero, Michael J, Harrigan, P Richard, Rebeiro, Peter, Bosch, Ronald J, Kirk, Gregory D, Mayer, Kenneth H, McKaig, Rosemary G, Coburn, Sally, Napravnik, Sonia, Kitahata, Mari M, Lober, William B, and Lee, Jennifer S
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Oncology and Carcinogenesis ,Sexually Transmitted Infections ,Hematology ,Prevention ,Lymphoma ,Rare Diseases ,Cancer ,Infectious Diseases ,Lymphatic Research ,HIV/AIDS ,Aetiology ,2.1 Biological and endogenous factors ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,Aged ,Aged ,80 and over ,CD4 Lymphocyte Count ,Canada ,Cohort Studies ,Female ,HIV Infections ,Humans ,Immune Tolerance ,Lymphoma ,Non-Hodgkin ,Male ,Middle Aged ,Risk Assessment ,United States ,Viral Load ,Young Adult ,North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS ,Medical and Health Sciences ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundResearch is needed to better understand relations between immunosuppression and HIV viraemia and risk for non-Hodgkin lymphoma, a common cancer in people living with HIV. We aimed to identify key CD4 count and HIV RNA (viral load) predictors of risk for non-Hodgkin lymphoma, overall and by subtype.MethodsWe studied people living with HIV during 1996-2014 from 21 Canadian and US cohorts participating in the North American AIDS Cohort Collaboration on Research and Design. To determine key independent predictors of risk for non-Hodgkin lymphoma, we assessed associations with time-updated recent, past, cumulative, and nadir or peak measures of CD4 count and viral load, using demographics-adjusted, cohort-stratified Cox models, and we compared models using Akaike's information criterion.FindingsOf 102 131 people living with HIV during the study period, 712 people developed non-Hodgkin lymphoma. The key independent predictors of risk for overall non-Hodgkin lymphoma were recent CD4 count (ie, lagged by 6 months;
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- 2019
31. Impaired insulin sensitivity is associated with worsening cognition in HIV-infected patients.
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Khuder, Saja S, Chen, Suming, Letendre, Scott, Marcotte, Thomas, Grant, Igor, Franklin, Donald, Rubin, Leah H, Margolick, Joseph B, Jacobson, Lisa P, Sacktor, Ned, D'Souza, Gypsyamber, Stosor, Valentina, Lake, Jordan E, Rapocciolo, Giovanna, McArthur, Justin C, Dickens, Alex M, and Haughey, Norman J
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Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Research ,Diabetes ,HIV/AIDS ,Aetiology ,2.1 Biological and endogenous factors ,Adult ,Anti-HIV Agents ,C-Peptide ,Case-Control Studies ,Cognition ,Cognitive Dysfunction ,Cohort Studies ,Female ,HIV Infections ,Humans ,Hyperinsulinism ,Insulin Resistance ,Lipoproteins ,Male ,Middle Aged ,Clinical Sciences ,Neurosciences ,Cognitive Sciences ,Neurology & Neurosurgery ,Clinical sciences - Abstract
ObjectiveTo determine the association of insulin sensitivity and metabolic status with declining cognition in HIV-infected individuals.MethodsWe conducted targeted clinical and metabolic measures in longitudinal plasma samples obtained from HIV-infected patients enrolled in the Central Nervous System HIV Anti-Retroviral Therapy Effects Research Study (CHARTER). Findings were validated with plasma samples from the Multicenter AIDS Cohort Study (MACS). Patients were grouped according to longitudinally and serially assessed cognitive performance as having stably normal or declining cognition.ResultsPatients with declining cognition exhibited baseline hyperinsulinemia and elevated plasma c-peptide levels with normal c-peptide/insulin ratios, suggesting that insulin production was increased, but insulin clearance was normal. The association of hyperinsulinemia with worsening cognition was further supported by low high-density lipoprotein (HDL), high low-density lipoprotein/HDL ratio, and elevated cholesterol/HDL ratio compared to patients with stably normal cognition.ConclusionsThese findings suggest that hyperinsulinemia and impaired insulin sensitivity are associated with cognitive decline in antiretroviral therapy-treated HIV-infected patients.
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- 2019
32. Sexual role and HIV-1 set point viral load among men who have sex with men
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Stansfield, Sarah E, Mittler, John E, Gottlieb, Geoffrey S, Murphy, James T, Hamilton, Deven T, Detels, Roger, Wolinsky, Steven M, Jacobson, Lisa P, Margolick, Joseph B, Rinaldo, Charles R, Herbeck, Joshua T, and Goodreau, Steven M
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Epidemiology ,Health Sciences ,Clinical Research ,Sexual and Gender Minorities (SGM/LGBT*) ,Infectious Diseases ,HIV/AIDS ,Infection ,Good Health and Well Being ,Adult ,Biomarkers ,Cohort Studies ,HIV Infections ,HIV-1 ,Homosexuality ,Male ,Humans ,Male ,Middle Aged ,Sexual Behavior ,Sexual Partners ,Viral Load ,Network modeling ,Mathematical modeling ,Men who have sex with men ,Sexual role ,MACS study ,Set point viral load ,Clinical Sciences ,Public Health and Health Services - Abstract
BackgroundHIV-1 set point viral load (SPVL) is a highly variable trait that influences disease progression and transmission risk. Men who are exclusively insertive (EI) during anal intercourse require more sexual contacts to become infected than exclusively receptive (ER) men. Thus, we hypothesize that EIs are more likely to acquire their viruses from highly infectious partners (i.e., with high SPVLs) and to have higher SPVLs than infected ERs.MethodsWe used a one-generation Bernoulli model, a dynamic network model, and data from the Multicenter AIDS Cohort Study (MACS) to examine whether and under what circumstances MSM differ in SPVL by sexual role.ResultsBoth models predicted higher SPVLs in EIs than role versatile (RV) or ER men, but only in scenarios where longer-term relationships predominated. ER and RV men displayed similar SPVLs. EI men remained far less likely than ER men to become infected, however. When the MACS data were limited by some estimates of lower sex partner counts (a proxy for longer relationships), EI men had higher SPVLs; these differences were clinically relevant (>0.3 log10 copies/mL) and statistically significant (p
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- 2019
33. One Size Fits (n)One: The Influence of Sex, Age, and Sexual Human Immunodeficiency Virus (HIV) Acquisition Risk on Racial/Ethnic Disparities in the HIV Care Continuum in the United States
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Desir, Fidel A, Lesko, Catherine R, Moore, Richard D, Horberg, Michael A, Wong, Cherise, Crane, Heidi M, Silverberg, Michael, Thorne, Jennifer E, Rachlis, Beth, Rabkin, Charles, Mayor, Angel M, Mathews, William C, Althoff, Keri N, Benson, Constance A, Bosch, Ronald J, Fenway, Gregory D Kirk, Boswell, Stephen, Mayer, Kenneth H, Grasso, Chris, Hogg, Robert S, Harrigan, P Richard, Montaner, Julio SG, Yip, Benita, Zhu, Julia, Salters, Kate, Gabler, Karyn, Buchacz, Kate, Brooks, John T, Gebo, Kelly A, Carey, John T, Rodriguez, Benigno, Silverberg, Michael J, Margolick, Joseph B, Jacobson, Lisa P, D’Souza, Gypsyamber, Klein, Marina B, Kroch, Abigail, Burchell, Ann, Rachlis, Anita, Cupido, Patrick, Lindsay, Joanne, Hunter-Mellado, Robert F, Gill, M John, Deeks, Steven G, Martin, Jeffrey N, Patel, Pragna, Saag, Michael S, Mugavero, Michael J, Willig, James, Eron, Joseph J, Napravnik, Sonia, Kitahata, Mari M, Drozd, Daniel R, Sterling, Timothy R, Haas, David, Rebeiro, Peter, Turner, Megan, Bebawy, Sally, Rogers, Ben, Justice, Amy C, Dubrow, Robert, Fiellin, David, Gange, Stephen J, Anastos, Kathryn, McKaig, Rosemary G, Freeman, Aimee M, Lent, Carol, Van Rompaey, Stephen E, Morton, Liz, McReynolds, Justin, Lober, William B, Lee, Jennifer S, You, Bin, Hogan, Brenna, Zhang, Jinbing, and Jing, Jerry
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Biomedical and Clinical Sciences ,Clinical Sciences ,HIV/AIDS ,Clinical Research ,Behavioral and Social Science ,Infectious Diseases ,Sexual and Gender Minorities (SGM/LGBT*) ,Health Disparities ,Sexually Transmitted Infections ,Minority Health ,Infection ,Adolescent ,Adult ,Cohort Studies ,Continuity of Patient Care ,Ethnicity ,Female ,HIV Infections ,Homosexuality ,Male ,Humans ,Male ,Middle Aged ,Racial Groups ,Risk Factors ,Sexual Behavior ,United States ,Viral Load ,Young Adult ,HIV care continuum ,racial/ethnic disparities ,key populations ,North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) Region of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundThe United States National HIV/AIDS Strategy established goals to reduce disparities in retention in human immunodeficiency virus (HIV) care, antiretroviral therapy (ART) use, and viral suppression. The impact of sex, age, and sexual HIV acquisition risk (ie, heterosexual vs same-sex contact) on the magnitude of HIV-related racial/ethnic disparities is not well understood.MethodsWe estimated age-stratified racial/ethnic differences in the 5-year restricted mean percentage of person-time spent in care, on ART, and virally suppressed among 19 521 women (21.4%), men who have sex with men (MSM; 59.0%), and men who have sex with women (MSW; 19.6%) entering HIV care in the North American AIDS Cohort Collaboration on Research and Design between 2004 and 2014.ResultsAmong women aged 18-29 years, whites spent 12.0% (95% confidence interval [CI], 1.1%-20.2%), 9.2% (95% CI, .4%-20.4%), and 13.5% (95% CI, 2.7%-22.5%) less person-time in care, on ART, and virally suppressed, respectively, than Hispanics. Black MSM aged ≥50 years spent 6.3% (95% CI, 1.3%-11.7%), 11.0% (95% CI, 4.6%-18.1%), and 9.7% (95% CI, 3.6%-16.8%) less person-time in these stages, respectively, than white MSM ≥50 years of age. Among MSM aged 40-49 years, blacks spent 9.8% (95% CI, 2.4%-16.5%) and 11.9% (95% CI, 3.8%-19.3%) less person-time on ART and virally suppressed, respectively, than whites.ConclusionsRacial/ethnic differences in HIV care persist in specific populations defined by sex, age, and sexual HIV acquisition risk. Clinical and public health interventions that jointly target these demographic factors are needed.
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- 2019
34. Contributions of traditional and HIV-related risk factors on non-AIDS-defining cancer, myocardial infarction, and end-stage liver and renal diseases in adults with HIV in the USA and Canada: a collaboration of cohort studies
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Althoff, Keri N, Gebo, Kelly A, Moore, Richard D, Boyd, Cynthia M, Justice, Amy C, Wong, Cherise, Lucas, Gregory M, Klein, Marina B, Kitahata, Mari M, Crane, Heidi, Silverberg, Michael J, Gill, M John, Mathews, William Christopher, Dubrow, Robert, Horberg, Michael A, Rabkin, Charles S, Klein, Daniel B, Re, Vincent Lo, Sterling, Timothy R, Desir, Fidel A, Lichtenstein, Kenneth, Willig, James, Rachlis, Anita R, Kirk, Gregory D, Anastos, Kathryn, Palella, Frank J, Thorne, Jennifer E, Eron, Joseph, Jacobson, Lisa P, Napravnik, Sonia, Achenbach, Chad, Mayor, Angel M, Patel, Pragna, Buchacz, Kate, Jing, Yuezhou, Gange, Stephen J, and Research and Design, North American AIDS Cohort Collaboration on
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Public Health ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Digestive Diseases ,Prevention ,HIV/AIDS ,Sexually Transmitted Infections ,Infectious Diseases ,Liver Disease ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,Aged ,Aged ,80 and over ,Canada ,End Stage Liver Disease ,Female ,HIV Infections ,Humans ,Kidney Failure ,Chronic ,Male ,Middle Aged ,Myocardial Infarction ,Neoplasms ,Risk Factors ,United States ,Young Adult ,North American AIDS Cohort Collaboration on Research and Design ,Medical and Health Sciences ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundAdults with HIV have an increased burden of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease. The objective of this study was to estimate the population attributable fractions (PAFs) of preventable or modifiable HIV-related and traditional risk factors for non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes.MethodsWe included participants receiving care in academic and community-based outpatient HIV clinical cohorts in the USA and Canada from Jan 1, 2000, to Dec 31, 2014, who contributed to the North American AIDS Cohort Collaboration on Research and Design and who had validated non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, or end-stage renal disease outcomes. Traditional risk factors were tobacco smoking, hypertension, elevated total cholesterol, type 2 diabetes, renal impairment (stage 4 chronic kidney disease), and hepatitis C virus and hepatitis B virus infections. HIV-related risk factors were low CD4 count (400 copies per mL), and history of a clinical AIDS diagnosis. PAFs and 95% CIs were estimated to quantify the proportion of outcomes that could be avoided if the risk factor was prevented.FindingsIn each of the study populations for the four outcomes (1405 of 61 500 had non-AIDS-defining cancer, 347 of 29 515 had myocardial infarctions, 387 of 35 044 had end-stage liver disease events, and 255 of 35 620 had end-stage renal disease events), about 17% were older than 50 years at study entry, about 50% were non-white, and about 80% were men. Preventing smoking would avoid 24% (95% CI 13-35) of these cancers and 37% (7-66) of the myocardial infarctions. Preventing elevated total cholesterol and hypertension would avoid the greatest proportion of myocardial infarctions: 44% (30-58) for cholesterol and 42% (28-56) for hypertension. For liver disease, the PAF was greatest for hepatitis C infection (33%; 95% CI 17-48). For renal disease, the PAF was greatest for hypertension (39%; 26-51) followed by elevated total cholesterol (22%; 13-31), detectable HIV RNA (19; 9-31), and low CD4 cell count (13%; 4-21).InterpretationThe substantial proportion of non-AIDS-defining cancers, myocardial infarction, end-stage liver disease, and end-stage renal disease outcomes that could be prevented with interventions on traditional risk factors elevates the importance of screening for these risk factors, improving the effectiveness of prevention (or modification) of these risk factors, and creating sustainable care models to implement such interventions during the decades of life of adults living with HIV who are receiving care.FundingNational Institutes of Health, US Centers for Disease Control and Prevention, the US Agency for Healthcare Research and Quality, the US Health Resources and Services Administration, the Canadian Institutes of Health Research, the Ontario Ministry of Health and Long Term Care, and the Government of Alberta.
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- 2019
35. Association of Fibroblast Growth Factor-23 (FGF-23) With Incident Frailty in HIV-Infected and HIV-Uninfected Individuals
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Wang, Ruibin, Shlipak, Michael G, Ix, Joachim H, Brown, Todd T, Jacobson, Lisa P, Palella, Frank J, Lake, Jordan E, Koletar, Susan L, Semba, Richard D, and Estrella, Michelle M
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HIV/AIDS ,Kidney Disease ,Prevention ,Clinical Research ,Infectious Diseases ,2.1 Biological and endogenous factors ,Aetiology ,Adult ,Aged ,Biomarkers ,Coronary Angiography ,Ethnicity ,Fibroblast Growth Factor-23 ,Fibroblast Growth Factors ,Frailty ,HIV Infections ,Humans ,Male ,Middle Aged ,Prevalence ,Proportional Hazards Models ,Prospective Studies ,HIV ,frailty ,FGF-23 ,Clinical Sciences ,Public Health and Health Services ,Virology - Abstract
BackgroundIn the Multicenter AIDS Cohort Study, we examined whether fibroblast growth factor-23 (FGF-23), a bone-derived phosphaturic hormone involved in bone metabolism, is associated with incident frailty. Furthermore, we examined whether this association differs by HIV serostatus and race.MethodsOf 715 men assessed for frailty and selected for FGF-23 measurements using stored blood samples (2007-2011), 512 men were nonfrail at/before the baseline visit. Frailty was defined by the presence of ≥3 of the following on 2 consecutive 6-month visits within 1 year: unintentional weight loss ≥10 pounds, weakness, slowness, low energy, and low physical activity. We determined the association of FGF-23 levels with incident frailty using proportional hazards models adjusting for sociodemographics, comorbidities, and kidney function.ResultsSixty-five percent were HIV-infected; 29% were black. Median baseline FGF-23 levels were lower in HIV-infected vs. HIV-uninfected men (33.7 vs. 39.9 rU/mL, P = 0.006) but similar by race. During a median follow-up of 6.6 years, 32 men developed frailty; they had higher baseline FGF-23 levels vs. men who remained nonfrail (45 vs. 36 rU/mL, P = 0.02). FGF-23 (per doubling) was associated with a 1.63-fold risk of frailty [95% confidence interval (CI): 1.19 to 2.23]; results did not differ by HIV serostatus. Conversely, FGF-23 was associated with a 2.72-fold risk of frailty among blacks (95% CI: 1.51 to 4.91) but had minimal association among nonblacks (hazard ratio = 1.26, 95% CI: 0.77 to 2.05; p-interaction = 0.024).ConclusionsAmong men with or at-risk of HIV infection, higher FGF-23 was associated with greater risk of frailty, particularly in blacks. The mechanisms by which FGF-23 may contribute to frailty warrant further study.
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- 2019
36. Suboptimal HIV suppression is associated with progression of coronary artery stenosis: The Multicenter AIDS Cohort Study (MACS) longitudinal coronary CT angiography study
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Post, Wendy S., Haberlen, Sabina A., Witt, Mallory D., Zhang, Long, Jacobson, Lisa P., Brown, Todd T., Margolick, Joseph B., Kingsley, Lawrence, Palella, Frank J., Jr., and Budoff, Matthew
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- 2022
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37. Beyond Learning about the Brain: A Situated Approach to Training Teachers in Mind, Brain, and Education
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Carey, Lisa B., Schmidt, Jonathan, Dommestrup, Aila K., Pritchard, Alison E., Stone, Maureen, Grasmick, Nancy, Mahone, E. Mark, Denckla, Martha B., and Jacobson, Lisa A.
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The field of Mind, Brain, and Education (MBE) has debated the strategies and merit of training teachers in principles of neuroscience. A previous study argued for groups of teachers to be trained as "educational engineers" capable of translating the work of cognitive neuroscientists and education researchers into practical application. While several teacher education programs currently offer MBE courses, we offer a program description of a "situated learning" model of MBE that brings teachers to a unique pediatric hospital with a focus on neurodevelopmental disabilities. The aims of the program are to train educational engineers capable of improving special education services through applications of MBE. Teachers participating in this program learn about neurodevelopment, behavior, models of scientific knowledge acquisition, as well as applications of educational law, policy, leadership, and instruction. This unique program may offer a way to develop competent educational engineers capable of improving education for students with disabilities.
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- 2020
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38. Impact of glycemic status on longitudinal cognitive performance in men with and without HIV infection
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Yang, Jingyan, Jacobson, Lisa P, Becker, James T, Levine, Andrew, Martin, Eileen M, Munro, Cynthia A, Palella, Frank J, Lake, Jordan E, Sacktor, Ned C, and Brown, Todd T
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Pediatric ,Prevention ,Diabetes ,Behavioral and Social Science ,Clinical Research ,Pediatric AIDS ,Neurosciences ,HIV/AIDS ,Metabolic and endocrine ,Adult ,Aged ,Aged ,80 and over ,Cities ,Cognition ,Cognitive Dysfunction ,Diabetes Complications ,HIV Infections ,Humans ,Longitudinal Studies ,Male ,Middle Aged ,Neuropsychological Tests ,Prospective Studies ,Risk Factors ,United States ,cognition ,diabetes mellitus ,HIV-1 ,male ,neuropsychological tests ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology - Abstract
ObjectivesTo determine the relationship between glycemic status and cognitive performance in men living with HIV (MLWH) and without HIV infection.DesignA prospective HIV/AIDS cohort study in four US cities between 1999 and 2016.MethodsGlycemic status was categorized as normal glucose, impaired fasting glucose, controlled diabetes mellitus and uncontrolled diabetes mellitus at each semiannual visit. Cognitive performance was evaluated using nine neuropsychological tests which measure attention, constructional ability, verbal learning, executive functioning, memory and psychomotor speed. Linear mixed models were used to assess the association between glycemic status and cognition.ResultsOverall, 900 MLWH and 1149 men without HIV were included. MLWH had significantly more person-visits with impaired fasting glucose (52.1 vs. 47.9%) and controlled diabetes mellitus (58.2 vs. 41.8%) than men without HIV (P
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- 2018
39. Long-term kidney function, proteinuria, and associated risks among HIV-infected and uninfected men
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Palella, Frank J, Li, Xiuhong, Gupta, Samir K, Estrella, Michelle M, Phair, John P, Margolick, Joseph B, Detels, Roger, Kingsley, Lawrence, and Jacobson, Lisa P
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Cardiovascular ,Infectious Diseases ,Kidney Disease ,Clinical Research ,HIV/AIDS ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Renal and urogenital ,Infection ,Good Health and Well Being ,Adult ,Aged ,Anti-Retroviral Agents ,Antiretroviral Therapy ,Highly Active ,Glomerular Filtration Rate ,HIV Infections ,Humans ,Longitudinal Studies ,Male ,Middle Aged ,Prevalence ,Prospective Studies ,Proteinuria ,Risk Factors ,Young Adult ,HIV serostatus differences ,longitudinal glomerular filtration rate ,proteinuria ,risks ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology - Abstract
BackgroundFactors affecting kidney function and proteinuria among HIV-positive (HIV+) and HIV-negative (HIV-) persons need better characterization.MethodsWe evaluated estimated glomerular filtration rate (eGFR, ml/min per 1.73 m) changes, proteinuria prevalence (a urine protein-to-creatinine ratio of ≥0.2 at two consecutive visits) and associated factors among HIV+ and HIV- men.ResultsThere were 917 HIV+ men receiving HAART, 159 HIV+ men not receiving HAART, and 1305 HIV- men seen from October 2003 to September 2014. Median annual eGFR change was -0.5, -0.8% for HIV+ and -0.3% for HIV- men (P
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- 2018
40. Vitamin D status and immune function reconstitution in HIV-infected men initiating therapy
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Abraham, Alison G, Zhang, Long, Calkins, Keri, Tin, Adrienne, Hoofnagle, Andrew, Palella, Frank J, Estrella, Michelle M, Jacobson, Lisa P, Witt, Mallory D, Kingsley, Lawrence A, and Brown, Todd T
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Infectious Diseases ,HIV/AIDS ,Clinical Research ,Infection ,Adult ,Anti-HIV Agents ,Antiretroviral Therapy ,Highly Active ,CD4 Lymphocyte Count ,HIV Infections ,Humans ,Immunologic Factors ,Longitudinal Studies ,Male ,Treatment Outcome ,Vitamin D ,HIV infection ,immune reconstitution ,vitamin D ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology - Abstract
ObjectiveDespite effective antiretroviral therapy (HAART) and durable viral suppression, many HIV-infected individuals still do not achieve CD4 cell count (CD4) normalization. Vitamin D has immunoregulatory functions, including inducing the development of T cells and higher levels may improve CD4 rebound.DesignLongitudinal study of men from the Multicenter AIDS Cohort Study who virally suppressed following HAART initiation and had pre-HAART and post-HAART 25(OH)D and 1,25(OH)2D measurements and repeated measures of CD4.MethodsCD4 rebound was modeled using a nonlinear mixed effects model. We estimated the adjusted effect (adjusted for pre-HAART antiretroviral exposure, black race, age and CD4 at HAART initiation) of pre-HAART and post-HAART vitamin D metabolite levels on the rate of CD4 increase and final CD4 plateau.ResultsAmong the 263 HIV-infected HAART initiators with pre-HAART vitamin D measurements, a 1-SD higher pre-HAART 25(OH)2D level was associated with a 9% faster rate of rise (P = 0.02) but no gain in final CD4 plateau. In contrast, a 1-SD higher 1,25(OH)2D level was associated with a 43-cell lower final CD4 (P = 0.04). Among 560 men with post-HAART measurements, findings were similar to those for pre-HAART 25(OH)2D with 1-SD higher level associated with faster rate of rise but no improvement in final CD4.ConclusionWe found no evidence that higher vitamin D metabolite levels pre-HAART or post-HAART are associated with better CD4 outcomes among HIV-infected HAART initiators. However, the value of pre-HAART 1,25(OH)2D levels as an indicator of immune response dysregulation could be further explored.
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- 2018
41. Multimorbidity Among Persons Living with Human Immunodeficiency Virus in the United States
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Wong, Cherise, Gange, Stephen J, Moore, Richard D, Justice, Amy C, Buchacz, Kate, Abraham, Alison G, Rebeiro, Peter F, Koethe, John R, Martin, Jeffrey N, Horberg, Michael A, Boyd, Cynthia M, Kitahata, Mari M, Crane, Heidi M, Gebo, Kelly A, Gill, M John, Silverberg, Michael J, Palella, Frank J, Patel, Pragna, Samji, Hasina, Thorne, Jennifer, Rabkin, Charles S, Mayor, Angel, Althoff, Keri N, Freeman, Aimee M, Cescon, Angela, Rachlis, Anita R, Rogers, Ben, Rodriguez, Benigno, Grasso, Chris, Benson, Constance A, Drozd, Daniel R, Fiellin, David, Haas, David, Kirk, Gregory D, Willig, James, Globerman, Jason, Brooks, John T, Eron, Joseph J, Montaner, Julio SG, Gabler, Karyn, Anastos, Kathryn, Mayer, Kenneth H, Jacobson, Lisa P, Kopansky-Giles, Madison, Klein, Marina B, Turner, Megan, Mugavero, Michael J, Saag, Michael S, Harrigan, P Richard, Dubrow, Robert, Hunter-Mellado, Robert F, Hogg, Robert S, Bosch, Ronald J, McKaig, Rosemary G, Bebawy, Sally, Rourke, Sean B, Napravnik, Sonia, Boswell, Stephen, and Sterling, Timothy R
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Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Sexually Transmitted Infections ,Cardiovascular ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,Good Health and Well Being ,Adult ,Age Factors ,Black People ,Cohort Studies ,Diabetes Mellitus ,Type 2 ,Female ,HIV ,HIV Infections ,Heterosexuality ,Homosexuality ,Male ,Humans ,Hypercholesterolemia ,Hypertension ,Longitudinal Studies ,Male ,Middle Aged ,Multimorbidity ,Renal Insufficiency ,Chronic ,Sexual and Gender Minorities ,United States ,White People ,multimorbidity ,age-associated conditions ,aging ,North American AIDS Cohort Collaboration on Research and Design ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundAge-associated conditions are increasingly common among persons living with human immunodeficiency virus (HIV) (PLWH). A longitudinal investigation of their accrual is needed given their implications on clinical care complexity. We examined trends in the co-occurrence of age-associated conditions among PLWH receiving clinical care, and differences in their prevalence by demographic subgroup.MethodsThis cohort study was nested within the North American AIDS Cohort Collaboration on Research and Design. Participants from HIV outpatient clinics were antiretroviral therapy-exposed PLWH receiving clinical care (ie, ≥1 CD4 count) in the United States during 2000-2009. Multimorbidity was irreversible, defined as having ≥2: hypertension, diabetes mellitus, chronic kidney disease, hypercholesterolemia, end-stage liver disease, or non-AIDS-related cancer. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) comparing demographic subgroups were obtained by Poisson regression with robust error variance, using generalized estimating equations for repeated measures.ResultsAmong 22969 adults, 79% were male, 36% were black, and the median baseline age was 40 years (interquartile range, 34-46 years). Between 2000 and 2009, multimorbidity prevalence increased from 8.2% to 22.4% (Ptrend < .001). Adjusting for age, this trend was still significant (P < .001). There was no difference by sex, but blacks were less likely than whites to have multimorbidity (aPR, 0.87; 95% CI, .77-.99). Multimorbidity was the highest among heterosexuals, relative to men who have sex with men (aPR, 1.16; 95% CI, 1.01-1.34). Hypertension and hypercholesterolemia most commonly co-occurred.ConclusionsMultimorbidity prevalence has increased among PLWH. Comorbidity prevention and multisubspecialty management of increasingly complex healthcare needs will be vital to ensuring that they receive needed care.
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- 2018
42. Low thigh muscle mass is associated with coronary artery stenosis among HIV-infected and HIV-uninfected men: The Multicenter AIDS Cohort Study (MACS)
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Tibuakuu, Martin, Zhao, Di, Saxena, Ankita, Brown, Todd T, Jacobson, Lisa P, Palella, Frank J, Witt, Mallory D, Koletar, Susan L, Margolick, Joseph B, Guallar, Eliseo, Korada, Sai Krishna C, Budoff, Matthew J, Post, Wendy S, and Michos, Erin D
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Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Clinical Sciences ,Clinical Research ,Atherosclerosis ,Heart Disease ,Cardiovascular ,HIV/AIDS ,Heart Disease - Coronary Heart Disease ,Prevention ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Aetiology ,2.1 Biological and endogenous factors ,Aged ,Body Composition ,Chi-Square Distribution ,Computed Tomography Angiography ,Coronary Angiography ,Coronary Artery Disease ,Coronary Stenosis ,Coronary Vessels ,Cross-Sectional Studies ,HIV Infections ,Humans ,Male ,Middle Aged ,Multivariate Analysis ,Muscle ,Skeletal ,Odds Ratio ,Plaque ,Atherosclerotic ,Predictive Value of Tests ,Prevalence ,Prospective Studies ,Risk Factors ,Sarcopenia ,Thigh ,Tomography ,X-Ray Computed ,United States ,Muscle mass ,HIV-infection ,Coronary atherosclerosis ,Coronary artery stenosis ,Cardiorespiratory Medicine and Haematology ,Cardiovascular System & Hematology ,Cardiovascular medicine and haematology ,Clinical sciences ,Applied computing - Abstract
BACKGROUND:HIV-infected individuals are at increased risk for both sarcopenia and cardiovascular disease. Whether an association between low muscle mass and subclinical coronary artery disease (CAD) exists, and if it is modified by HIV serostatus, are unknown. METHODS:We performed cross-sectional analysis of 513 male MACS participants (72% HIV-infected) who underwent mid-thigh computed tomography (CT) and non-contrast cardiac CT for coronary artery calcium (CAC) during 2010-2013. Of these, 379 also underwent coronary CT angiography for non-calcified coronary plaque (NCP) and obstructive coronary stenosis ≥50%. Multivariable-adjusted Poisson regression was used to estimate prevalence risk ratios of associations between low muscle mass (
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- 2018
43. Vitamin D Status and Kidney Function Decline in HIV-Infected Men: A Longitudinal Study in the Multicenter AIDS Cohort Study.
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Tin, Adrienne, Zhang, Long, Estrella, Michelle M, Hoofnagle, Andy, Rebholz, Casey M, Brown, Todd T, Palella, Frank J, Witt, Mallory D, Jacobson, Lisa P, Kingsley, Lawrence A, and Abraham, Alison G
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Humans ,HIV Infections ,AIDS-Associated Nephropathy ,Vitamin D Deficiency ,Kidney Function Tests ,Longitudinal Studies ,Adult ,Middle Aged ,United States ,Male ,White People ,Black People ,1 ,25(OH)2D ,25(OH)D ,glomerular filtration rate ,kidney function decline ,vitamin D ,Kidney Disease ,Nutrition ,Clinical Research ,HIV/AIDS ,Complementary and Integrative Health ,Prevention ,Renal and urogenital ,Blacks ,Whites ,1 ,25(OH)(2)D ,Clinical Sciences ,Virology - Abstract
Vitamin D may play an important role in a range of disease processes. In the general population, lower vitamin D levels have been associated with kidney dysfunction. HIV-infected populations have a higher risk of chronic kidney disease. Few studies have examined the link between lower vitamin D levels and kidney function decline among HIV-infected persons. We investigated the associations of serum 25-hydroxyvitamin D [25(OH)D] and 1,25-dihydroxyvitamin D [1,25(OH)2D] with kidney function decline in a cohort of HIV-infected white and black men under highly active antiretroviral therapy treatment in the vitamin D ancillary study of the Multicenter AIDS Cohort Study. The associations of 25(OH)D and 1,25(OH)2D with annual change in estimated glomerular filtration rate (eGFR) were evaluated using linear mixed effects models. This study included 187 whites and 86 blacks with vitamin D measures and eGFR ≥60 ml/min/1.73 m2 at baseline. Over a median follow-up of 8.0 years, lower 25(OH)D levels were significantly associated with faster eGFR decline in whites (adjusted annual change in eGFR, tertile 1: -2.06 ml/min/1.73 m2 vs. tertile 3: -1.23 ml/min/1.73 m2, p trend .03), while no significant association was detected in blacks. Lower 1,25(OH)2D was associated with faster kidney function decline in both whites and blacks, although the estimates were not statistically significant. In conclusion, lower 25(OH)D levels were significantly associated with faster eGFR decline in a cohort of HIV-infected white men, but not in those with black ancestry. Further research is warranted to investigate the association of 25(OH)D and 1,25(OH)2D with kidney function decline in larger and ethnically diverse populations.
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- 2017
44. Frailty and subclinical coronary atherosclerosis: The Multicenter AIDS Cohort Study (MACS).
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Korada, Sai Krishna C, Zhao, Di, Tibuakuu, Martin, Brown, Todd T, Jacobson, Lisa P, Guallar, Eliseo, Bolan, Robert K, Palella, Frank J, Margolick, Joseph B, Martinson, Jeremy J, Budoff, Matthew J, Post, Wendy S, and Michos, Erin D
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Humans ,Acquired Immunodeficiency Syndrome ,Muscle Weakness ,Weight Loss ,Coronary Angiography ,Prognosis ,Exercise ,Prevalence ,Multivariate Analysis ,Linear Models ,Risk Factors ,Cross-Sectional Studies ,Health Status ,Middle Aged ,United States ,Male ,Muscle Strength ,Coronary Artery Disease ,Asymptomatic Diseases ,Plaque ,Atherosclerotic ,Vascular Calcification ,Computed Tomography Angiography ,Frailty ,Cardiac CT ,Coronary artery calcium ,Coronary atherosclerosis ,HIV-Infection ,Clinical Research ,Cardiovascular ,HIV/AIDS ,Prevention ,Heart Disease - Coronary Heart Disease ,Heart Disease ,Aging ,Atherosclerosis ,Cardiovascular System & Hematology ,Cardiorespiratory Medicine and Haematology ,Clinical Sciences - Abstract
Background and aimsFrailty and cardiovascular disease share many risk factors. We evaluated whether frailty is independently associated with subclinical coronary atherosclerosis and whether any relationships differ by HIV-serostatus.MethodsWe studied 976 [62% HIV-infected] male participants of the Multicenter AIDS Cohort Study who underwent assessment of frailty and non-contrast cardiac CT scanning; of these, 747 men also underwent coronary CT angiography (CCTA). Frailty was defined as having ≥3 of 5 of the following: weakness, slowness, weight loss, exhaustion, and low physical activity. Coronary artery calcium (CAC) was assessed by non-contrast CT, and total plaque score (TPS), mixed plaque score (MPS), and non-calcified plaque score (NCPS) by CCTA. Multivariable-adjusted regression was used to assess the cross-sectional associations between frailty and subclinical coronary atherosclerosis.ResultsMean (SD) age of participants was 54 (7) years; 31% were black. Frailty existed in 7.5% and 14.3% of HIV-uninfected and HIV-infected men, respectively. After adjustment for demographics, frailty was significantly associated with prevalence of any CAC (CAC>0), any plaque (TPS>0), and mixed plaque (MPS>0) in HIV-uninfected but not in HIV-infected men (p-interactionHIV0 [Prevalence Ratio 1.27 (95%CI 1.02, 1.59)] and TPS>0 [1.19 (1.06, 1.35)]. No association was found for NCPS.ConclusionsFrailty was independently associated with subclinical coronary atherosclerosis among HIV-uninfected men, but not among HIV-infected men. Further work is needed to ascertain mechanisms underlying these differences and whether interventions that improve frailty (i.e. strength training) can improve cardiovascular outcomes.
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- 2017
45. Unsafe Sexual Behavior Among Gay/Bisexual Men in the Era of Combination Antiretroviral Therapy (cART)
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Surkan, Pamela J, Li, Ying, Jacobson, Lisa P, Cox, Christopher, Silvestre, Anthony, Gorbach, Pamina, Teplin, Linda, and Plankey, Michael
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Public Health ,Health Sciences ,Infectious Diseases ,Behavioral and Social Science ,HIV/AIDS ,Sexual and Gender Minorities (SGM/LGBT*) ,Clinical Research ,Infection ,Adult ,Antiretroviral Therapy ,Highly Active ,Bisexuality ,Cohort Studies ,HIV Infections ,Homosexuality ,Male ,Humans ,Longitudinal Studies ,Male ,Safe Sex ,Sexual Behavior ,Sexual Partners ,Sexual and Gender Minorities ,Surveys and Questionnaires ,Unsafe Sex ,Cohort study ,Homosexuality ,Anti-retroviral agents ,Sexual behavior ,HIV ,Public Health and Health Services ,Social Work ,Public health - Abstract
The aim of this study was to determine the association between psychosocial determinants of unprotected receptive anal intercourse (URAI) and unprotected insertive anal intercourse (UIAI). Data from 417 HIV positive men who have sex with men (MSM) in the Multicenter AIDS Cohort Study from April 1999 to March 2012 were analyzed and adjusted odds were calculated. It was found that 66% (n = 277) and 72% (n = 299) reported any UIAI or URAI over follow-up, respectively. Cumulative cART-years (median = 5.30 years) was associated with 33 and 47% increases in UIAI and URAI, respectively. Not having reduced concern about HIV transmission (UIAI: OR 0.37, p-value = 0.0004; URAI: OR 0.57, p-value = 0.04), increased safe sex fatigue (UIAI: OR 2.32, 95% p-value = 0.0002; URAI: OR 1.94, p-value = 0.003), and sexual sensation seeking (UIAI: OR 1.76, p-value = 0.002; URAI: OR 1.56, p-value = 0.02) were associated with UIAI and URAI. Serosorting was associated with UIAI (OR 6.11, p-value
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- 2017
46. Educating Childhood Cancer Survivors: a Qualitative Analysis of Parents Mobilizing Social and Cultural Capital
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Beeler, Dori, Paré-Blagoev, E. Juliana, Jacobson, Lisa A., and Ruble, Kathy
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- 2021
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47. Correction to: Will the Real Theoretical Structure of the WISC-V Please Stand Up? Implications for Clinical Interpretation
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Dombrowski, Stefan C., McGill, Ryan J., Watkins, Marley W., Canivez, Gary L., Pritchard, Alison E., and Jacobson, Lisa A.
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- 2022
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48. Cancer-Attributable Mortality Among People With Treated Human Immunodeficiency Virus Infection in North America
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Engels, Eric A, Yanik, Elizabeth L, Wheeler, Willian, Gill, M John, Shiels, Meredith S, Dubrow, Robert, Althoff, Keri N, Silverberg, Michael J, Brooks, John T, Kitahata, Mari M, Goedert, James J, Grover, Surbhi, Mayor, Angel M, Moore, Richard D, Park, Lesley S, Rachlis, Anita, Sigel, Keith, Sterling, Timothy R, Thorne, Jennifer E, Pfeiffer, Ruth M, Benson, Constance A, Bosch, Ronald J, Kirk, Gregory D, Boswell, Stephen, Mayer, Kenneth H, Grasso, Chris, Hogg, Robert S, Harrigan, P Richard, Montaner, Julio SG, Yip, Benita, Zhu, Julia, Salters, Kate, Gabler, Karyn, Buchacz, Kate, Gebo, Kelly A, Carey, John T, Rodriguez, Benigno, Horberg, Michael A, Rabkin, Charles, Jacobson, Lisa P, D’Souza, Gypsyamber, Klein, Marina B, Rourke, Sean B, Rachlis, Anita R, Globerman, Jason, Kopansky-Giles, Madison, Hunter-Mellado, Robert F, Deeks, Steven G, Martin, Jeffrey N, Patel, Pragna, Saag, Michael S, Mugavero, Michael J, Willig, James, Eron, Joseph J, Napravnik, Sonia, Crane, Heidi M, Drozd, Daniel R, Haas, David, Rebeiro, Peter, Turner, Megan, Bebawy, Sally, Rogers, Ben, Justice, Amy C, Fiellin, David, Gange, Stephen J, Anastos, Kathryn, McKaig, Rosemary G, Freeman, Aimee M, Lent, Carol, Van Rompaey, Stephen E, Morton, Liz, McReynolds, Justin, Lober, William B, Abraham, Alison G, Lau, Bryan, Zhang, Jinbing, and Jing, Jerry
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Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Lung ,Sexually Transmitted Infections ,Hematology ,Lymphatic Research ,HIV/AIDS ,Infectious Diseases ,Cancer ,Lymphoma ,Rare Diseases ,Lung Cancer ,2.1 Biological and endogenous factors ,2.4 Surveillance and distribution ,Aetiology ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,CD4 Lymphocyte Count ,Female ,HIV Infections ,Humans ,Male ,Middle Aged ,Neoplasms ,North America ,Proportional Hazards Models ,Retrospective Studies ,Viral Load ,Young Adult ,HIV ,AIDS ,cancer ,mortality ,aging ,North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS ,North American AIDS Cohort Collaboration on Research and Design of the International Epidemiologic Databases to Evaluate AIDS ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundCancer remains an important cause of morbidity and mortality in people with human immunodeficiency virus (PWHIV) on effective antiretroviral therapy (ART). Estimates of cancer-attributable mortality can inform public health efforts.MethodsWe evaluated 46956 PWHIV receiving ART in North American HIV cohorts (1995-2009). Using information on incident cancers and deaths, we calculated population-attributable fractions (PAFs), estimating the proportion of deaths due to cancer. Calculations were based on proportional hazards models adjusted for age, sex, race, HIV risk group, calendar year, cohort, CD4 count, and viral load.ResultsThere were 1997 incident cancers and 8956 deaths during 267145 person-years of follow-up, and 11.9% of decedents had a prior cancer. An estimated 9.8% of deaths were attributable to cancer (cancer-attributable mortality rate 327 per 100000 person-years). PAFs were 2.6% for AIDS-defining cancers (ADCs, including non-Hodgkin lymphoma, 2.0% of deaths) and 7.1% for non-AIDS-defining cancers (NADCs: lung cancer, 2.3%; liver cancer, 0.9%). PAFs for NADCs were higher in males and increased strongly with age, reaching 12.5% in PWHIV aged 55+ years. Mortality rates attributable to ADCs and NADCs were highest for PWHIV with CD4 counts
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- 2017
49. Increased Risk of Myocardial Infarction in HIV-Infected Individuals in North America Compared With the General Population
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Drozd, Daniel R, Kitahata, Mari M, Althoff, Keri N, Zhang, Jinbing, Gange, Stephen J, Napravnik, Sonia, Burkholder, Greer A, Mathews, William C, Silverberg, Michael J, Sterling, Timothy R, Heckbert, Susan R, Budoff, Matthew J, Van Rompaey, Stephen, Delaney, Joseph AC, Wong, Cherise, Tong, Weiqun, Palella, Frank J, Elion, Richard A, Martin, Jeffrey N, Brooks, John T, Jacobson, Lisa P, Eron, Joseph J, Justice, Amy C, Freiberg, Matthew S, Klein, Daniel B, Post, Wendy S, Saag, Michael S, Moore, Richard D, and Crane, Heidi M
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Health Sciences ,Prevention ,Sexually Transmitted Infections ,Cardiovascular ,Infectious Diseases ,Clinical Research ,Heart Disease ,Atherosclerosis ,HIV/AIDS ,Infection ,Good Health and Well Being ,Adult ,Anti-HIV Agents ,Antiretroviral Therapy ,Highly Active ,CD4 Lymphocyte Count ,Comorbidity ,Female ,HIV Infections ,Humans ,Incidence ,Male ,Middle Aged ,Myocardial Infarction ,North America ,Proportional Hazards Models ,Risk Assessment ,Risk Factors ,Viral Load ,Clinical Sciences ,Public Health and Health Services ,Virology ,Clinical sciences ,Epidemiology ,Public health - Abstract
BackgroundPrevious studies of cardiovascular disease (CVD) among HIV-infected individuals have been limited by the inability to validate and differentiate atherosclerotic type 1 myocardial infarctions (T1MIs) from other events. We sought to define the incidence of T1MIs and risk attributable to traditional and HIV-specific factors among participants in the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) and compare adjusted incidence rates (IRs) to the general population Atherosclerosis Risk in Communities (ARIC) cohort.MethodsWe ascertained and adjudicated incident MIs among individuals enrolled in 7 NA-ACCORD cohorts between 1995 and 2014. We calculated IRs, adjusted incidence rate ratios (aIRRs), and 95% confidence intervals of risk factors for T1MI using Poisson regression. We compared aIRRs of T1MIs in NA-ACCORD with those from ARIC.ResultsAmong 29,169 HIV-infected individuals, the IR for T1MIs was 2.57 (2.30 to 2.86) per 1000 person-years, and the aIRR was significantly higher compared with participants in ARIC [1.30 (1.09 to 1.56)]. In multivariable analysis restricted to HIV-infected individuals and including traditional CVD risk factors, the rate of T1MI increased with decreasing CD4 count [≥500 cells/μL: ref; 350-499 cells/μL: aIRR = 1.32 (0.98 to 1.77); 200-349 cells/μL: aIRR = 1.37 (1.01 to 1.86); 100-199 cells/μL: aIRR = 1.60 (1.09 to 2.34);
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- 2017
50. Association of long-term patterns of depressive symptoms and attention/executive function among older men with and without human immunodeficiency virus
- Author
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Armstrong, Nicole M, Surkan, Pamela J, Treisman, Glenn J, Sacktor, Ned C, Irwin, Michael R, Teplin, Linda A, Stall, Ron, Martin, Eileen M, Becker, James T, Munro, Cynthia, Levine, Andrew J, Jacobson, Lisa P, and Abraham, Alison G
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Depression ,Behavioral and Social Science ,HIV/AIDS ,Infectious Diseases ,Mental Health ,2.1 Biological and endogenous factors ,Aetiology ,Infection ,Good Health and Well Being ,Anti-HIV Agents ,Antiretroviral Therapy ,Highly Active ,Attention ,CD4 Lymphocyte Count ,Cognitive Dysfunction ,Executive Function ,HIV Infections ,HIV-1 ,Homosexuality ,Male ,Humans ,Longitudinal Studies ,Male ,Middle Aged ,Neuropsychological Tests ,Viral Load ,Human immunodeficiency virus ,Aging ,Attention/executive function ,Neurosciences ,Virology ,Clinical sciences ,Medical microbiology - Abstract
Older HIV-infected men are at higher risk for both depression and cognitive impairments, compared to HIV-uninfected men. We evaluated the association between longitudinal patterns of depressive symptoms and attention/executive function in HIV-infected and HIV-uninfected men aged 50+ years to understand whether HIV infection influenced the long-term effect of depression on attention/executive function. Responses to the Center for Epidemiologic Studies-Depression scale and attention/executive function tests (Trail Making Test Part B and Symbol Digit Modalities Test) were collected semiannually from May 1986 to April 2015 in 1611 men. Group-based trajectory models, stratified by HIV status, were used to identify latent patterns of depressive symptoms and attention/executive function across 12 years of follow-up. We identified three depression patterns for HIV-infected and HIV-uninfected men (rare/never 50.0 vs. 60.6%, periodically depressed 29.6 vs. 24.5%, chronic high 20.5 vs.15.0%, respectively) and three patterns of attention/executive function for HIV-infected and HIV-uninfected men (worst-performing 47.4 vs. 45.1%; average 41.9 vs. 47.0%; best-performing 10.7 vs. 8.0%, respectively). Multivariable logistic regression models were used to assess associations between depression patterns and worst-performing attention/executive function. Among HIV-uninfected men, those in the periodically depressed and chronic high depressed groups had higher odds of membership in the worst-performing attention/executive function group (adjusted odds ratio [AOR] = 1.45, 95% CI 1.04, 2.03; AOR = 2.25, 95% CI 1.49, 3.39, respectively). Among HIV-infected men, patterns of depression symptoms were not associated with patterns of attention/executive function. Results suggest that HIV-uninfected, but not HIV-infected, men with chronic high depression are more likely to experience a long-term pattern of attention/executive dysfunction.
- Published
- 2017
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