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Article ; Online: Latent Profile Analysis of Cognitive Performance and Depressive Symptoms Among People with HIV.

Kohli, Maulika / Ham, Lillian / Saloner, Rowan / Dung, Devin / Iudicello, Jennifer / Ellis, Ronald J / Moore, David J

2024 Volume 38, Issue 2, Page(s) 93–106

Abstract: Depression and cognitive impairment are prevalent conditions among people with HIV (PWH), likely attributable to shared causes and common risk factors. Identifying subtypes of PWH with similar patterns of neurocognitive impairment (NCI) and depressive ... ...

Abstract	Depression and cognitive impairment are prevalent conditions among people with HIV (PWH), likely attributable to shared causes and common risk factors. Identifying subtypes of PWH with similar patterns of neurocognitive impairment (NCI) and depressive symptoms may inform development of patient-centered interventions that target-specific profiles. This study aimed to (1) classify PWH based on patterns of domain-specific NCI and depression; and (2) determine the relationship between latent class membership and pertinent clinical characteristics. PWH (
MeSH term(s)	Humans ; Male ; Female ; Depression/epidemiology ; Depression/diagnosis ; HIV Infections/complications ; Frailty ; Cognition ; Cognitive Dysfunction/epidemiology ; Cognitive Dysfunction/diagnosis
Language	English
Publishing date	2024-02-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1326868-5
ISSN	1557-7449 ; 0893-5068 ; 1087-2914
ISSN (online)	1557-7449
ISSN	0893-5068 ; 1087-2914
DOI	10.1089/apc.2023.0224
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Article: Automatic Brain Tissue and Lesion Segmentation and Multi-Parametric Mapping of Contrast-Enhancing Gliomas without the Injection of Contrast Agents: A Preliminary Study.

Liu, Jing / Jakary, Angela / Villanueva-Meyer, Javier E / Butowski, Nicholas A / Saloner, David / Clarke, Jennifer L / Taylor, Jennie W / Oberheim Bush, Nancy Ann / Chang, Susan M / Xu, Duan / Lupo, Janine M

Cancers

2024 Volume 16, Issue 8

Abstract: This study aimed to develop a rapid, 1 ... ...

Abstract	This study aimed to develop a rapid, 1 mm
Language	English
Publishing date	2024-04-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16081524
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Article ; Online: Neopterin Relates to Lifetime Depression in Older Adults With HIV on Suppressive Antiretroviral Therapy.

Saloner, Rowan / Savini, Natalie / Letendre, Scott L / Moore, David J / Montoya, Jessica L

Journal of acquired immune deficiency syndromes (1999)

2022 Volume 89, Issue 4, Page(s) 454–461

Abstract: Background: Chronic inflammation contributes to the pathogenesis of depression in persons with HIV (PWH). Neopterin, a biomarker of HIV-related immune activation that partially normalizes with antiretroviral therapy (ART), correlates with major ... ...

Abstract	Background: Chronic inflammation contributes to the pathogenesis of depression in persons with HIV (PWH). Neopterin, a biomarker of HIV-related immune activation that partially normalizes with antiretroviral therapy (ART), correlates with major depressive disorder (MDD) and subclinical depressive symptoms in persons without HIV and acutely infected, young PWH. The sensitivity of neopterin, however, to both lifetime and current depression is poorly understood in older PWH on suppressive ART. Methods: Participants were 70 PWH and 35 persons without HIV (HIV-) who were at least 50 years old and completed standardized neurobehavioral and neuromedical assessments. Depressive symptoms in the past 2 weeks, measured with the Beck Depression Inventory-II (BDI-II), and lifetime MDD diagnoses, defined as meeting Diagnostic and Statistical Manual of Mental Disorders-IV criteria for a depressive episode at any point in one's lifetime, were separately modeled as a function of plasma neopterin levels in the full sample and by HIV serostatus. Results: Compared with HIV- adults, PWH had higher neopterin levels (P < 0.001) and BDI-II scores (P < 0.01) and were more likely to have lifetime MDD (P < 0.01). Higher neopterin related to lifetime MDD, but only in PWH, even after controlling for clinically relevant comorbidities and treatment factors in logistic regression (odds ratio = 3.11, P = 0.002). Higher neopterin correlated with higher BDI-II scores in the full sample (rs = 0.25; P = 0.010), but not within either group (PWH: rs = 0.03, P = 0.819; HIV-: rs = 0.09, P = 0.588). Conclusion: Neopterin was associated with lifetime MDD, but not current depressive symptoms in older PWH on suppressive ART. This may reflect a legacy of inflammation-related disruptions to amino acid metabolism and neurotransmitter synthesis, similar to prior observations. Identification of biopsychosocial and resilience factors underlying the null association between neopterin and current depression in older PWH is warranted.
MeSH term(s)	Aged ; Biomarkers ; Case-Control Studies ; Depression/complications ; Depression/diagnosis ; Depressive Disorder, Major/complications ; HIV Infections/complications ; HIV Infections/diagnosis ; HIV Infections/drug therapy ; Humans ; Middle Aged ; Neopterin
Chemical Substances	Biomarkers ; Neopterin (670-65-5)
Language	English
Publishing date	2022-02-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000002883
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Article ; Online: The clinical utility of three frailty measures in identifying HIV-associated neurocognitive disorders.

Moore, David J / Sun-Suslow, Ni / Nichol, Ariadne A / Paolillo, Emily W / Saloner, Rowan / Letendre, Scott L / Iudicello, Jennifer / Morgan, Erin E

AIDS (London, England)

2023 Volume 38, Issue 5, Page(s) 645–655

Abstract: Objective: Frailty measures vary widely and the optimal measure for predicting HIV-associated neurocognitive disorders (HAND) is unclear.: Design: A study was conducted to examine the clinical utility of three widely used frailty measures in ... ...

Abstract	Objective: Frailty measures vary widely and the optimal measure for predicting HIV-associated neurocognitive disorders (HAND) is unclear. Design: A study was conducted to examine the clinical utility of three widely used frailty measures in identifying HIV-associated neurocognitive disorders. Methods: The study involved 284 people with HIV (PWH) at least 50 years enrolled at UC San Diego's HIV Neurobehavioral Research Program. Frailty measurements included the Fried Phenotype, the Rockwood Frailty Index, and the Veterans Aging Cohort Study (VACS) Index. HAND was diagnosed according to Frascati criteria. ANOVAs examined differences in frailty severity across HAND conditions. ROC analyses evaluated sensitivity and specificity of each measure to detect symptomatic HAND [mild neurocognitive disorder (MND) and HIV-associated dementia (HAD)] from no HAND. Results: Across all frailty measures, frailty was found to be higher in HAD compared with no HAND. For Fried and Rockwood (not VACS), frailty was significantly more severe in MND vs. no HAND and in HAD vs. ANI (asymptomatic neurocognitive impairment). For discriminating symptomatic HAND from no HAND, Fried was 37% sensitive and 92% specific, Rockwood was 85% sensitive and 43% specific, and VACS was 58% sensitive and 65% specific. Conclusion: These findings demonstrate that Fried and Rockwood outperform VACS in predicting HAND. However, ROC analyses suggest none of the indices had adequate predictive validity in detecting HAND. The results indicate that the combined use of the Rockwood and Fried indices may be an appropriate alternative.
MeSH term(s)	Humans ; HIV Infections/complications ; HIV Infections/psychology ; Cohort Studies ; HIV ; Frailty/diagnosis ; Frailty/complications ; AIDS Dementia Complex/diagnosis ; Neurocognitive Disorders/diagnosis
Language	English
Publishing date	2023-12-01
Publishing country	England
Document type	Journal Article
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003805
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Article ; Online: Multimodal lifestyle engagement patterns support cognitive stability beyond neuropathological burden.

Paolillo, Emily W / Saloner, Rowan / VandeBunte, Anna / Lee, Shannon / Bennett, David A / Casaletto, Kaitlin B

Alzheimer's research & therapy

2023 Volume 15, Issue 1, Page(s) 221

Abstract: Background: Modifiable lifestyle behaviors account for a large proportion of dementia risk. However, the combined contributions of multidomain lifestyle patterns to cognitive aging are poorly understood, as most studies have examined individual ... ...

Abstract	Background: Modifiable lifestyle behaviors account for a large proportion of dementia risk. However, the combined contributions of multidomain lifestyle patterns to cognitive aging are poorly understood, as most studies have examined individual lifestyle behaviors in isolation and without neuropathological characterization. This study examined data-driven patterns of lifestyle behaviors across multiple domains among older adults and tested their associations with disease-specific neuropathological burden and cognitive decline. Methods: Participants included 2059 older adults enrolled in the longitudinal Memory and Aging Project (MAP) at the Rush Alzheimer's Disease Center; none of whom had dementia at baseline (73% no cognitive impairment (NCI), 27% mild cognitive impairment [MCI]). All participants completed cognitive testing annually. Lifestyle factors were measured during at least one visit and included (1) actigraphy-measured physical activity, as well as self-reported (2) sleep quality, (3) life space, (4) cognitive activities, (5) social activities, and (6) social network. A subset of participants (n = 791) had autopsy data for which burden of Alzheimer's disease (AD), cerebrovascular disease (CVD), Lewy body disease, and hippocampal sclerosis/TDP-43 was measured. Latent profile analysis across all 2059 participants identified distinct subgroups (i.e., classes) of lifestyle patterns. Linear mixed-effects models examined relationships between lifestyle classes and global cognitive trajectories, with and without covarying for all neuropathologies. Classes were also compared on rates of incident MCI/dementia. Results: Five classes were identified: Class 1 Conclusions: Lifestyle behavior patterns among older adults account for differential rates of cognitive decline and clinical progression. Those with at least average engagement across all lifestyle domains exhibit greater cognitive stability after adjustment for neuropathology, highlighting the importance of engagement in multiple healthy lifestyle behaviors for later life cognitive health.
MeSH term(s)	Humans ; Aged ; Alzheimer Disease/epidemiology ; Alzheimer Disease/pathology ; Cognitive Dysfunction/epidemiology ; Cognitive Dysfunction/pathology ; Life Style ; Cerebrovascular Disorders ; Cognition
Language	English
Publishing date	2023-12-18
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	2506521-X
ISSN	1758-9193 ; 1758-9193
ISSN (online)	1758-9193
ISSN	1758-9193
DOI	10.1186/s13195-023-01365-9
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Article ; Online: Contrast-enhanced CT radiomics improves the prediction of abdominal aortic aneurysm progression.

Wang, Yan / Xiong, Fei / Leach, Joseph / Kao, Evan / Tian, Bing / Zhu, Chengcheng / Zhang, Yue / Hope, Michael / Saloner, David / Mitsouras, Dimitrios

European radiology

2023 Volume 33, Issue 5, Page(s) 3444–3454

Abstract: Objectives: To determine if three-dimensional (3D) radiomic features of contrast-enhanced CT (CECT) images improve prediction of rapid abdominal aortic aneurysm (AAA) growth.: Methods: This longitudinal cohort study retrospectively analyzed 195 ... ...

Abstract	Objectives: To determine if three-dimensional (3D) radiomic features of contrast-enhanced CT (CECT) images improve prediction of rapid abdominal aortic aneurysm (AAA) growth. Methods: This longitudinal cohort study retrospectively analyzed 195 consecutive patients (mean age, 72.4 years ± 9.1) with a baseline CECT and a subsequent CT or MR at least 6 months later. 3D radiomic features were measured for 3 regions of the AAA, viz. the vessel lumen only; the intraluminal thrombus (ILT) and aortic wall only; and the entire AAA sac (lumen, ILT, and wall). Multiple machine learning (ML) models to predict rapid growth, defined as the upper tercile of observed growth (> 0.25 cm/year), were developed using data from 60% of the patients. Diagnostic accuracy was evaluated using the area under the receiver operating characteristic curve (AUC) in the remaining 40% of patients. Results: The median AAA maximum diameter was 3.9 cm (interquartile range [IQR], 3.3-4.4 cm) at baseline and 4.4 cm (IQR, 3.7-5.4 cm) at the mean follow-up time of 3.2 ± 2.4 years (range, 0.5-9 years). A logistic regression model using 7 radiomic features of the ILT and wall had the highest AUC (0.83; 95% confidence interval [CI], 0.73-0.88) in the development cohort. In the independent test cohort, this model had a statistically significantly higher AUC than a model including maximum diameter, AAA volume, and relevant clinical factors (AUC = 0.78, 95% CI, 0.67-0.87 vs AUC = 0.69, 95% CI, 0.57-0.79; p = 0.04). Conclusion: A radiomics-based method focused on the ILT and wall improved prediction of rapid AAA growth from CECT imaging. Key points: • Radiomic analysis of 195 abdominal CECT revealed that an ML-based model that included textural features of intraluminal thrombus (if present) and aortic wall improved prediction of rapid AAA progression compared to maximum diameter. • Predictive accuracy was higher when radiomic features were obtained from the thrombus and wall as opposed to the entire AAA sac (including lumen), or the lumen alone. • Logistic regression of selected radiomic features yielded similar accuracy to predict rapid AAA progression as random forests or support vector machines.
MeSH term(s)	Humans ; Aged ; Retrospective Studies ; Longitudinal Studies ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Aorta, Abdominal ; Tomography, X-Ray Computed ; Thrombosis
Language	English
Publishing date	2023-03-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1085366-2
ISSN	1432-1084 ; 0938-7994 ; 1613-3749
ISSN (online)	1432-1084
ISSN	0938-7994 ; 1613-3749
DOI	10.1007/s00330-023-09490-7
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Article: Height and body surface area versus wall stress for stratification of mid-term outcomes in ascending aortic aneurysm.

Zamirpour, Siavash / Xuan, Yue / Wang, Zhongjie / Gomez, Axel / Leach, Joseph R / Mitsouras, Dimitrios / Saloner, David A / Guccione, Julius M / Ge, Liang / Tseng, Elaine E

International journal of cardiology. Heart & vasculature

2024 Volume 51, Page(s) 101375

Abstract: Objectives: Current diameter-based guidelines for ascending thoracic aortic aneurysms (aTAA) do not consistently predict risk of dissection/rupture. ATAA wall stresses may enhance risk stratification independent of diameter. The relation of wall ... ...

Abstract	Objectives: Current diameter-based guidelines for ascending thoracic aortic aneurysms (aTAA) do not consistently predict risk of dissection/rupture. ATAA wall stresses may enhance risk stratification independent of diameter. The relation of wall stresses and diameter indexed to height and body surface area (BSA) is unknown. Our objective was to compare aTAA wall stresses with indexed diameters in relation to all-cause mortality at 3.75 years follow-up. Methods: Finite element analyses were performed in a veteran population with aortas ≥ 4.0 cm. Three-dimensional geometries were reconstructed from computed tomography with models accounting for pre-stress geometries. A fiber-embedded hyperelastic material model was applied to obtain wall stress distributions under systolic pressure. Peak wall stresses were compared across guideline thresholds for diameter/BSA and diameter/height. Hazard ratios for all-cause mortality and surgical aneurysm repair were estimated using cause-specific Cox proportional hazards models. Results: Of 253 veterans, 54 (21 %) had aneurysm repair at 3.75 years. Indexed diameter alone would have prompted repair at baseline in 17/253 (6.7 %) patients, including only 4/230 (1.7 %) with diameter < 5.5 cm. Peak wall stresses did not significantly differ across guideline thresholds for diameter/BSA (circumferential: Conclusions: Diameter/height improved stratification of peak wall stresses compared to diameter/BSA. Peak longitudinal stresses predicted all-cause mortality independent of age and indexed diameter and may aid risk stratification for aTAA adverse events.
Language	English
Publishing date	2024-02-28
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	2818464-6
ISSN	2352-9067
ISSN	2352-9067
DOI	10.1016/j.ijcha.2024.101375
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Article ; Online: Letter by Zhu et al Regarding Article, "Aortic Wall Inflammation Predicts Abdominal Aortic Aneurysm Expansion, Rupture, and Need for Surgical Repair".

Zhu, Chengcheng / Saloner, David / Hope, Michael D

Circulation

2018 Volume 137, Issue 12, Page(s) 1293–1294

MeSH term(s)	Aorta, Abdominal ; Aortic Aneurysm, Abdominal/surgery ; Aortic Rupture/surgery ; Humans ; Inflammation
Language	English
Publishing date	2018-03-16
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80099-5
ISSN	1524-4539 ; 0009-7322 ; 0069-4193 ; 0065-8499
ISSN (online)	1524-4539
ISSN	0009-7322 ; 0069-4193 ; 0065-8499
DOI	10.1161/CIRCULATIONAHA.117.030788
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Article: Abdominal aortic aneurysm measurement at CT/MRI: potential clinical ramifications of non-standardized measurement technique and importance of multiplanar reformation.

Leach, Joseph R / Zhu, Chengcheng / Mitsouras, Dimitrios / Saloner, David / Hope, Michael D

Quantitative imaging in medicine and surgery

2021 Volume 11, Issue 2, Page(s) 823–830

Abstract: Accurate and reproducible measurement of abdominal aortic aneurysm (AAA) size is an essential component of patient management, and most reliably performed at CT using a multiplanar reformat (MPR) strategy. This approach is not universal, however. This ... ...

Abstract	Accurate and reproducible measurement of abdominal aortic aneurysm (AAA) size is an essential component of patient management, and most reliably performed at CT using a multiplanar reformat (MPR) strategy. This approach is not universal, however. This study aims to characterize the measurement error present in routine clinical assessment of AAAs and the potential clinical ramifications. Patients were included if they had AAA assessed by CT and/or MRI at two time points at least 6 months apart. Clinical maximal AAA diameter, assessed by non-standardized methods, was abstracted from the radiology report at each time point and compared to the reference aneurysm diameter measured using a MPR strategy. Discrepancies between clinical and reference diameters, and associated aneurysm enlargement rates were analyzed. Two hundred thirty patients were included, with average follow-up 3.3±2.5 years. When compared to MPR-derived diameters, clinical aneurysm measurement inaccuracy was, on average, 3.3 mm. Broad limits of agreement were found for both clinical diameters [-6.7 to +6.5 mm] and aneurysm enlargement rates [-4.6 to +4.2 mm/year] when compared to MPR-based measures. Of 78 AAAs measuring 5-6 cm by the MPR method, 21 (26.9%) were misclassified by the clinical measurement with respect to a common repair threshold (5.5 cm), of which 5 were misclassified as below, and 16 were misclassified as above the threshold. The clinical use of non-standardized AAA measurement strategies can lead to incorrect classification of AAAs as larger or smaller than the commonly accepted repair threshold of 5.5 cm and can induce large errors in quantification of aneurysm enlargement rate.
Language	English
Publishing date	2021-01-16
Publishing country	China
Document type	Journal Article
ZDB-ID	2653586-5
ISSN	2223-4306 ; 2223-4292
ISSN (online)	2223-4306
ISSN	2223-4292
DOI	10.21037/qims-20-888
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Article ; Online: Intracranial vascular imaging detects arterial wall abnormalities in persons with treated HIV infection.

Chow, Felicia C / Callen, Andrew / Arechiga, Victor / Saloner, David / Narvid, Jared / Hsue, Priscilla Y

AIDS (London, England)

2021 Volume 36, Issue 1, Page(s) 69–73

Abstract: Objective: Although a substantial proportion of ischemic strokes in persons with HIV infection (PWH) is related to large artery disease, studies evaluating elevated cerebrovascular risk in PWH have focused primarily on microvascular disease. We compared ...

Abstract	Objective: Although a substantial proportion of ischemic strokes in persons with HIV infection (PWH) is related to large artery disease, studies evaluating elevated cerebrovascular risk in PWH have focused primarily on microvascular disease. We compared the burden of intracranial large artery disease on vessel wall MRI (VW-MRI) in PWH and HIV-uninfected individuals. Design: Cross-sectional study. Methods: We recruited antiretroviral therapy-treated PWH with undetectable plasma viral load and HIV-uninfected individuals. All participants were at least 40 years of age and at moderate-to-high cardiovascular risk. We used Poisson and mixed effects logistic regression models to compare the number and associated characteristics of enhancing intracranial arteries on VW-MRI by HIV status. Results: Of 46 participants (mean age 59 years), 33 were PWH. PWH had nearly four-fold as many enhancing intracranial arteries on VW-MRI than HIV-uninfected individuals (rate ratio 3.94, 95% CI 1.57-9.88, P = 0.003). The majority of wall enhancement was eccentric (76%) and short-segment (93%), suggestive of intracranial atherosclerotic disease (ICAD). Sixty-nine percent of enhancing arteries were not associated with luminal narrowing on magnetic resonance angiography (MRA). None of these characteristics differed significantly by HIV status. Conclusion: In persons at moderate-to-high cardiovascular risk, HIV infection, even when well controlled, may be associated with a greater burden of intracranial large artery disease and, specifically, of ICAD. Studies of the mechanisms underlying higher rates of ischemic stroke in PWH should include evaluation for intracranial large artery disease. VW-MRI provides added value as an adjunct to traditional luminal imaging when evaluating cerebrovascular risk in PWH.
MeSH term(s)	Arteries ; Cross-Sectional Studies ; HIV Infections/complications ; HIV Infections/drug therapy ; Humans ; Magnetic Resonance Angiography/methods ; Magnetic Resonance Imaging/methods ; Middle Aged ; Stroke
Language	English
Publishing date	2021-08-31
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003064
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