Immune Dysregulation Is Associated with Neurodevelopment and Neurocognitive Performance in HIV Pediatric Populations—A Scoping Review

HIV-1 is known for its complex interaction with the dysregulated immune system and is responsible for the development of neurocognitive deficits and neurodevelopmental delays in pediatric HIV populations. Considering that HIV-1-induced immune dysregulation and its association with neurodevelopmental and neurocognitive impairments in pediatric populations are not well understood, we conducted a scoping review on this topic. The study aimed to systematically review the association of blood and cerebrospinal fluid (CSF) immune markers with neurocognitive deficits and neurodevelopmental delays in pediatric HIV populations. PubMed, Scopus, and Web of Science databases were searched using a search protocol designed specifically for this study. Studies were selected based on a set eligibility criterion. Titles, abstracts, and full texts were assessed by two independent reviewers. Data from the selected studies were extracted and analyzed by two independent reviewers. Seven studies were considered eligible for use in this context, which included four cross-sectional and three longitudinal studies. An average of 130 (±70.61) children living with HIV, 138 (±65.37) children exposed to HIV but uninfected and 90 (±86.66) HIV-negative participants were included across the seven studies. Results indicate that blood and CSF immune markers are associated with neurocognitive development/performance in pediatric HIV populations. Only seven studies met the inclusion criteria, therefore, these limited the number of significant conclusions which could have been made by using such an approach. All considered, the evidence suggests that immune dysregulation, as in the case of adult HIV populations, also has a significant association with neurocognitive performance in pediatric HIV populations.

Download Full-text

Saliva microRNA Biomarkers of Cumulative Concussion

International Journal of Molecular Sciences ◽

10.3390/ijms21207758 ◽

2020 ◽

Vol 21 (20) ◽

pp. 7758

Author(s):

Steven D. Hicks ◽

Robert P. Olympia ◽

Cayce Onks ◽

Raymond Y. Kim ◽

Kevin J. Zhen ◽

...

Keyword(s):

Case Control Study ◽

Cross Sectional Study ◽

Professional Athletes ◽

Neurocognitive Deficits ◽

Sectional Study ◽

Neurocognitive Performance ◽

Cross Sectional ◽

Increase Risk ◽

History Of ◽

Control Study

Recurrent concussions increase risk for persistent post-concussion symptoms, and may lead to chronic neurocognitive deficits. Little is known about the molecular pathways that contribute to persistent concussion symptoms. We hypothesized that salivary measurement of microribonucleic acids (miRNAs), a class of epitranscriptional molecules implicated in concussion pathophysiology, would provide insights about the molecular cascade resulting from recurrent concussions. This hypothesis was tested in a case-control study involving 13 former professional football athletes with a history of recurrent concussion, and 18 age/sex-matched peers. Molecules of interest were further validated in a cross-sectional study of 310 younger individuals with a history of no concussion (n = 230), a single concussion (n = 56), or recurrent concussions (n = 24). There was no difference in neurocognitive performance between the former professional athletes and their peers, or among younger individuals with varying concussion exposures. However, younger individuals without prior concussion outperformed peers with prior concussion on three balance assessments. Twenty salivary miRNAs differed (adj. p < 0.05) between former professional athletes and their peers. Two of these (miR-28-3p and miR-339-3p) demonstrated relationships (p < 0.05) with the number of prior concussions reported by younger individuals. miR-28-3p and miR-339-5p may play a role in the pathophysiologic mechanism involved in cumulative concussion effects.

Download Full-text

Exome Sequencing Reveals a Putative Role for HLA-C*03:02 in Control of HIV-1 in African Pediatric Populations

Frontiers in Genetics ◽

10.3389/fgene.2021.720213 ◽

2021 ◽

Vol 12 ◽

Author(s):

Samuel Kyobe ◽

Savannah Mwesigwa ◽

Grace P. Kisitu ◽

John Farirai ◽

Eric Katagirya ◽

...

Keyword(s):

Disease Progression ◽

Exome Sequencing ◽

Population Attributable Risk ◽

Hla Class I ◽

Pediatric Hiv ◽

Class I ◽

European Ancestry ◽

Heterozygote Advantage ◽

Pediatric Populations ◽

Hiv 1

Human leucocyte antigen (HLA) class I molecules present endogenously processed antigens to T-cells and have been linked to differences in HIV-1 disease progression. HLA allelotypes show considerable geographical and inter-individual variation, as does the rate of progression of HIV-1 disease, with long-term non-progression (LTNP) of disease having most evidence of an underlying genetic contribution. However, most genetic analyses of LTNP have occurred in adults of European ancestry, limiting the potential transferability of observed associations to diverse populations who carry the burden of disease. This is particularly true of HIV-1 infected children. Here, using exome sequencing (ES) to infer HLA allelotypes, we determine associations with HIV-1 LTNP in two diverse African pediatric populations. We performed a case-control association study of 394 LTNPs and 420 rapid progressors retrospectively identified from electronic medical records of pediatric HIV-1 populations in Uganda and Botswana. We utilized high-depth ES to perform high-resolution HLA allelotyping and assessed evidence of association between HLA class I alleles and LTNP. Sixteen HLA alleles and haplotypes had significantly different frequencies between Uganda and Botswana, with allelic differences being more prominent in HLA-A compared to HLA-B and C allelotypes. Three HLA allelotypes showed association with LTNP, including a novel association in HLA-C (HLA-B∗57:03, aOR 3.21, Pc = 0.0259; B∗58:01, aOR 1.89, Pc = 0.033; C∗03:02, aOR 4.74, Pc = 0.033). Together, these alleles convey an estimated population attributable risk (PAR) of non-progression of 16.5%. We also observed novel haplotype associations with HLA-B∗57:03-C∗07:01 (aOR 5.40, Pc = 0.025) and HLA-B∗58:01-C∗03:02 (aOR 4.88, Pc = 0.011) with a PAR of 9.8%, as well as a previously unreported independent additive effect and heterozygote advantage of HLA-C∗03:02 with B∗58:01 (aOR 4.15, Pc = 0.005) that appears to limit disease progression, despite weak LD (r2 = 0.18) between these alleles. These associations remained irrespective of gender or country. In one of the largest studies of HIV in Africa, we find evidence of a protective effect of canonical HLA-B alleles and a novel HLA-C association that appears to augment existing HIV-1 control alleles in pediatric populations. Our findings outline the value of using multi-ethnic populations in genetic studies and offer a novel HIV-1 association of relevance to ongoing vaccine studies.

Download Full-text

Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-041379 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041379

Author(s):

Allard Willem de Smalen ◽

Zhie X Chan ◽

Claudia Abreu Lopes ◽

Michaella Vanore ◽

Tharani Loganathan ◽

...

Keyword(s):

Scoping Review ◽

Multiple Correspondence Analysis ◽

Population Data ◽

Good Health ◽

Migrant Health ◽

High Quality ◽

Level Of Evidence ◽

Cross Sectional ◽

Academic Literature

BackgroundA large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies.MethodsA scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if they were conducted in Malaysia, peer-reviewed, focused on a health dimension according to the Bay Area Regional Health Inequities Initiative (BARHII) framework, and targeted the vulnerable international migrant population. Data were extracted by using the BARHII framework and a newly developed decision tree to identify the type of study design and corresponding level of evidence. Modified Joanna Briggs Institute checklists were used to assess study quality, and a multiple-correspondence analysis (MCA) was conducted to identify associations between different variables.Results67 publications met the selection criteria and were included in the study. The majority (n=41) of studies included foreign workers. Over two-thirds (n=46) focused on disease and injury, and a similar number (n=46) had descriptive designs. The average quality of the papers was low, yet quality differed significantly among them. The MCA showed that high-quality studies were mostly qualitative designs that included refugees and focused on living conditions, while prevalence and analytical cross-sectional studies were mostly of low quality.ConclusionThis study provides an overview of the scientific literature on migrant health in Malaysia published between 1965 and 2019. In general, the quality of these studies is low, and various health dimensions have not been thoroughly researched. Therefore, researchers should address these issues to improve the evidence base to support policy-makers with high-quality evidence for decision-making.

Download Full-text

Frequent neurocognitive deficits after recovery from mild COVID-19

Brain Communications ◽

10.1093/braincomms/fcaa205 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Marcel S Woo ◽

Jakob Malsy ◽

Jana Pöttgen ◽

Susan Seddiq Zai ◽

Friederike Ufer ◽

...

Keyword(s):

Short Term Memory ◽

Telephone Interview ◽

Acute Infection ◽

Young Patients ◽

Cross Sectional Study ◽

Cognitive Status ◽

Neurocognitive Deficits ◽

Cross Sectional ◽

Neuropsychiatric Complications ◽

Moderate Disease

Abstract Neuropsychiatric complications associated with coronavirus disease 2019 caused by the Coronavirus SARS-CoV-2 (COVID-19) are increasingly appreciated. While most studies have focussed on severely affected individuals during acute infection, it remains unclear whether mild COVID-19 results in neurocognitive deficits in young patients. Here, we established a screening approach to detect cognitive deficiencies in post-COVID-19 patients. In this cross-sectional study, we recruited 18 mostly young patients 20–105 days (median, 85 days) after recovery from mild to moderate disease who visited our outpatient clinic for post-COVID-19 care. Notably, 14 (78%) patients reported sustained mild cognitive deficits and performed worse in the Modified Telephone Interview for Cognitive Status screening test for mild cognitive impairment compared to 10 age-matched healthy controls. While short-term memory, attention and concentration were particularly affected by COVID-19, screening results did not correlate with hospitalization, treatment, viremia or acute inflammation. Additionally, Modified Telephone Interview for Cognitive Status scores did not correlate with depressed mood or fatigue. In two severely affected patients, we excluded structural or other inflammatory causes by magnetic resonance imaging, serum and cerebrospinal fluid analyses. Together, our results demonstrate that sustained sub-clinical cognitive impairments might be a common complication after recovery from COVID-19 in young adults, regardless of clinical course that were unmasked by our diagnostic approach.

Download Full-text

Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010029 ◽

2021 ◽

Vol 6 (1) ◽

pp. 29

Author(s):

Cruz S. Sebastião ◽

Joana Morais ◽

Miguel Brito

Keyword(s):

Drug Resistance ◽

Pregnant Women ◽

Rural Areas ◽

Cross Sectional Study ◽

Drug Resistant ◽

Sectional Study ◽

Cross Sectional ◽

Hiv Drug Resistance ◽

Hiv 1 ◽

High Educational

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

Download Full-text

Quality of life of patients with lung cancer: A scoping review

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562019022.180162 ◽

2019 ◽

Vol 22 (2) ◽

Author(s):

Rafael Turano Mota ◽

Helder Márcio Ferreira Júnior ◽

Fabiane Silva Pereira ◽

Maria Aparecida Vieira ◽

Simone de Melo Costa

Keyword(s):

Quality Of Life ◽

Lung Cancer ◽

Scoping Review ◽

Prospective Studies ◽

Current Knowledge ◽

Care Quality ◽

Life Questionnaire ◽

Cross Sectional ◽

European Organization

Abstract Objective: To characterize scientific publications on the quality of life of people with lung cancer in order to explore current knowledge of the subject, with emphasis on assessment instruments and methodological aspects. Method: A scoping type literature review was performed. Articles were sought in the databases of the Virtual Health Library, in an integrative manner, with the descriptors: Quality of life and Lung Neoplasms, with no date of publication or language restrictions (n=138). The selection of articles was based on inclusion and exclusion criteria defined in the study proposal. Results: We included 18 publications published between 2006 and 2017, the majority (n = 10) of which had a cross-sectional design. Eight different instruments were used to evaluate the quality of life of patients with lung cancer, four of which were specific for people with cancer. There was a prevalence of the use of the European Organization for Research and Treatment of Cancer Care Quality of Life Questionnaire - EORTC QLQ-C30 (n=8). Prospective studies (n=8) assessed quality of life before and after chemotherapy, physical therapy or pulmonary resection. The studies adopted different methodologies and provided conflicting results of quality of life. Cross-sectional studies with comparatively healthy subjects found an inferior quality of life for people with lung cancer. Conclusion: The scoping review contributed to the identification of the multiple evaluated instruments, both generic and specific. It found a lack of homogeneity in the methodological approaches of the studies. Further prospective studies with a specific instrument and methodological standardization to evaluate the quality of life of people with lung cancer are recommended.

Download Full-text

Cannabis Use, Age of Initiation, and Neurocognitive Performance: Findings from a Large Sample of Heavy Drinking Emerging Adults

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000618 ◽

2021 ◽

Vol 27 (6) ◽

pp. 533-545

Author(s):

Melissa Parlar ◽

Emily MacKillop ◽

Tashia Petker ◽

James Murphy ◽

James MacKillop

Keyword(s):

Working Memory ◽

Emerging Adults ◽

Memory Performance ◽

Heavy Drinking ◽

Cannabis Use ◽

Neurocognitive Functioning ◽

Adhd Symptoms ◽

Neurocognitive Performance ◽

Cross Sectional ◽

Large Sample

AbstractObjective:To evaluate the associations between cannabis use and neurocognitive functioning, including self-reported attention deficit hyperactivity disorder (ADHD) symptoms, in a large sample of emerging adults (ages 21–25) using a cross-sectional design. A secondary objective was to examine age of cannabis initiation as a moderator.Methods:Participants were high-risk drinking emerging adults (n = 598) reporting past-month cannabis use in the following categories: 1) non-users (i.e., never or not in the past month; n = 276), 2) occasional users (i.e., monthly or weekly users; n = 201), and 3) daily users (n = 121). Categorical comparisons were conducted on working memory, attention, behavioral inhibition, delay and probability discounting, verbal intelligence, and ADHD symptoms. Complementary dimensional analyses examined cannabis severity in relation to neurocognition using regressions. Covariates were age, race, sex, income, years of education, tobacco use, and alcohol use.Results:Frequency of cannabis use was significantly associated with poorer working memory performance, more impulsive delay discounting, and greater endorsement of ADHD symptoms, but not other domains. Effect sizes were small and poorer performance was selectively present among daily, not occasional, cannabis users. Earlier age of initiation was not independently or interactively associated with neurocognitive performance.Conclusions:Daily cannabis use was selectively adversely associated with aspects of memory, impulsivity, and subjective attentional functioning, but most cognitive indicators were not implicated, and evidence of amplification by earlier age of initiation was not observed. Ascertaining causal versus consequential roles of cannabis in neurocognitive functioning is an important priority.

Download Full-text

Definitions and Prevalence of Multimorbidity in Large Database Studies: A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041673 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1673

Author(s):

Ying Pin Chua ◽

Ying Xie ◽

Poay Sian Sabrina Lee ◽

Eng Sing Lee

Keyword(s):

Scoping Review ◽

Chronic Conditions ◽

Meta Analysis ◽

Epidemiological Studies ◽

Cross Sectional ◽

Coding Systems ◽

Wide Range ◽

Scoping Reviews ◽

Retrospective Cohort Studies ◽

Definition Of

Background: Multimorbidity presents a key challenge to healthcare systems globally. However, heterogeneity in the definition of multimorbidity and design of epidemiological studies results in difficulty in comparing multimorbidity studies. This scoping review aimed to describe multimorbidity prevalence in studies using large datasets and report the differences in multimorbidity definition and study design. Methods: We conducted a systematic search of MEDLINE, EMBASE, and CINAHL databases to identify large epidemiological studies on multimorbidity. We used the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) protocol for reporting the results. Results: Twenty articles were identified. We found two key definitions of multimorbidity: at least two (MM2+) or at least three (MM3+) chronic conditions. The prevalence of multimorbidity MM2+ ranged from 15.3% to 93.1%, and 11.8% to 89.7% in MM3+. The number of chronic conditions used by the articles ranged from 15 to 147, which were organized into 21 body system categories. There were seventeen cross-sectional studies and three retrospective cohort studies, and four diagnosis coding systems were used. Conclusions: We found a wide range in reported prevalence, definition, and conduct of multimorbidity studies. Obtaining consensus in these areas will facilitate better understanding of the magnitude and epidemiology of multimorbidity.

Download Full-text

Family Variables and Quality of Life in Children with Down Syndrome: A Scoping Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18020419 ◽

2021 ◽

Vol 18 (2) ◽

pp. 419

Author(s):

Anna Lee ◽

Kathleen Knafl ◽

Marcia Van Riper

Keyword(s):

Quality Of Life ◽

Down Syndrome ◽

Scoping Review ◽

Personal Development ◽

Well Being ◽

Future Research ◽

Cross Sectional ◽

Children With Down Syndrome ◽

Family Variables

The purpose of this scoping review was to identify the family and child quality of life variables that have been studied in relation to one another in children with Down syndrome, the frequency with which different relationships have been studied, and the extent to which family variables were the focus of the research aims. A literature search was conducted to find studies published between January 2007 and June 2018. The initial search yielded 2314 studies; of these, 43 were selected for a final review. Researchers most often addressed family resources and family problem-solving and coping concerning child personal development and physical well-being. Little attention to child emotional well-being was observed, with none considering family appraisal of child emotional well-being. The relationship between family variables and child QoL rarely was the primary focus of the study. Methodologically, most reviewed studies used cross-sectional designs, were conducted in North America and based on maternal report. From future research considering the issues found in this review, healthcare providers can obtain an in-depth understanding of relationships between children and family variables.

Download Full-text