Journal of Acquired Immune Deficiency Syndromes, Dec 12, 2022
Background: To collect and compare selected hearing measures in a pilot study of young adults wit... more Background: To collect and compare selected hearing measures in a pilot study of young adults with perinatally acquired HIV (YAPHIV) and those with perinatal HIV exposure who are uninfected young adults with PHEU (YAPHEU). Setting: Cross-sectional hearing measures in YAPHIV and YAPHEU enrolled in the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) for Participants 18 Years of Age and Older (AMP Up). Methods: Pure-tone air conduction audiometry and distortion product otoacoustic emission (DPOAE) data were collected in 1 visit. A low-frequency pure-tone average (PTA) (LFPTA, at 0.25, 0.5, 1, and 2 kHz), a speech-frequency PTA (SFPTA, at 0.5, 1, 2, and 4 kHz), and a high-frequency PTA (HFPTA, at 3, 4, 6, and 8 kHz) were calculated. Hearing loss was defined as worse ear SFPTA of ≥20 dB HL. Separate linear regression models were fit for worse ear LFPTA, SFPTA, and HFPTA to assess associations with PHIV status. DPOAE signal-to-noise ratios (SNRs) were obtained at 3 frequencies in each ear. Results: Forty-seven YAPHIV and 9 YAPHEU completed hearing testing. All adjusted mean PTAs were similar between YAPHIV and YAPHEU. Hearing loss occurred more in YAPHIV (7/47, 15.2%; 95% CI: 6.3%–28.9%), compared with YAPHEU (0/9, 0%). No associations were detected between HIV disease severity measures and worse ear SFPTA. DPOAE SNRs were similar between YAPHIV and YAPHEU. Conclusions: In this pilot study, peripheral hearing (ie, PTAs) and cochlear function (ie, DPOAEs) were similar between YAPHIV and YAPHEU. A larger study is warranted to confirm these findings.
We identified associations between cigarette-smoking and taste function in the U.S. NHANES 2013-2... more We identified associations between cigarette-smoking and taste function in the U.S. NHANES 2013-2014. Adults ≥40 years (n=2849, nearly half former or current smokers) rated whole-mouth and tongue-tip bitter (1mM quinine) and salt (1M NaCl, 0.32 M NaCl) intensities and reported smoking history (pack years, PY), dependence (time to first cigarette, TTFC) and menthol/non-menthol use. Perceived intensity on the tongue-tip averaged just below moderate for quinine and moderate to strong for 1M NaCl. Current chronic smokers (≥20 PY) reported lower bitter and salty intensities on the tongue-tip (β: -2.0, 95% CI: -3.7 to -0.4 and β: -3.6, 95% CI: -6.9 to -0.3, respectively) than never smokers. Similarly, compared to never smokers, dependent current smokers (TTFC≤30 minutes) and dependent chronic smokers (≥20 PY, TTFC≤30 minutes) rated less bitter (β: -2.0, 95% CI: -4.0 to 0.1 and β: -2.9, 95% CI: -4.5 to -1.3, respectively) and salty (β: -5.3, 95% CI: -9.3 to -1.4 and β: -4.7, 95% CI: -8.6 to -0.7, respectively) intensities on the tongue-tip. Depressed tongue-tip intensity in dependent smokers (with/without chronicity) versus never smokers was significant in younger (40-65 years), but not older (>65 years) adults. Former smokers, non-chronic/less dependent smokers, and menthol smokers were more likely to report elevated whole-mouth quinine and 1 M NaCl intensities. Tongue-tip and whole-mouth taste intensity concordance varied between smokers and never smokers-current dependent smokers were more likely to rate tongue-tip quinine and NaCl lower than their respective whole-mouth tastants (OR: 1.8, 95% CI: 1.0 to 3.1 and OR: 1.8, 95% CI: 1.1 to 2.8, respectively). In summary, these U.S. nationally-representative data show that current smoking with chronicity and/or dependence associates with lower tongue-tip intensity for bitter and salty stimuli. Smokers with greater exposure to nicotine and/or dependence showed greater risk of taste alterations, with implications for diet- and smoking-related health outcomes.
Objectives To assess the associations between smell function and adiposity and cardiometabolic me... more Objectives To assess the associations between smell function and adiposity and cardiometabolic measures in a nationally representative sample of US adults. Methods In the 2013–2014 NHANES, 3527 adults ≥40 years, completed the NHANES Taste and Smell Exam. Smell function was assessed with an 8-item odor identification test. Participants smelled and identified each odorant by selecting one of four descriptors. Smell impairment was defined as incorrect identification of ≥3 (of 8) odors. Survey-weighted linear regression models estimated cross-sectional associations of smell function with adiposity (body mass index (BMI), waist circumference (WC)) and cardiometabolic measures (total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, fasting plasma glucose (FPG), and systolic (SBP) and diastolic blood pressure (DBP)). Models were adjusted for age, race, education, physical activity, self-reported health status, smoking history, and income-poverty ratio, and stratified by sex and age group (40–64 years vs. ≥65 years). Results In US adults ≥40 years, smell function was significantly associated with several adiposity and cardiometabolic measures in adjusted models, with significant interactions by sex and age. Compared to normal smell, smell impairment was significantly associated with higher BMI [β = 3.0; 95% CI: 0.6, 5.4)] and WC [β = 5.0; 95% CI: 0.3, 9.8] among women <65 years; conversely among men ≥65 years, smell impairment associated with lower BMI [β = −1.6; 95% CI: −3.2, −0.01)]. In adults
142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 18, 2014
ABSTRACT Background: Serious vision and hearing impairments limit the ability of many individuals... more ABSTRACT Background: Serious vision and hearing impairments limit the ability of many individuals to function independently, particularly older adults with acute and chronic health conditions. The 2013 National Center for Health Statistics (NCHS) Urban–Rural Classification Scheme of Counties was developed to examine health disparities by geography, based on population density. Furthermore, the Census Bureau’s American Community Survey (ACS) is uniquely capable of generating small area estimates of reported disabilities to document disparities at local administrative levels. Methods: The ACS collects data in a rolling sample of 250,000 households each month on over 40 topics, including disability, in the civilian non-institutionalized U.S. population. Since 2008 the six disability questions have asked about difficulty with hearing (deaf or having serious difficulty), vision (blind or having serious difficulty, even when wearing glasses), cognition, ambulation, self-care, and independent living. By aggregating five years of data collection, the ACS is capable of generating reliable estimates for all 3,143 U.S. counties. We have estimated county-level disability rates from the 2008-2012 ACS. The counties were further partitioned according to the 2013 NCHS Urban–Rural Classification Scheme. Results: Lowest disability rates were in 368 large 'fringe' metropolitan counties; highest rates in 1,335 rural noncore counties. In fringe metropolitan counties, children <18 years, had prevalences of hearing, vision, and overall disability of 0.55% (+0.02%; 95% confidence interval), 0.56% (+0.02%), and 3.59% (+0.05%); adults aged 18–64 had prevalences of 1.76% (+0.02%), 1.33% (+0.02%), and 8.36 (+0.05%); older adults 65+ had prevalences of 13.82% (+0.09%), 5.89% (+0.07%), and 33.92% (+0.12%), respectively. Among older adults in low population density rural counties, these prevalences were 18.69% (+0.15%), 8.42% (+0.10%), and 41.30% (+0.21%). Of 14.5 million (M) older adults with disability, serious hearing and vision impairment comprised 41.2% (6.0M) and 18.8% (2.7M), respectively. Conclusions: As population density decreases, the prevalence of serious vision and hearing impairment (and all disability) increases. A recent NCHS report showed similar geographic patterns for "all-cause mortality" and "no health insurance coverage". Our analysis revealed geographic areas with poor healthcare access; area-level models will be used to examine underlying factors that contribute to poorer vision and hearing health outcomes.
Objective: To determine the relationship between measures of maternal protein nutriture and fetal... more Objective: To determine the relationship between measures of maternal protein nutriture and fetal size at birth. Methods: We obtained serum samples at 18 and 30 weeks' gestation from 289 indigent multiparous women. The concentrations of albumin, prealbumin, and retinol-binding protein were correlated with birth weight, fetal growth retardation, and other measures of nutritional status. Results: Serum albumin levels at 18 weeks correlated inversely with birth weight (P = .05). This negative correlation was explained by an inverse relationship between albumin concentration and maternal body mass index (BMI), and disappeared in a regression analysis adjusting for BMI. There was no significant correlation between albumin levels at 30 weeks and birth weight or between birth weight and the concentrations of the other two proteins at either gestational age. In individual subjects, the concentration of each protein correlated significantly with the concentration of the other proteins, and the levels at 18 weeks correlated with those at 30 weeks. Conclusion: Serum protein levels are not predictive of birth weight or growth retardation at birth, but do correlate significantly with a number of other measures of nutritional status.
Acta Obstetricia et Gynecologica Scandinavica, 1989
Member states of the International and Collaborative Effort (ICE) are the United States of Americ... more Member states of the International and Collaborative Effort (ICE) are the United States of America, England and Wales, Denmark, Bavaria and North Rhine-Westphalia of the Federal Republic of Germany, Israel, Japan, Norway, Scotland and Sweden. The group has collected, analysed and compared distributions of birthweight for member countries, where available from 1970 onwards, for singleton and all livebirths, stillbirths, early and late neonatal and postneonatal deaths. The present paper is an account of the differences in birthweight distributions, and trends over time seen between and within countries, for livebirths and stillbirths. The major findings are the relative robustness over time of the parameters which characterize the distribution of birthweight within countries, and the marked and consistent differences between these distributions in different countries.
Journal of Acquired Immune Deficiency Syndromes, Dec 12, 2022
Background: To collect and compare selected hearing measures in a pilot study of young adults wit... more Background: To collect and compare selected hearing measures in a pilot study of young adults with perinatally acquired HIV (YAPHIV) and those with perinatal HIV exposure who are uninfected young adults with PHEU (YAPHEU). Setting: Cross-sectional hearing measures in YAPHIV and YAPHEU enrolled in the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) for Participants 18 Years of Age and Older (AMP Up). Methods: Pure-tone air conduction audiometry and distortion product otoacoustic emission (DPOAE) data were collected in 1 visit. A low-frequency pure-tone average (PTA) (LFPTA, at 0.25, 0.5, 1, and 2 kHz), a speech-frequency PTA (SFPTA, at 0.5, 1, 2, and 4 kHz), and a high-frequency PTA (HFPTA, at 3, 4, 6, and 8 kHz) were calculated. Hearing loss was defined as worse ear SFPTA of ≥20 dB HL. Separate linear regression models were fit for worse ear LFPTA, SFPTA, and HFPTA to assess associations with PHIV status. DPOAE signal-to-noise ratios (SNRs) were obtained at 3 frequencies in each ear. Results: Forty-seven YAPHIV and 9 YAPHEU completed hearing testing. All adjusted mean PTAs were similar between YAPHIV and YAPHEU. Hearing loss occurred more in YAPHIV (7/47, 15.2%; 95% CI: 6.3%–28.9%), compared with YAPHEU (0/9, 0%). No associations were detected between HIV disease severity measures and worse ear SFPTA. DPOAE SNRs were similar between YAPHIV and YAPHEU. Conclusions: In this pilot study, peripheral hearing (ie, PTAs) and cochlear function (ie, DPOAEs) were similar between YAPHIV and YAPHEU. A larger study is warranted to confirm these findings.
We identified associations between cigarette-smoking and taste function in the U.S. NHANES 2013-2... more We identified associations between cigarette-smoking and taste function in the U.S. NHANES 2013-2014. Adults ≥40 years (n=2849, nearly half former or current smokers) rated whole-mouth and tongue-tip bitter (1mM quinine) and salt (1M NaCl, 0.32 M NaCl) intensities and reported smoking history (pack years, PY), dependence (time to first cigarette, TTFC) and menthol/non-menthol use. Perceived intensity on the tongue-tip averaged just below moderate for quinine and moderate to strong for 1M NaCl. Current chronic smokers (≥20 PY) reported lower bitter and salty intensities on the tongue-tip (β: -2.0, 95% CI: -3.7 to -0.4 and β: -3.6, 95% CI: -6.9 to -0.3, respectively) than never smokers. Similarly, compared to never smokers, dependent current smokers (TTFC≤30 minutes) and dependent chronic smokers (≥20 PY, TTFC≤30 minutes) rated less bitter (β: -2.0, 95% CI: -4.0 to 0.1 and β: -2.9, 95% CI: -4.5 to -1.3, respectively) and salty (β: -5.3, 95% CI: -9.3 to -1.4 and β: -4.7, 95% CI: -8.6 to -0.7, respectively) intensities on the tongue-tip. Depressed tongue-tip intensity in dependent smokers (with/without chronicity) versus never smokers was significant in younger (40-65 years), but not older (>65 years) adults. Former smokers, non-chronic/less dependent smokers, and menthol smokers were more likely to report elevated whole-mouth quinine and 1 M NaCl intensities. Tongue-tip and whole-mouth taste intensity concordance varied between smokers and never smokers-current dependent smokers were more likely to rate tongue-tip quinine and NaCl lower than their respective whole-mouth tastants (OR: 1.8, 95% CI: 1.0 to 3.1 and OR: 1.8, 95% CI: 1.1 to 2.8, respectively). In summary, these U.S. nationally-representative data show that current smoking with chronicity and/or dependence associates with lower tongue-tip intensity for bitter and salty stimuli. Smokers with greater exposure to nicotine and/or dependence showed greater risk of taste alterations, with implications for diet- and smoking-related health outcomes.
Objectives To assess the associations between smell function and adiposity and cardiometabolic me... more Objectives To assess the associations between smell function and adiposity and cardiometabolic measures in a nationally representative sample of US adults. Methods In the 2013–2014 NHANES, 3527 adults ≥40 years, completed the NHANES Taste and Smell Exam. Smell function was assessed with an 8-item odor identification test. Participants smelled and identified each odorant by selecting one of four descriptors. Smell impairment was defined as incorrect identification of ≥3 (of 8) odors. Survey-weighted linear regression models estimated cross-sectional associations of smell function with adiposity (body mass index (BMI), waist circumference (WC)) and cardiometabolic measures (total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, fasting plasma glucose (FPG), and systolic (SBP) and diastolic blood pressure (DBP)). Models were adjusted for age, race, education, physical activity, self-reported health status, smoking history, and income-poverty ratio, and stratified by sex and age group (40–64 years vs. ≥65 years). Results In US adults ≥40 years, smell function was significantly associated with several adiposity and cardiometabolic measures in adjusted models, with significant interactions by sex and age. Compared to normal smell, smell impairment was significantly associated with higher BMI [β = 3.0; 95% CI: 0.6, 5.4)] and WC [β = 5.0; 95% CI: 0.3, 9.8] among women <65 years; conversely among men ≥65 years, smell impairment associated with lower BMI [β = −1.6; 95% CI: −3.2, −0.01)]. In adults
142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014), Nov 18, 2014
ABSTRACT Background: Serious vision and hearing impairments limit the ability of many individuals... more ABSTRACT Background: Serious vision and hearing impairments limit the ability of many individuals to function independently, particularly older adults with acute and chronic health conditions. The 2013 National Center for Health Statistics (NCHS) Urban–Rural Classification Scheme of Counties was developed to examine health disparities by geography, based on population density. Furthermore, the Census Bureau’s American Community Survey (ACS) is uniquely capable of generating small area estimates of reported disabilities to document disparities at local administrative levels. Methods: The ACS collects data in a rolling sample of 250,000 households each month on over 40 topics, including disability, in the civilian non-institutionalized U.S. population. Since 2008 the six disability questions have asked about difficulty with hearing (deaf or having serious difficulty), vision (blind or having serious difficulty, even when wearing glasses), cognition, ambulation, self-care, and independent living. By aggregating five years of data collection, the ACS is capable of generating reliable estimates for all 3,143 U.S. counties. We have estimated county-level disability rates from the 2008-2012 ACS. The counties were further partitioned according to the 2013 NCHS Urban–Rural Classification Scheme. Results: Lowest disability rates were in 368 large 'fringe' metropolitan counties; highest rates in 1,335 rural noncore counties. In fringe metropolitan counties, children <18 years, had prevalences of hearing, vision, and overall disability of 0.55% (+0.02%; 95% confidence interval), 0.56% (+0.02%), and 3.59% (+0.05%); adults aged 18–64 had prevalences of 1.76% (+0.02%), 1.33% (+0.02%), and 8.36 (+0.05%); older adults 65+ had prevalences of 13.82% (+0.09%), 5.89% (+0.07%), and 33.92% (+0.12%), respectively. Among older adults in low population density rural counties, these prevalences were 18.69% (+0.15%), 8.42% (+0.10%), and 41.30% (+0.21%). Of 14.5 million (M) older adults with disability, serious hearing and vision impairment comprised 41.2% (6.0M) and 18.8% (2.7M), respectively. Conclusions: As population density decreases, the prevalence of serious vision and hearing impairment (and all disability) increases. A recent NCHS report showed similar geographic patterns for "all-cause mortality" and "no health insurance coverage". Our analysis revealed geographic areas with poor healthcare access; area-level models will be used to examine underlying factors that contribute to poorer vision and hearing health outcomes.
Objective: To determine the relationship between measures of maternal protein nutriture and fetal... more Objective: To determine the relationship between measures of maternal protein nutriture and fetal size at birth. Methods: We obtained serum samples at 18 and 30 weeks' gestation from 289 indigent multiparous women. The concentrations of albumin, prealbumin, and retinol-binding protein were correlated with birth weight, fetal growth retardation, and other measures of nutritional status. Results: Serum albumin levels at 18 weeks correlated inversely with birth weight (P = .05). This negative correlation was explained by an inverse relationship between albumin concentration and maternal body mass index (BMI), and disappeared in a regression analysis adjusting for BMI. There was no significant correlation between albumin levels at 30 weeks and birth weight or between birth weight and the concentrations of the other two proteins at either gestational age. In individual subjects, the concentration of each protein correlated significantly with the concentration of the other proteins, and the levels at 18 weeks correlated with those at 30 weeks. Conclusion: Serum protein levels are not predictive of birth weight or growth retardation at birth, but do correlate significantly with a number of other measures of nutritional status.
Acta Obstetricia et Gynecologica Scandinavica, 1989
Member states of the International and Collaborative Effort (ICE) are the United States of Americ... more Member states of the International and Collaborative Effort (ICE) are the United States of America, England and Wales, Denmark, Bavaria and North Rhine-Westphalia of the Federal Republic of Germany, Israel, Japan, Norway, Scotland and Sweden. The group has collected, analysed and compared distributions of birthweight for member countries, where available from 1970 onwards, for singleton and all livebirths, stillbirths, early and late neonatal and postneonatal deaths. The present paper is an account of the differences in birthweight distributions, and trends over time seen between and within countries, for livebirths and stillbirths. The major findings are the relative robustness over time of the parameters which characterize the distribution of birthweight within countries, and the marked and consistent differences between these distributions in different countries.
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