Predictors of HIV Testing Among African American Men Who Have Sex with Men

African Americans (AA) men who have sex with men (MSM) are disproportionately affected with HIV. This study used a sampling of 344 AA MSM from the 2000-2016 NHANES Surveys who had reported HIV test results. Age, income, and educational status were predictive of an HIV test result among AA MSM. The results of this study could be used to train patient navigators on coping strategies using Lazarus and Folkman’s theory of stress, appraisal, and coping for reducing stigma among AA MSM, encouraging them to seek HIV testing to decrease the incidence and prevalence of HIV among AA MSM. Recommended Citation Higgins, J. M. (2020, October 1-2). Predictors of HIV testing among African American men who have sex with men [Poster presentation]. Walden University Research Conference 2020 (online). https://scholarworks.waldenu.edu/researchconference/2020/posters/1

Predictors of HIV Testing Among African American Men Who Have Sex with Men

Human immunodeficiency virus (HIV) infections affect more than 1.2 million people living in the United States and disproportionately affect African Americans (AA) men who have sex with men (MSM). The numbers of those who have HIV infections are likely higher due to lack of HIV testing by all individuals living at risk for HIV in the United States. Prior research has been inconclusive in determining the exact cause of the disparity among AA MSM. Therefore, the purpose of this quantitative secondary data study was to explore barriers to HIV testing within the AA MSM population. The sample for this study was a representative sampling from 2000-2016 from the national cross-sectional National Health and Nutrition Examination Survey of 344 African American men who have sex with men and had taken an HIV test. The theory used was the theory of stress, appraisal, and coping by Lazarus and Folkman. The research questions asked what variables (age, income, education status, depression, and access to health care) might be predictive of an HIV test result. Data analysis consisted of descriptive statistics, chi-square, Hosmer and Lemeshow chi-square, and logistic regression analysis. Results revealed that age, income, and educational status were predictive of an HIV test result among AA MSM. Implications for positive social change include using the results of this study to develop an HIV prevention program and train patient navigators on coping strategies for reducing stress and fear of appraisal (stigma) among AA MSM, encouraging them to seek HIV testing and possibly decreasing the incidence and prevalence of HIV among AA MSM

Relation between myocardial edema and myocardial mass during the acute and convalescent phase of myocarditis – a CMR study

<p>Abstract</p> <p>Background</p> <p>Myocardial edema is a substantial feature of the inflammatory response in human myocarditis. The relation between myocardial edema and myocardial mass in the course of healing myocarditis has not been systematically investigated. We hypothesised that the resolution of myocardial edema as visualised by T2-weighted cardiovascular magnetic resonance (CMR) is associated with a decrease of myocardial mass in steady state free precession (SSFP)-cine imaging.</p> <p>Methods</p> <p>21 patients with acute myocarditis underwent CMR shortly after onset of symptoms and 1 year later. For visualization of edema, a T2-weighted breath-hold black-blood triple-inversion fast spin echo technique was applied and the ratio of signal intensity of myocardium/skeletal muscle was assessed. Left ventricular (LV) mass, volumes and function were quantified from biplane cine steady state free precession images.</p> <p>11 healthy volunteers served as a control group for interstudy reproducibility of LV mass.</p> <p>Results</p> <p>In patients with myocarditis, a significant decrease in LV mass was observed during follow-up compared to the acute phase (156.7 ± 30.6 g vs. 140.3 ± 28.3 g, p < 0.0001). The reduction of LV mass paralleled the normalization of initially increased myocardial signal intensity on T2-weighted images (2.4 ± 0.4 vs. 1.68 ± 0.3, p < 0.0001).</p> <p>In controls, the interstudy difference of LV mass was lower than in patients (5.1 ± 2.9 g vs. 16.3 ± 14.2 g, p = 0.02) resulting in a lower coefficient of variability (2.1 vs 8.9%, p = 0.04).</p> <p>Conclusion</p> <p>Reversible abnormalities in T2-weighted CMR are paralleled by a transient increase in left ventricular mass during the course of myocarditis. Myocardial edema may be a common pathway explaining these findings.</p

Cystatin C and Cardiovascular Disease

Background Epidemiological studies show that high circulating cystatin C is associated with risk of cardiovascular disease (CVD), independent of creatinine-based renal function measurements. It is unclear whether this relationship is causal, arises from residual confounding, and/or is a consequence of reverse causation. Objectives The aim of this study was to use Mendelian randomization to investigate whether cystatin C is causally related to CVD in the general population. Methods We incorporated participant data from 16 prospective cohorts (n = 76,481) with 37,126 measures of cystatin C and added genetic data from 43 studies (n = 252,216) with 63,292 CVD events. We used the common variant rs911119 in CST3 as an instrumental variable to investigate the causal role of cystatin C in CVD, including coronary heart disease, ischemic stroke, and heart failure. Results Cystatin C concentrations were associated with CVD risk after adjusting for age, sex, and traditional risk factors (relative risk: 1.82 per doubling of cystatin C; 95% confidence interval [CI]: 1.56 to 2.13; p = 2.12 × 10−14). The minor allele of rs911119 was associated with decreased serum cystatin C (6.13% per allele; 95% CI: 5.75 to 6.50; p = 5.95 × 10−211), explaining 2.8% of the observed variation in cystatin C. Mendelian randomization analysis did not provide evidence for a causal role of cystatin C, with a causal relative risk for CVD of 1.00 per doubling cystatin C (95% CI: 0.82 to 1.22; p = 0.994), which was statistically different from the observational estimate (p = 1.6 × 10−5). A causal effect of cystatin C was not detected for any individual component of CVD. Conclusions Mendelian randomization analyses did not support a causal role of cystatin C in the etiology of CVD. As such, therapeutics targeted at lowering circulating cystatin C are unlikely to be effective in preventing CVD

Genome-wide association and functional follow-up reveals new loci for kidney function

Chronic kidney disease (CKD) is an important public health problem with a genetic component. We performed genome-wide association studies in up to 130,600 European ancestry participants overall, and stratified for key CKD risk factors. We uncovered 6 new loci in association with estimated glomerular filtration rate (eGFR), the primary clinical measure of CKD, in or near MPPED2, DDX1, SLC47A1, CDK12, CASP9, and INO80. Morpholino knockdown of mpped2 and casp9 in zebrafish embryos revealed podocyte and tubular abnormalities with altered dextran clearance, suggesting a role for these genes in renal function. By providing new insights into genes that regulate renal function, these results could further our understanding of the pathogenesis of CKD

Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

The Relationship Between Abuse History and Recidivism Risk in Adolescents Who Offend Sexuality

Adolescents who demonstrate sexually abusive behavior create significant demands on a taxed juvenile justice system whose purpose is to assess the risks of offenders to society and to determine optimal dispositions for offenders. There has been . relatively little research specific to youthful sexual offenders. Although adolescents who offend sexually represent a small percentage of the juvenile criminal population, the impact of their offending behaviors warrants more intensive research in order to assist treatment providers, legislators, and families in preventing additional abusive behavior. With little empirical justification, major components of treatment models and conceptualizations for adolescents who offend sexually have been derived from literature pertaining to adults who offend sexually, yet studies have demonstrated that adolescents do not have as many commonalities with adults who offend sexually as previously presumed. Literature to date indicates that adolescents who offend sexually as an aggregate group have many similarities to the general population of criminally offending adolescents. It is therefore imperative to pursue further study of adolescents who offend sexually. In the current study, several risk factors are explored in regard to their ability to predict reoffense of sexual abuse. The sample consisted of 46 adolescent males from a large residential treatment facility that provides services to boys with and without sexual behavior problems. Participants were demographically similar to one another. Half of the participants (n = 23) were referred for sexual behavior problems and the other half (n = 11 23) were.referred for problems that did not include sexual behavior. Data were collected from file information and included scores from the Trauma Symptom Checklist for Children (TSCC), the Psychopathy Checklist: Youth Version (PCL:YV), the Juvenile Sex Offender Protocol- II (J-SOAP-II), and the Program Compliance Index (pCl), an internally-developed measure within the facility. Hypotheses were tested using correlational analysis, analysis of variance, and localizing t-tests. The results indicated that sex offenders had significantly lower Denial scores than non-sex offenders and that subjects who experienced no abuse had significantly higher Denial scores than those who experienced two types of abuse (e.g., physical and sexual). In addition, offender status (e.g., sex offender and non-sex offender) and abuse history were not related to PCL: YV or PCI scores within the whole sample. However, results approached significance in favor of sex offenders when compared to non-sex offenders on PCI scores. There were no significant differences in PTS scores between the sex offender and non-sex offender groups. JSOAP-II scores were not related to types of abuse (i.e., physical or sexual), but the scores were significantly and positively associated when the no-abuse group was compared to the two types of abuse group