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Frascati international research criteria for HIV-associated neurocognitive disorders (HAND) are controversial; some investigators have argued that Frascati criteria are too liberal, resulting in a high false positive rate. Meyer et al. recommended more conservative revisions to HAND criteria, including exploring other commonly used methodologies for neurocognitive impairment (NCI) in HIV including the global deficit score (GDS). This study compares NCI classifications by Frascati, Meyer, and GDS methods, in relation to neuroimaging markers of brain integrity in HIV.
Two hundred forty-one people living with HIV (PLWH) without current substance use disorder or severe (confounding) comorbid conditions underwent comprehensive neurocognitive testing and brain structural magnetic resonance imaging and magnetic resonance spectroscopy. Participants were classified using Frascati criteria versus Meyer criteria: concordant unimpaired [Frascati(Un)/Meyer(Un)], concordant impaired [Frascati(Imp)/Meyer(Imp)], or discordant [Frascati(Imp)/Meyer(Un)] which were impaired via Frascati criteria but unimpaired via Meyer criteria. To investigate the GDS versus Meyer criteria, the same groupings were utilized using GDS criteria instead of Frascati criteria.
When examining Frascati versus Meyer criteria, discordant Frascati(Imp)/Meyer(Un) individuals had less cortical gray matter, greater sulcal cerebrospinal fluid volume, and greater evidence of neuroinflammation (i.e., choline) than concordant Frascati(Un)/Meyer(Un) individuals. GDS versus Meyer comparisons indicated that discordant GDS(Imp)/Meyer(Un) individuals had less cortical gray matter and lower levels of energy metabolism (i.e., creatine) than concordant GDS(Un)/Meyer(Un) individuals. In both sets of analyses, the discordant group did not differ from the concordant impaired group on any neuroimaging measure.
The Meyer criteria failed to capture a substantial portion of PLWH with brain abnormalities. These findings support continued use of Frascati or GDS criteria to detect HIV-associated CNS dysfunction.
Objectives: Studies of neurocognitively elite older adults, termed SuperAgers, have identified clinical predictors and neurobiological indicators of resilience against age-related neurocognitive decline. Despite rising rates of older persons living with HIV (PLWH), SuperAging (SA) in PLWH remains undefined. We aimed to establish neuropsychological criteria for SA in PLWH and examined clinically relevant correlates of SA. Methods: 734 PLWH and 123 HIV-uninfected participants between 50 and 64 years of age underwent neuropsychological and neuromedical evaluations. SA was defined as demographically corrected (i.e., sex, race/ethnicity, education) global neurocognitive performance within normal range for 25-year-olds. Remaining participants were labeled cognitively normal (CN) or impaired (CI) based on actual age. Chi-square and analysis of variance tests examined HIV group differences on neurocognitive status and demographics. Within PLWH, neurocognitive status differences were tested on HIV disease characteristics, medical comorbidities, and everyday functioning. Multinomial logistic regression explored independent predictors of neurocognitive status. Results: Neurocognitive status rates and demographic characteristics differed between PLWH (SA=17%; CN=38%; CI=45%) and HIV-uninfected participants (SA=35%; CN=55%; CI=11%). In PLWH, neurocognitive groups were comparable on demographic and HIV disease characteristics. Younger age, higher verbal IQ, absence of diabetes, fewer depressive symptoms, and lifetime cannabis use disorder increased likelihood of SA. SA reported increased independence in everyday functioning, employment, and health-related quality of life than non-SA. Conclusions: Despite combined neurological risk of aging and HIV, youthful neurocognitive performance is possible for older PLWH. SA relates to improved real-world functioning and may be better explained by cognitive reserve and maintenance of cardiometabolic and mental health than HIV disease severity. Future research investigating biomarker and lifestyle (e.g., physical activity) correlates of SA may help identify modifiable neuroprotective factors against HIV-related neurobiological aging. (JINS, 2019, 25, 507–519)
Invention is an investment in which the costs of the Research and Development (R&D) project balance future returns. Those returns depend on objective factors like wage and capital costs but also on subjective factors because they are future projections. The more optimistic the inventor, the higher are the projected returns. Baumard uses Life History Theory (LHT) to relate optimism to the affluence of inventors and their societies.
Objectives: Human immunodeficiency virus (HIV) disproportionately affects Hispanics/Latinos in the United States, yet little is known about neurocognitive impairment (NCI) in this group. We compared the rates of NCI in large well-characterized samples of HIV-infected (HIV+) Latinos and (non-Latino) Whites, and examined HIV-associated NCI among subgroups of Latinos. Methods: Participants included English-speaking HIV+ adults assessed at six U.S. medical centers (194 Latinos, 600 Whites). For overall group, age: M=42.65 years, SD=8.93; 86% male; education: M=13.17, SD=2.73; 54% had acquired immunodeficiency syndrome. NCI was assessed with a comprehensive test battery with normative corrections for age, education and gender. Covariates examined included HIV-disease characteristics, comorbidities, and genetic ancestry. Results: Compared with Whites, Latinos had higher rates of global NCI (42% vs. 54%), and domain NCI in executive function, learning, recall, working memory, and processing speed. Latinos also fared worse than Whites on current and historical HIV-disease characteristics, and nadir CD4 partially mediated ethnic differences in NCI. Yet, Latinos continued to have more global NCI [odds ratio (OR)=1.59; 95% confidence interval (CI)=1.13–2.23; p<.01] after adjusting for significant covariates. Higher rates of global NCI were observed with Puerto Rican (n=60; 71%) versus Mexican (n=79, 44%) origin/descent; this disparity persisted in models adjusting for significant covariates (OR=2.40; CI=1.11–5.29; p=.03). Conclusions: HIV+ Latinos, especially of Puerto Rican (vs. Mexican) origin/descent had increased rates of NCI compared with Whites. Differences in rates of NCI were not completely explained by worse HIV-disease characteristics, neurocognitive comorbidities, or genetic ancestry. Future studies should explore culturally relevant psychosocial, biomedical, and genetic factors that might explain these disparities and inform the development of targeted interventions. (JINS, 2018, 24, 163–175)
Objectives: The present study examined differences in neurocognitive outcomes among non-Hispanic Black and White stroke survivors using the NIH Toolbox-Cognition Battery (NIHTB-CB), and investigated the roles of healthcare variables in explaining racial differences in neurocognitive outcomes post-stroke. Methods: One-hundred seventy adults (91 Black; 79 White), who participated in a multisite study were included (age: M=56.4; SD=12.6; education: M=13.7; SD=2.5; 50% male; years post-stroke: 1–18; stroke type: 72% ischemic, 28% hemorrhagic). Neurocognitive function was assessed with the NIHTB-CB, using demographically corrected norms. Participants completed measures of socio-demographic characteristics, health literacy, and healthcare use and access. Stroke severity was assessed with the Modified Rankin Scale. Results: An independent samples t test indicated Blacks showed more neurocognitive impairment (NIHTB-CB Fluid Composite T-score: M=37.63; SD=11.67) than Whites (Fluid T-score: M=42.59, SD=11.54; p=.006). This difference remained significant after adjusting for reading level (NIHTB-CB Oral Reading), and when stratified by stroke severity. Blacks also scored lower on health literacy, reported differences in insurance type, and reported decreased confidence in the doctors treating them. Multivariable models adjusting for reading level and injury severity showed that health literacy and insurance type were statistically significant predictors of the Fluid cognitive composite (p<.001 and p=.02, respectively) and significantly mediated racial differences on neurocognitive impairment. Conclusions: We replicated prior work showing that Blacks are at increased risk for poorer neurocognitive outcomes post-stroke than Whites. Health literacy and insurance type might be important modifiable factors influencing these differences. (JINS, 2017, 23, 640–652)
This paper discusses some of the criticisms recently raised by Rafael Dobado-González about our work on real wages in the Americas in the long run. Although addressing a series of issues, Dobado mainly questions our use of the welfare ratio methodology to assess standards of living in colonial Spanish America. In this article we explain how, despite its limitations, this methodology provides a solid, transparent metric to compare economic development across space and time. In particular, welfare ratios present more economically relevant information on living standards than the commodity wages that Dobado prefers (Dobado González and García Montero 2014). We argue that Dobado fails to offer convincing evidence against our findings; hence, we stand by these results, which suggest that the divergence between North and Latin America began early in the colonial period.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
The causes of the United States’ exceptional economic performance are investigated by comparing American wages and prices with wages and prices in Great Britain, Egypt, and India. American industrialization in the nineteenth century required tariff protection since the country's comparative advantage lay in agriculture. After 1895 surging American productivity shifted the country's comparative advantage to manufacturing. Egypt and India could not have industrialized by following American policies since their wages were so low and their energy costs so high that the modern technology that was cost effective in Britain and the United States would not have paid in their circumstances.
Before the industrial revolution, most of the world's manufacturing production took place in China and India. While the traditional manufacturing centers declined in the nineteenth century, other centers developed and, indeed, joined Britain to form the "industrial West". On the eve of the industrial revolution, British GDP per head was considerably above the world average. Economic growth was driven by the expansion of international trade, but the policies of the British state were at some variance with the prescriptions of Adam Smith. This chapter discusses colonialism, economic development, and standard model in Europe, Mexico, Russia, Latin America, Egypt and Japan. It then focuses on Big Push industrialization in Japan, China and Soviet Union. By the middle of the nineteenth century, the Standard Model was bearing fruit in the United States and Western Europe. China was not successful in building its own fertilizer plants in the 1960s, and in 1973-1974 the country contracted with foreign firms to build thirteen ammonia factories.
This article introduces the Americas in the Great Divergence debate by measuring real wages in various North and South American cities between colonization and independence, and comparing them to Europe and Asia. We find that for much of the period, North America was the most prosperous region of the world, while Latin America was much poorer. We then discuss a series of hypotheses that can explain these results, including migration, the demography of the American Indian populations, and the various labor systems implemented in the continent.
In “The Industrial Revolution in Miniature,” I calculated that the spinning jenny was profitable to install in England in the 1780s but not in France.1 My calculations assumed that a spinner using a wheel in a domestic setting worked a total of 100 days per year and spun 100 pounds of coarse cotton (one pound per day). The jenny raised labor productivity to three pounds per day in the “most likely” scenario. I showed that it would have been cheaper to spin 100 pounds per year with a jenny than with a wheel in England, while the reverse would have been true in France. Hence, the jenny was installed in England rather than France. Ugo Gragnolati, Daniele Moschella, and Emanuele Pugliese have pointed out that this argument assumes that output was kept at 100 pounds per year, and the effect of the jenny was to reduce the spinner's work year to only 33–1/3 days per year.2 They suggest that it was more likely that the spinner would have continued to work 100 days per year and produce 300 pounds of yarn instead. In that case, they argue, it would have been profitable to install the jenny in France as well as England. Profitability would have increased in both countries under these assumptions because capital costs would have been cut by a third if three times as much output was produced from the same capital (although profitability was still much higher in England). Hence, they conclude that economic considerations do not explain the diffusion of the jenny.