Publications by authors named "Adam A Szpiro"

Background: Long-term exposure to air pollution may be related to neural atrophy or cerebrovascular pathology. A major source of air pollution is vehicle traffic, which is modifiable. In this study, we estimated associations between four traffic-related air pollutants and five neuroimaging biomarkers.

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Purpose/aims: Sleep health is an understudied but potentially important outcome of joint air pollution and psychosocial stress exposures in children. This study examined children's sleep health outcomes in relation to air pollution (PM, NO, O; aim 1), adverse childhood experiences (ACEs; aim 2), and air-pollution-by-ACEs interactions (aim 3).

Methods: Participants were from ECHO-PATHWAYS, a three-cohort consortium.

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Introduction: As differentiated HIV services provided outside of clinics are scaled up, clients may have fewer interactions with ancillary services for non-communicable disease (NCD) prevention and management traditionally offered within facilities. This study was embedded in the DO ART randomised trial (2016-2019), which demonstrated that community-based differentiated service delivery (DSD) improved HIV viral suppression compared with facility-based care. We assessed NCD risk among men and women living with HIV accessing community-based DSD versus facility-based care in KwaZulu-Natal, South Africa.

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Growing evidence links ultrafine particles (UFP) to neurotoxicity, but human studies remain limited. Various mobile monitoring approaches have been used to develop air pollution exposure models. However, whether design choices impact epidemiology, including for UFP and cognitive function, remains unclear.

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Despite demonstrated adverse health effects of air pollution, the impact of exposure measurement error on these associations remains unexplored, especially for NO and PM components. We compiled daily personal measurements of PM, NO, and PM components - including Al, Cd, Fe, K, Ni, Pb, S, and Si - from previous studies as true exposure indicators. These were compared against ambient concentrations from the nearest monitors.

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Importance: Ozone (O3) is the most frequently exceeded air pollutant standard in the US. While short-term exposure is associated with acute respiratory health, the epidemiologic evidence linking postnatal O3 exposure to childhood asthma and wheeze is inconsistent and rarely evaluated as a mixture with other air pollutants.

Objectives: To determine associations between ambient O3 and subsequent asthma and wheeze outcomes both independently and in mixture with fine particulate matter and nitrogen dioxide in regions with low annual O3 concentrations.

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Prenatal exposure to organophosphate ester (OPE) chemicals, commonly used as flame retardants and plasticizers, has been associated with adverse birth outcomes. The placenta is a critical fetal organ and therefore may be involved in pathogenesis of birth outcomes. The goal of this study was to evaluate associations of 10 maternal urinary OPE metabolites, individually and as a mixture, with the placental transcriptome at birth in the Conditions Affecting Neurocognitive Development and Learning in Early Childhood (CANDLE) study.

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Article Synopsis
  • Prenatal exposure to ozone (O) might influence child lung function, particularly through oxidative stress, and diet may play a role in modifying these effects.
  • In a study of 661 women in the CANDLE cohort, no significant associations were found between prenatal O exposure and lung function; however, there were hints of adverse effects during specific fetal development periods.
  • Interactions between maternal diet (OBS) and race did not consistently modify the effects of O, although some associations were noted among specific racial groups under certain dietary conditions.
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Background: Evidence suggests that long-term exposure to air pollution may increase the risk of dementia and related cognitive outcomes. A major source of air pollution is automotive traffic, which is modifiable by technological and regulatory interventions.

Objectives: We examined associations of four traffic-related air pollutants with rates of cognitive decline in a cohort of older adults.

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Background: PAH exposure is associated with adverse health outcomes, but exposure sources in pregnancy are not well-understood.

Objectives: We examined associations between urinary OH-PAHs during pregnancy and environmental tobacco smoke (ETS) and short-term ambient air pollution exposure. Participants included 1603 pregnant non-smokers in three cohorts from 7 sites across the USA.

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Nationwide PM exposure models typically rely on regulatory monitoring data as the only ground-level measurements. In this study, we develop a high-resolution spatiotemporal PM model for the contiguous United States from 2000 to 2019 with dense monitoring data at both regulatory and residential sites. Specifically, we combine publicly-available data from 1843 regulatory monitors with our own set of multiple 2-week measurements at 939 residential locations.

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Background: Exposure to ambient air pollution is associated with morbidity and mortality, making it an important public health concern. Emissions from motorized traffic are a common source of air pollution but evaluating the contribution of traffic-related air pollution (TRAP) emissions to health risks is challenging because it is difficult to disentangle the contribution of individual air pollution sources to exposure contrasts in an epidemiological study.

Objective: This paper describes a new framework to identify whether air pollution differences reflect contrasts in TRAP exposures.

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Article Synopsis
  • Background research highlights that prenatal exposure to ambient fine particulate matter (PM) may negatively affect child lung health, yet studies specifically investigating the timing of exposure during critical lung development phases are limited.
  • The study involved 675 children, tracking prenatal PM exposure and assessing lung function at ages 8-9 through spirometry while controlling for various factors like maternal and child characteristics.
  • Results showed weak associations between PM exposure during specific fetal development phases and lung function measures (FEV1 and FVC), with no significant effect from factors like child sex or allergic sensitization.
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Objective: Evaluate the clinical utility of patient-collected dried blood spots (DBS) in measuring HIV-1 viral load (VL) for monitoring antiretroviral therapy (ART) compared to provider-collected DBS and blood plasma.

Design: In a randomized trial of community-based delivery of ART in South Africa, we assessed performance of: DBS specimens compared to plasma, and participant-collected vs. staff-collected DBS specimens, to measure HIV-1 VL.

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Missing covariate data is a common problem that has not been addressed in observational studies of gene expression. Here, we present a multiple imputation method that accommodates high dimensional gene expression data by incorporating principal component analysis of the transcriptome into the multiple imputation prediction models to avoid bias. Simulation studies using three datasets show that this method outperforms complete case and single imputation analyses at uncovering true positive differentially expressed genes, limiting false discovery rates, and minimizing bias.

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Objective: Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) is associated with adverse birth and developmental outcomes in children. We aimed to describe prenatal PAH exposures in a large, multisite U.S.

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Article Synopsis
  • - The Deliver Health Study assessed the effectiveness of home-delivered antiretroviral therapy (ART) compared to clinic-based care for people living with HIV during the COVID-19 pandemic, revealing that home delivery significantly improved viral suppression rates.
  • - Researchers tracked 155 adults in KwaZulu-Natal, South Africa, from October 2019 to December 2020 to evaluate the influence of changing COVID-19 restrictions on missed ART doses and late clinic refill visits using statistical analyses.
  • - Although the pandemic did not notably affect self-reported ART use between the groups, there was a significant increase in the risk of late clinic refill visits during COVID-19 alert levels, indicating that as restrictions worsened, more patients delayed their clinic
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Article Synopsis
  • Executive functions, crucial for problem-solving and planning, develop rapidly in childhood, but prenatal exposure to environmental toxicants like polycyclic aromatic hydrocarbons (PAHs) may hinder this development.
  • The study analyzed 814 children from non-smoking mothers, measuring urine levels of PAH metabolites during pregnancy and evaluating their executive functions at age 8-9, focusing on cognitive flexibility, working memory, and inhibitory control.
  • Results showed mostly null associations between PAH exposure and executive functions, although some interactions between specific PAH metabolites and working memory were observed, highlighting the need for further research in this area.
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  • The study investigates the impact of early childhood air pollution on executive function in school-aged children, using data from 1235 participants across three US pregnancy cohorts.
  • It examines the effects of pollutants like PM 2.5, nitrogen dioxide (NO2), and ozone (O3) during the ages of 0-4, assessing various cognitive abilities such as working memory and cognitive flexibility.
  • Results suggest that air pollution exposure, particularly NO2, negatively affects executive function, with stronger effects observed in areas with higher educational opportunities; further research is needed to deepen understanding of these environmental influences on child development.
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  • The study examined the relationship between exposure to particulate matter (PM) and cognitive outcomes, highlighting mixed findings in previous research due to differing estimation methods.
  • Researchers used data from the Atherosclerosis Risk in Communities (ARIC) Study to compare PM exposure levels across 11 different methods, assessing their effect on cognitive and MRI outcomes.
  • Results showed high agreement in exposure estimates across different sites, but low within-site consistency; however, findings indicated no significant associations between PM levels and cognitive outcomes, raising concerns about potential biases related to unmeasured confounding factors.
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Background: Statistical models of air pollution enable intra-urban characterization of pollutant concentrations, benefiting exposure assessment for environmental epidemiology. The new generation of low-cost sensors facilitate the deployment of dense monitoring networks and can potentially be used to improve intra-urban models of air pollution.

Objective: Develop and evaluate a spatiotemporal model for nitrogen dioxide (NO) in the Puget Sound region of WA, USA for the Adult Changes in Thought Air Pollution (ACT-AP) study and assess the contribution of low-cost sensor data to the model's performance through cross-validation.

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