Faculty Bibliography

BACKGROUND:Dietary acid load is a clinically important aspect of the diet that reflects the balance between acid-producing foods, for example, meat and cheese, and base-producing foods, for example, fruits and vegetables. METHODS:We used metabolomics to identify blood biomarkers of dietary acid load in 2 independent studies of chronic kidney disease patients: the African American Study of Kidney Disease and Hypertension (AASK, n = 689) and the Modification of Diet in Renal Disease (MDRD, n = 356) study. Multivariable linear regression was used to assess the cross-sectional association between serum metabolites whose identity was known (outcome) and dietary acid load (exposure), estimated with net endogenous acid production (NEAP) based on 24-h urine urea nitrogen and potassium, and adjusted for age, sex, race, randomization group, measured glomerular filtration rate, log-transformed urine protein-to-creatinine ratio, history of cardiovascular disease, BMI, and smoking status. RESULTS:Out of the 757 known, nondrug metabolites identified in AASK, 26 were significantly associated with NEAP at the Bonferroni threshold for significance (P < 6.6 × 10-5). Twenty-three of the 26 metabolites were also identified in the MDRD study, and 13 of the 23 (57%) were significantly associated with NEAP (P < 2.2 × 10-3), including 5 amino acids (S-methylmethionine, indolepropionylglycine, indolepropionate, N-methylproline, N-δ-acetylornithine), 2 cofactors and vitamins (threonate, oxalate), 1 lipid (chiro-inositol), and 5 xenobiotics (methyl glucopyranoside, stachydrine, catechol sulfate, hippurate, and tartronate). Higher levels of all 13 replicated metabolites were associated with lower NEAP in both AASK and the MDRD study. CONCLUSION:Metabolomic profiling of serum specimens from kidney disease patients in 2 study populations identified 13 replicated metabolites associated with dietary acid load. Additional studies are needed to validate these compounds in healthy populations. These 13 compounds may potentially be used as objective markers of dietary acid load in future nutrition research studies.

BACKGROUND:Research on women with substance use disorders has expanded, yet knowledge and implementation gaps remain. METHODS:Drawing from topics discussed at the 2017 meeting of InWomen's in Montreal, Canada, this article reviews key progress in research on substance use among women, adolescents, and families to delineate priorities for the next generation of research. RESULTS:The field has seen significant accomplishments in multiple domains, including the management of pregnant women with substance use and comorbid psychiatric disorders, caring for neonates in opioid withdrawal, greater inclusion of and treatment options for LGBTQ + communities, gendered instrumentation, and gender-focused HIV interventions for adolescent girls and women. Women who use alcohol and other drugs often experience other comorbid medical conditions (chronic Hepatitis C and HIV), contextual confounders (intimate partner violence exposure, homelessness, trauma), and social expectations (e.g., as caretakers) that must be addressed as part of integrated care to effectively treat women's substance use issues. Although significant advances have been made in the field to date, gender-based issues for women remain a neglected area in much of substance abuse research. Few dedicated and gender-focused funding opportunities exist and research has been siloed, limiting the potential for collaborations or interdisciplinary cross-talk. CONCLUSION:Given renewed attention to substance use in the context of the burgeoning opioid epidemic and shifts in global politics that affect women's substance use, the field requires a strategic rethink to invigorate a pipeline of future research and researchers.

Low T cell counts and acute rejection are associated with increased cardiovascular events (CVEs); T cell-depleting agents decrease both. Thus, we aimed to characterize the risk of CVEs by using an induction agent used in kidney transplant recipients. We conducted a secondary data analysis of patients who received a kidney transplant and used Medicare as their primary insurance from 1999 to 2010. Outcomes of interest were incident CVE, all-cause mortality, CVE-related mortality, and a composite outcome of mortality and CVE. Of 47 258 recipients, 29.3% received IL-2 receptor antagonist (IL-2RA), 33.3% received anti-thymocyte globulin (ATG), 7.3% received alemtuzumab, and 30.0% received no induction. Compared with IL-2RA, there was no difference in the risk of CVE in the ATG (adjusted hazard ratio [aHR] 0.98, 95% confidence interval [CI] 0.92-1.05) and alemtuzumab group (aHR 1.01, 95% CI 0.89-1.16), but slightly higher in the no induction group (aHR 1.06, 95% CI 1.00-1.14). Acute rejection did not modify this association in the latter group but did increase CVE by 46% in the alemtuzumab group. There was no difference in the hazard of all-cause or CVE-related mortality. Only in the ATG group, a 7% lower hazard of the composite outcome of mortality and CVE was noted. Induction agents are not associated with incident CVE, although prospective trials are needed to determine a personalized approach to prevention.

Background and aims.- Prevalence of psychiatric disorders differs in males and females, and neurological studies suggest that sex-linked variation in the brain may underlie this dissociation. However, the origin of this difference, and how early in human life sexual dimorphism in brain function emerges is a topic that requires further investigation. Here, we address this gap by assessing brain resting-state functional connectivity (RSFC) between and within brain networks as it relates to fetal sex and gestational age (GA). Methods.- We examined 118 typical human fetuses (70 male; 48 female) between 25.9 and 39.6 weeks GA. Infomap was used to derive 16 separable fetal neural networks distributed across cortical, subcortical, and cerebellar regions. Using enrichment analysis, we identified network pairs revealing distinct patterns of GArelated change in males and females. Results.- Sex-dependent variation of between- and within- network RSFC-GA associations was observed: while females exhibited GA-related variation in connectivity between posterior cingulate and temporal pole regions, and between pre-frontal and cerebellar regions, males demonstrated increased intracerebellar RSFC with advancing age. Conclusions.- Such observations confirm that sex-related differences in functional brain development are present before birth. An important next step in this line of research will be to follow children across early development and discover how sex-related variation in network development relates to future health outcomes

Diagnostic World Health Organization (WHO) Group 1 pulmonary arterial hypertension (PAH) and Diagnostic Group 1' pulmonary veno-occlusive disease (PVOD) and/or pulmonary capillary hemangiomatosis (PCH) are progressive and fatal disorders. Past registries provided important insights into these disorders, but did not include hormonal exposures or genomic data. The United States Pulmonary Hypertension Scientific Registry (USPHSR) will provide demographic, physiologic, anorexigen and hormone exposure, genomic, and survival data in the current therapeutic era for 499 patients diagnosed with PAH, PVOD, or PCH. The USPHSR also will explore the relationship between pharmacologic, non-pharmacologic, and dietary hormonal exposures and the increased risk for women to develop idiopathic or heritable PAH.

Introduction: Sedative-hypnotic (SDH) medications are often prescribed for treatment of insomnia despite concerns about their safety. There is anecdotal evidence to suggest cannabis, when medicinally used, may be efficacious for insomnia, although it's unclear whether SDH users are now turning to cannabis for sleep, and if so, whether it is used as a substitute. We examine trends in SDH use from 2005-2014 stratified by cannabis user groups.
Method(s): Data came from 2005-2014 waves of National Health and Nutrition Examination Survey. Participants self-reported cannabis use (never users, past users, and current users [within past year]) and medications currently using prescribed by a doctor. SDHs included benzodiazepines and other non-benzodiazepine hypnotics. We examined trends using logistic regression in order to model changes in the odds of prescribed SDH use over the entire study period (e.g., 2005-2014), and explored differences across cannabis user groups. Our sample was limited to those age 18 to 59 years as only these ages were queried about cannabis use.
Result(s): Overall, 6.0% of current, 5.8% of past, and 3.1% of never cannabis users reported SDH use (p<0.001). From 2005-2014 the odds of SDH use increased 84% (95% CI=1.05-3.20), with significant increases for current cannabis users (OR=4.49, 95% CI=1.59- 12.71), a modest (albeit nonsignificant) increase for past users (OR=1.75, 95% CI=0.84-3.62), and no changes in never users.
Conclusion(s): Sedative-hypnotic use was high in current and past cannabis users and even increased across these groups in the study period. Results suggest cannabis may not be substituting for use of these medications. More research is needed to identify trends in SDH use after 2014 and in older age cohorts, examine trends based on indication for cannabis use (e.g., medicinally and/or recreationally) and determine the ways in which cannabis use may help or worsen insomnia symptoms

OBJECTIVES/OBJECTIVE:The present study investigates the association between skin color and academic achievement in young Latino students. METHOD/METHODS:= 750) were 4 and 5 years old when they were enrolled (baseline) and were followed through the end of first grade. Structural equation models and bootstrapping mediation tests were conducted to examine the effects of skin color on academic achievement at the end of first grade, partially mediated by academic and social emotional domains of school readiness in prekindergarten or kindergarten. This study considered the intersectionality of ethnicity and gender in the models. RESULTS:The findings showed that for Dominican-origin boys, being "collectively black" was indirectly associated with lower academic achievement in first grade, mediated by lower teacher-rated adaptive behavior in prekindergarten or kindergarten. CONCLUSIONS:Discussion focuses on the need for educational policies and practices to be conscious of phenotypicality bias. (PsycINFO Database Record (c) 2018 APA, all rights reserved).