2,170 research outputs found
Severity of cardiovascular disease outcomes among patients with hiv is related to markers of inflammation and coagulation
No full textBackground: In the general population, raised levels of inflammatory markers are stronger predictors of fatal than nonfatal cardiovascular disease (CVD) events. People with HIV have elevated levels of interleukin-6 (IL-6), high-sensitivity C-reactive protein (hsCRP), and D-dimer; HIV-induced activation of inflammatory and coagulation pathways may be responsible for their greater risk of CVD. Whether the enhanced inflammation and coagulation associated with HIV is associated with more fatal CVD events has not been investigated. Methods and Results: Biomarkers were measured at baseline for 9764 patients with HIV and no history of CVD. Of these patients, we focus on the 288 that experienced either a fatal (n=74) or nonfatal (n=214) CVD event over a median of 5 years. Odds ratios (ORs) (fatal versus nonfatal CVD) (95% confidence intervals [CIs]) associated with a doubling of IL-6, D-dimer, hsCRP, and a 1-unit increase in an IL-6 and D-dimer score, measured a median of 2.6 years before the event, were 1.39 (1.07 to 1.79), 1.40 (1.10 to 1.78), 1.09 (0.93 to 1.28), and 1.51 (1.15 to 1.97), respectively. Of the 214 patients with nonfatal CVD, 23 died during follow-up. Hazard ratios (95% CI) for all-cause mortality were 1.72 (1.28 to 2.31), 1.73 (1.27 to 2.36), 1.44 (1.15 to 1.80), and 1.88 (1.39 to 2.55), respectively, for IL-6, D-dimer, hsCRP, and the IL-6 and D-dimer score. Conclusions: Higher IL-6 and D-dimer levels reflecting enhanced inflammation and coagulation associated with HIV are associated with a greater risk of fatal CVD and a greater risk of death after a nonfatal CVD event. Clinical Trial Registration: URL: http://www.clinicaltrial.gov Unique identifier: SMART: NCT00027352, ESPRIT: NCT00004978, SILCAAT: NCT00013611
Development and validation of a risk score for chronic kidney disease in HIV infection using prospective cohort data from the D:A:D study
No full textChronic kidney disease (CKD) is a major health issue for HIV-positive individuals, associated with increased morbidity and mortality. Development and implementation of a risk score model for CKD would allow comparison of the risks and benefits of adding potentially nephrotoxic antiretrovirals to a treatment regimen and would identify those at greatest risk of CKD. The aims of this study were to develop a simple, externally validated, and widely applicable long-term risk score model for CKD in HIV-positive individuals that can guide decision making in clinical practice
Factors Associated with D-Dimer Levels in HIV-Infected Individuals
No full textBackground: Higher plasma D-dimer levels are strong predictors of mortality in HIV+ individuals. The factors associated with D-dimer levels during HIV infection, however, remain poorly understood.
Methods: In this cross-sectional study, participants in three randomized controlled trials with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4(+) count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol.
Results: Women from all age groups had higher D-dimer levels than men, though a steeper increase of D-dimer with age occurred in men. Hepatitis B/C co-infection was the only co-morbidity associated with higher D-dimer levels. In this subgroup, the degree of hepatic fibrosis, as demonstrated by higher hyaluronic acid levels, but not viral load of hepatitis viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high-density lipoprotein cholesterol were negatively correlated with D-dimer levels.
Conclusions: D-dimer levels increase with age in HIV+ men, but are already elevated in women at an early age due to reasons other than a higher burden of concomitant diseases. In hepatitis B/C co-infected individuals, hepatic fibrosis, but not hepatitis viral load, was associated with higher D-dimer levels
Frequent hepatitis B virus rebound among HIV-hepatitis B virus-coinfected patients following antiretroviral therapy interruption.
No full textData Study Group Final Report: eGym
No full textData Study Groups are week-long events at The Alan Turing Institute bringing together some of the country’s top talent from data science, artificial intelligence, and wider fields, to analyse real-world data science challenges.
Improved strength training using smart gym equipment data
We were provided with information about users of specialised smart gym equipment and usage data over a period of 2 years. The brief was to explore the data and provide insight into how best to help users improve performance. Of particular interest was the link between training and increased strength (as measured by the machines). Also of interest were longitudinal usage of gym-goers, with the view of aiding adherence to the program, and the creation of a simple performance metric by which user improvement could be measured
Research, Analysis and Insight into National Standards (RAINS) Project Final Report: National Standards and the Damage Done
No full textThis is the final report of the Research Analysis and Insight into National Standards (RAINS) project, a three-year study of the enactment of the National Standards policy in six diverse primary and intermediate schools. This report provides an overview discussion of the pros and cons of the National Standards policy as experienced by staff, children and parents in the RAINS schools. It summarises the policy and methodological background to the research and the findings of the two previous RAINS reports. The report is also being accompanied by online case studies and other data files
Opportunistic disease and mortality in patients coinfected with hepatitis B or C virus in the strategic management of antiretroviral therapy (SMART) study.
No full textInsight and strategy in multiple cue learning
No full textIn multiple-cue learning (also known as probabilistic category learning) people acquire information about cue-outcome relations and combine these into predictions or judgments. Previous studies claim that people can achieve high levels of performance without explicit knowledge of the task structure or insight into their own judgment policies. It has also been argued that people use a variety of suboptimal strategies to solve such tasks. In three experiments we re-examined these conclusions by introducing novel measures of task knowledge and self-insight, and using ‘rolling regression’ methods to analyze individual learning. Participants successfully learned a four-cue probabilistic environment and showed accurate knowledge of both the task structure and their own judgment processes. Learning analyses suggested that the apparent use of suboptimal strategies emerges from the incremental tracking of statistical contingencies in the environment
Protease inhibitors and cardiac autonomic function in hiv-infected patients: a cross-sectional analysis from the strategies for management of antiretroviral therapy (smart) trial
No full textObjective: To compare cardiac autonomic function as measured by heart rate variability for HIV-infected participants taking protease inhibitors (PIs) with those taking a non-nucleoside reverse transcriptase inhibitor without a PI (NNRTI-no PI) regimen. Design: Cross-sectional analysis. Setting: Multicentre study. Participants: 2998 participants (average age 44 years, 28% females) enrolled in the Strategies for Management of Antiretroviral Therapy (SMART) trial. Primary outcome measures: Heart rate and two heart rate variability measures (the SD of all filtered RR intervals over the length of the recording (SDNN) and the root mean square of successive differences in normal RR intervals (rMSSD)). Results: At study entry, 869 participants were taking a boosted PI (PI/r), 579 a non-boosted PI and 1550 an NNRTI-no PI. Median values (IQR) of heart rate, SDNN and rMSSD were: 68 (60-75) beats/min (bpm), 21 (13-33) ms, 22 (13-35) ms in the PI/r group, 68 (60-75) bpm, 21 (13-33) ms and 21 (14-33) ms in the non-boosted PI group and 69 (62-77) bpm, 20 (13-31) ms and 21(13-33) ms in the NNRTI-no PI group. After adjustment for baseline factors, for those given PI/r and nonboosted PI, heart rate was 2.2 and 2.8 bpm, respectively, lower than the NNRTI-no PI group (
Perspectives on the Acceptance and Social Implications of Smart Glasses: A Qualitative Focus Group Study in Healthcare
No full textSmart glasses were perceived to be potentially revolutionary for healthcare, however, there is only limited research on the acceptance and social implications of smart glasses in healthcare. This study aims to get a better insight into the theoretical foundations and the purpose was to identify themes regarding adoption, mediation, and the use of smart glasses from the perspective of healthcare professionals. A qualitative research design with focus groups was used to collect data. Three focus groups with 22 participants were conducted. Data were analyzed using content analysis. Our analysis revealed six overarching themes related to the anticipated adoption of smart glasses: knowledge, innovativeness, use cases, ethical issues, persuasion, and attitude. Nine themes were found related to anticipated mediation and use of smart glasses: attention, emotions, social influences, design, context, camera use, risks, comparisons to known products, and expected reaction and might influence the acceptance of smart glasses
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