Faculty Bibliography

The impact of COVID-19-related mental health effects on health behaviors among people living with HIV (PLWH) remains unknown. Our qualitative study explored the relationship between the mental health consequences of the COVID-19 pandemic and self-management of HIV and cardiovascular disease (CVD) among PLWH in the United States. Twenty-four PLWH enrolled in a multicenter, cardiovascular, clinical trial completed one-on-one semistructured interviews to assess changes in mood, health behaviors, and comorbid CVD management during the COVID-19 pandemic. The majority of participants (ages 43-70 years) were male (n = 17, 70.8%) and Black (n = 19, 79.2%). Participants reported increased mental distress during the COVID-19 pandemic, which they perceived to negatively affect heart-healthy behaviors. Despite mental health stressors, this population continued to adhere to medications, including antiretroviral therapy. Future initiatives should focus on improving mental health outcomes and promotion of healthy lifestyle choices among PLWH to mitigate adverse CVD outcomes.

This manuscript explores the myriad ethical controversies associated with declaration of brain death/death by neurologic criteria (BD/DNC) during pregnancy raised by the case of Ms. Adriana Smith, a 30-year-old Georgia nurse, who came to international attention in May 2025. We will discuss: (1) the factors that may have impacted the decision not to perform neuroimaging when she first presented to medical attention; (2) the significance of identifying and deferring performance of futile interventions to decrease intracranial pressure relative to BD/DNC declaration; (3) the medical, ethical and legal complexities associated with BD/DNC declaration and continuation of maternal organ support in pregnancy; (4) the impact of continuing maternal organ support after BD/DNC declaration on the fetus, the family, Ms. Smith and the treatment team; and (5) the effects of media coverage of this case. This case's influence on future BD/DNC declarations during pregnancy, both in Georgia and elsewhere, remains to be seen.

OBJECTIVE:The objective of this study is to use a machine learning approach to identify predictors of BMI percentile among Hispanic/Latino youth in the United States. METHODS:Participants were Hispanic/Latino 8- to 16-year-olds from the cross-sectional Study of Latino Youth (SOL Youth; n = 1466). A supervised machine learning approach, LASSO regression, was used with BMI percentile as the outcome. A total of 102 predictor variables were examined spanning parent and child demographics; health behaviors; and psychological, sociocultural, and environmental measures. RESULTS: = 0.42), but a 10-variable solution was selected for parsimony. Six associations were significant. Dieting 1-4 or ≥ 5 times/year (β = 8.69 [95% CI: 10.25 to 14.52] or 10.86 [95% CI: 13.14 to 18.33], respectively) and having a parent of Dominican heritage (β = 3.48 [95% CI: 4.05 to 9.90]) or with obesity (β = 2.96 [95% CI: 2.99 to 6.85]) were associated with a higher BMI percentile. Perception of being smaller than the "ideal" body size (β = -1.65 [95% CI: -6.84 to -1.35]) and use of the food/activity parenting practice Control (β = -1.17 [95% CI: -3.63 to -1.69]) were associated with a lower BMI percentile. CONCLUSIONS:Family-based approaches and focusing on dieting and body image satisfaction may be important for weight management in Hispanic/Latino youth.

Standard genome-wide association studies (GWAS) and rare variant burden tests are essential tools for identifying trait-relevant genes¹. Although these methods are conceptually similar, by analysing association studies of 209 quantitative traits in the UK Biobank^2-4, we show that they systematically prioritize different genes. This raises the question of how genes should ideally be prioritized. We propose two prioritization criteria: (1) trait importance - how much a gene quantitatively affects a trait; and (2) trait specificity - the importance of a gene for the trait under study relative to its importance across all traits. We find that GWAS prioritize genes near trait-specific variants, whereas burden tests prioritize trait-specific genes. Because non-coding variants can be context specific, GWAS can prioritize highly pleiotropic genes, whereas burden tests generally cannot. Both study designs are also affected by distinct trait-irrelevant factors, complicating their interpretation. Our results illustrate that burden tests and GWAS reveal different aspects of trait biology and suggest ways to improve their interpretation and usage.

We developed and implemented a PrEP navigation program ("SNAPS") in a NYC safety-net hospital with the objectives to co-locate navigation, clinical PrEP services, and payment assistance. Adherence and retention to PrEP-related care were assessed by mean medication possession ratios (MPRs) and number of appointments over 12 months. Compared to the pre-SNAPS cohort, the post-SNAPS cohort was less likely to be cisgender male (64.8% vs. 84.2%), White (6.5% vs. 23%) and to speak English (33.3% vs. 80.6%) (all p < 0.001). Mean MPR was lower for post-SNAPS (0.68, SD = 0.33) compared to pre-SNAPS (0.89, SD = 0.22) (p = 0.001). Among post-SNAPS patients, cisgender men and MSM were more likely to be retained in PrEP care compared to cisgender women (p < 0.05). Although SNAPS linked diverse patients to PrEP-care, mean MPR was lower post-SNAPS compared to the pre-SNAPS. Continued investments to strengthen later stages of the PrEP cascade model for all populations vulnerable to HIV are needed.

RATIONALE & OBJECTIVE/UNASSIGNED:exposure and mortality, overall and by race and ethnicity. STUDY DESIGN/UNASSIGNED:Cohort study (2003-2019). SETTING & PARTICIPANTS/UNASSIGNED:National registry for patients with kidney failure. EXPOSURES/UNASSIGNED:), segregation scores (Theil's H method), deprivation scores (American Community Survey), and built environment factors (medically underserved areas [MUA] and urbanicity) by patients' residential ZIP code at dialysis initiation. OUTCOME/UNASSIGNED:All-cause mortality. ANALYTICAL APPROACH/UNASSIGNED:and mortality, overall and stratified by race and ethnicity. RESULTS/UNASSIGNED:< 0.001]). LIMITATIONS/UNASSIGNED:may not reflect individual-level exposures. CONCLUSIONS/UNASSIGNED:and reduce related mortality.

BACKGROUND/UNASSIGNED:Urinary albumin-creatinine ratio (UACR) and urinary protein-creatinine ratio (UPCR) are both used in clinical practice to diagnose and monitor chronic kidney disease (CKD). Which measure exhibits stronger associations with clinical outcomes and whether this varies by patient characteristics are unknown. OBJECTIVE/UNASSIGNED:To assess and compare the performance of UACR and UPCR across CKD-related clinical outcomes. DESIGN/UNASSIGNED:Individual patient-level meta-analysis. SETTING/UNASSIGNED:38 research and clinical cohorts. PARTICIPANTS/UNASSIGNED:148 994 participants with same-day measurements of UACR and UPCR. MEASUREMENTS/UNASSIGNED:, and glomerular disease. RESULTS/UNASSIGNED:, diabetes, and glomerular disease. Associations between UACR and UPCR were generally similar for cardiovascular outcomes but favored UACR in subgroups with moderately to severely elevated UACR. LIMITATION/UNASSIGNED:Assessment of UACR and UPCR in spot urine samples. CONCLUSION/UNASSIGNED:Overall, UACR was more strongly associated with kidney failure than UPCR (particularly in subgroups with higher UACR), supporting the use of UACR rather than UPCR to diagnose and risk-stratify patients. PRIMARY FUNDING SOURCE/UNASSIGNED:National Kidney Foundation and National Institute of Diabetes and Digestive and Kidney Diseases.