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The Lawson's Classroom Test of Scientific Reasoning (LCTSR) is a popular instrument that measures the development of students' scientific reasoning skills. The instrument has a two-tier question design, which has led to multiple ways of scoring and interpretation. In this research, a method of pattern analysis was proposed and applied to analyze two-tier item pairs on the subskill of Control-of-Variable (COV) of LCTSR. The data were collected from students in grade 4 through college in both the United States and China. Students' response patterns to two combined item pairs were analyzed and compared against students at different grade levels and reasoning development levels. Six performance levels were established based on students' response patterns, serving as indicators of COV reasoning development levels. With the new method, a relation was obtained between students' level of COV skills and grade level, as well as their level of overall reasoning development. It can provide useful information on the possible developmental levels of students' reasoning skills.

Background: This study was conducted to assess the association of serum 25-hydroxyvitamin D [25(OH)D] concentrations with all-cause and cardiovascular disease (CVD) mortality in older people with chronic kidney disease (CKD) in the United States. Methods: We identified 3230 CKD participants aged ≥ 60 years from the National Health and Nutrition Examination Survey (2001–2018). CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2. Mortality outcomes were determined by linkage to National Death Index (NDI) records through December 31, 2019. Restricted cubic spline based on Cox regression models were utilized to elucidate the nonlinear relationship between serum 25(OH)D concentrations and mortality in patients with CKD. Results: During median 74 months of follow-up, 1615 all-cause death and 580 CVD death were recorded. We found an L-shaped association between serum 25(OH)D concentrations and all-cause and CVD mortality, reaching a plateau at 90 nmol/L. Accordingly, per one-unit increment in natural log-transformed 25(OH)D was associated with a 32% and 33% reduced risk of all-cause mortality (hazard ratio [HR] 0.68; 95%CI, 0.56 to 0.83) and CV mortality (HR 0.69; 95%CI, 0.49 to 0.97) in participants with serum 25(OH)D < 90 nmol/L, but no considerable difference was observed in participants with serum 25(OH)D ≥ 90 nmol/L. Compared with those in the deficiency group (< 50 nmol/L), insufficient (50 to < 75 nmol/L) and sufficient group (≥ 75 nmol/L) were significantly associated with lower all-cause mortality (HR,0.83; 95%CI, 0.71 to 0.97 and HR, 0.75; 95%CI, 0.64 to 0.89) and CV mortality (HR,0.87; 95%CI, 0.68 to 1.10 and HR, 0.77; 95%CI, 0.59 to < 1.0), respectively. Conclusion: An L-shaped relationship between serum 25(OH)D levels with all-cause and CVD mortality was observed in elderly CKD patients in the United States. A 25(OH)D concentration of 90 nmol/L may be the target to reduce the risk of premature death. [ABSTRACT FROM AUTHOR]

The current study aimed to investigate Chinese immigrants' sleep quality and associations between the coronavirus disease 2019 pandemic's impact and racism and sleep disruption using a cross-sectional online survey. A total of 507 Chinese immigrants were recruited via social network sites. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The pandemic's impact and racism were measured using questions developed for this study. More than 42% of participants reported poor sleep quality. Those who reported having been affected by the pandemic had poorer subjective sleep quality, longer sleep latency, and greater daytime dysfunction. Those who experienced racist incidents were more likely to use sleep medication and exhibit poor subjective sleep quality, long sleep latency, short sleep duration, and daytime dysfunction. Chinese immigrants' sleep health warrants particular consideration by health care professionals. Timely, effective interventions, such as relaxation techniques and online psychoeducation, need to be delivered in the Chinese community. [Journal of Psychosocial Nursing and Mental Health Services, 61(4), 45–51.] [ABSTRACT FROM AUTHOR]

Chinese immigrant survivors of intimate partner violence (IPV) in the United States have been overlooked and underserved. The purpose of this study was to explore their perceptions of resources for assistance as well as their priority needs. We conducted phone interviews with 20 Chinese immigrant women who had experienced IPV in the past year. The women expressed their needs for emotional support, culturally specific services, a variety of online resources to meet different demands, being empowered, raising the Chinese community's awareness about IPV, and batterer intervention programs. These women's testimonies shows that greater effort should be directed toward addressing those needs in order to reduce IPV and its impacts on health in this vulnerable group of women. [ABSTRACT FROM AUTHOR]

Knowledge of the Social Security Old-Age and Survivors Insurance program affects people's work, consumption, and savings decisions before retirement and in turn impacts financial well-being in retirement. This study examines whether the type of employer-sponsored pension is associated with varying levels of Social Security knowledge using data from the Understanding America Study. Results indicate that people with various pension types are consistently more knowledgeable about disability benefits, age adjustment, claiming upon retirement, and spousal benefits, relative to pensionless individuals. Interventions to enhance Social Security knowledge may benefit from targeting the most financially vulnerable individuals, particularly women without a pension, for enhanced retirement security. [ABSTRACT FROM AUTHOR]

Introduction: Chinese immigrants have faced tremendous health challenges during the coronavirus disease 2019 pandemic. The purpose of this study was to examine the prevalence of depression and anxiety and associated factors among Chinese immigrants in the United States. Methodology: This is a cross-sectional study conducted online. Sociodemographic, immigration-related, and pandemic-related factors, racism, social support, depression, and anxiety were measured. Results: A total of 507 Chinese immigrants completed the survey, with 36% of participants having depression and 29% having anxiety. Younger age (p =.048), residing in the South (p =.017), being affected by the pandemic (p <.001), racism (p <.001), and lower levels of social support (p <.001) were associated with depression. Lower education levels (p =.017), unemployment (p =.036), being U.S.-born (China-born: p =.012; Other nativity: p =.034), being affected by the pandemic (p =.006), racism (p <.001), and lower levels of social support (p =.006) were associated with anxiety. Discussion: There is a pressing need for health care professionals and policymakers to develop effective strategies to decrease anti-Chinese racism and address Chinese immigrants' mental health needs during the pandemic and afterward. [ABSTRACT FROM AUTHOR]

• Used eight U.S. national travel surveys to construct a panel data that covers a continuous range of ages. • Analyzed the trend of daily vehicle miles traveled (VMT) by an average person from each generation and its subgroups. • Baby Boomers, Generation X, and Millennials shared a three-phased trending pattern of VMT over the life course. • Millennials have kept their daily VMT consistently lower than that of Generation X during adulthood. • Estimated generation-specific VMT elasticities WRT person age, driving licensure, car ownership, household size, and income. Millennials' automobility preferences and choices have attracted widespread attention from academia, policy makers, and business industries. Existing studies, however, have reported mixed findings on whether Millennials differ from their predecessor generations, leading to contradictory conclusions drawn for transportation planning and policy recommendations. This study utilized eight U.S. national travel surveys to construct a panel data that covers a continuous range of ages for persons five years and older for Baby Boomers, Generation X, and Millennials. With this unique dataset, the study performed analyses on the trend of daily vehicle miles traveled (VMT) by an average person from each generation and its subgroups. The study found that Baby Boomers, Generation X, and Millennials shared a three-phased trending pattern of VMT over the life course but exhibited varying levels of daily VMT in different life stages. During adulthood, Millennials have kept their daily VMT consistently lower than that of Generation X by about 3 VMT, or 8%, whereas the younger group of Baby Boomers outdrove the older Millennials at age 28 and after by about 3.5 VMT, or 9% daily. When each generation is considered over its life course, peak-level daily VMT tends to occur at earlier ages for each successive generation. From the multi-level modeling of daily VMT, the study identified generation-related group effects and estimated VMT elasticities with respect to person age, driving licensure, vehicle ownership, household size, and gasoline price-adjusted income. The study's findings on the direction and size of VMT influences associated with the five planning or policy variables did not support the speculation that Millennials would match or surpass Baby Boomers and Generation X in their future daily VMT trajectory. Public policies should be designed to nurture the shifting trend of reduced automobility from the older to the younger generations. [ABSTRACT FROM AUTHOR]

Child flourishing includes healthy social and emotional development and an open, engaged approach to learning. However, there remains a significant knowledge gap concerning a minority of children with ADHD who may demonstrate flourishing in one or more areas of functioning. This study investigated the association between positive childhood experiences (PCEs) and flourishing among children with ADHD. Data were derived from the 2021 National Survey of Children's Health in the United States. The analysis included a final sample of 3727 children with ADHD. Logistic regression, restricted cubic splines, and random forest were used to examine the associations between seven PCEs and flourishing. The adjusted odds of flourishing were 72% lower (odds ratio [OR] = 0.28,95% confidence interval [CI] = 0.21, 0.38) among children with PCE scores of 0–2 compared to those with scores of 3–5. In addition, the adjusted odds of flourishing were 2.45 times (95%CI = 2.00, 2.99) greater for children with PCE scores of 6–7 compared to those with scores of 3–5. These associations were consistent regardless of the level of adverse childhood experiences. Having a "connected caregiver" was the PCE most closely related to flourishing (unweighted OR = 3.24, 95%CI = 2.72, 3.89). Our findings revealed a positive association between higher levels of PCEs and greater flourishing among children with ADHD, regardless of the level of childhood adversity they experienced. These results highlight the importance of positive experiences in the lives of children with ADHD, with a specific focus on nurturing supportive relationships within families. • Positive childhood experiences and childhood flourishing association were studied. • The associations between PCEs and flourishing were consistent regardless of the level of ACEs. • Having a "connected caregiver" was the PCE most closely related to flourishing. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies investigated the physical, psychological and sociological effects of infertility; however, stigma and violence experiences of infertile women haven't yet been studied in the US. The objective of the study is to examine the perceived stress, stigma, violence experiences, and social support of US infertile women and to compare with fertile women in order to understand the effects of infertility on stress levels, violence exposures, and support. Methods: The descriptive, cross-sectional study was conducted with fertile and infertile women who use social media for an online support group. A convenience sample of 786 women completed an online survey. Results: In the study, 41.6% of participants were fertile and 58.4% were infertile. We found infertile women experienced high levels of stigma and moderate stress. One in five infertile women has been exposed to emotional or physical violence. Compared to fertile women, infertile women had significantly higher perceived stress levels and were less likely to experience emotional or physical violence. Conclusion: These findings highlight that infertile women have experienced stigma and high levels of stress in a developed country. They are also exposed to emotional or physical violence, but surprisingly infertile women are less likely to report violence than fertile women. [ABSTRACT FROM AUTHOR]

Background: Globally lung cancer is one of the most common cancers, and is responsible for almost 20% of all cancer care costs. As a potential treatment for lung cancer, anti-PD-1/PD-L1 therapy has become a novel scientific hotspot in recent decades. The present study aims at exploring the status and trends of the top frequently cited publications about the anti-PD-1/PD-L1 therapy for lung cancer via bibliometric analysis. Methods: The publications concerning anti-PD-1/PD-L1 therapy for lung cancer were searched on the core collection database of Web of Science, setting the time period for retrieval from 1950 to 2019. The top 100 most frequently cited publications were retrieved, and the bibliometric data were mainly accessed through an open online analysis platform and VOSviewer software. Results: The cited frequencies about the top 100 cited publications ranged from 218 to 6248. These articles were published in 39 publications, which were mainly ranked in Q1. The top journal in terms of the number of the articles was the New England Journal of Medicine (16 articles). The most frequently nominated author was Brahmer, JR from Sidney Kimmel Comprehensive Cancer Center, while the most contributing institution was Memorial Sloan Kettering Cancer. The United States acted as the pioneer in this new field of research and led plentiful of national and international co-operations. Immunotherapy, nivolumab, cell lung-cancer, safety, and docetaxel appeared more frequently as keywords. Discussions: To sum up, high quality journals, influential authors and institutions and research with high quality evidence were apt to attract more attention and possess more public credibility. Moreover, the bibliometric analysis is yielding up its advantage of identifying and analyzing the characteristics and changes in the intellectual structures of a special topic. [ABSTRACT FROM AUTHOR]

Aims: To investigate the prevalence and risk factors of intimate partner violence among Chinese immigrant women residing in the USA. Design: A cross‐sectional study using the online survey approach. Methods: A total of 475 Chinese immigrant women were recruited online between April–June 2019. We measured past year intimate partner violence, sociodemographic, relationship‐related and immigration‐related factors, religion, social support, acculturation, adverse childhood experiences, and gender role beliefs. Results: Twenty‐one percent of Chinese immigrant women experienced past year intimate partner violence. Younger age, cohabiting relationship, lower levels of relationship satisfaction and social support, older age at arrival, longer length of stay, religious belief, and adverse childhood experiences were associated with the occurrence of intimate partner violence. Conclusion: Chinese immigrant women experience higher rates of intimate partner violence compared with other populations of women. Future research is still needed to elucidate abused Chinese immigrant women's violence experiences, help‐seeking behaviours, availability of resources and needs for services to tailor prevention and intervention programs culturally. Impact: The findings added to our understanding of intimate partner violence among this largest Asian immigrant group. Modifiable risk factors such as social support should be targeted in future preventions and interventions for abused Chinese immigrant women residing in the USA. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted communities throughout the United States and worldwide. While the implications of the concomitant economic downturn for older adults are just beginning to be recognized, past experience suggests that the consequences could be devastating for many. Analyses indicate that more than one out of five Americans aged 65 years or older live in counties where high infection rates and high economic insecurity risks occur simultaneously. These findings highlight the overlap between current infection patterns and subsequent challenges to economic security that are impacting older people. Strategies and supports for getting people back to work must take into account the large segment of older people who rely on earnings well into later life. Social Security serves as the foundation of economic security for older adults across the income continuum, but it is frequently insufficient in and of itself, let alone during a crisis. Recognizing the importance of cost of living in shaping economic security highlights the need for the federal and state governments and municipalities to take older people into account in the economic recovery effort. [ABSTRACT FROM AUTHOR]

Background: Testicular cancer (TC) is the most common malignancy in young adult men, and in many countries the incidence rates of testicular cancer have been increasing since the middle of the twentieth century. Since disease presentation and tumor progression patterns are often heterogeneous across racial groups, there may be important racial differences in recent TC trends.Methods: In this study, Surveillance, Epidemiology, and End Results (SEER) data on TC patients diagnosed between 1973 and 2015 were analyzed, including the following racial/ethnic groups: non-Hispanic whites (NHW), Hispanic whites (HW), blacks, and Asians and Pacific Islanders (API). Patient characteristics, age-adjusted incidence rates, and survival were compared across racial groups. A multivariate Cox model was used to analyze the survival data of TC patients, in order to evaluate racial differences across several relevant factors, including marital status, age group, histologic type, treatment, stage, and tumor location.Results: NHWs had the highest incidence rates, followed by blacks, HWs, and APIs. There were significant survival differences among the racial groups, with NHWs having the highest survival rates and blacks having the lowest.Conclusion: An analysis of SEER data showed that racial differences existed among TC patients in the United States with respect to patient characteristics, incidence, and survival. The results can be useful to stakeholders interested in reducing the burden of TC morbidity and mortality. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the association between hardship and self-rated health among older adults and determine whether this association differed by age.Methods: Using data from the 2014 Survey of Income and Program Participation, we conducted logistic regression analysis to examine the association between hardship and self-rated health among adults aged 55 years and older in the United States, and the moderating effect of age on this relationship. Analyses were weighted using replicate weights provided by the survey. Indicators of hardship were dichotomized (1 = experienced hardship, 0 = no hardship).Results: Analyses indicated that individuals who were unable to pay utility bills, unable to pay rent or mortgage, or who experienced food insecurity had higher odds of reporting fair or poor health relative to those not experiencing these hardships. The association between hardship and self-rated health was moderated by age.Conclusions: Hardship is directly relevant to health outcomes as it signals unfulfilled needs experienced by individuals lacking adequate economic resources. This study contributes to our understanding of the role of age in the association between hardship and self-rated health. [ABSTRACT FROM AUTHOR]

Background and Objectives The ongoing shift from defined benefit (DB) to defined contribution (DC) pension plans means that middle-aged and older adults are increasingly being called upon to manage their own fiscal security in retirement. Yet, half of older Americans are financially illiterate, lacking the knowledge and skills to manage financial resources. This study investigates whether pension plan types are associated with varying levels of financial literacy among older Americans. Research Design and Methods Cross-sectional analyses of the 2010 Health and Retirement Study (HRS) (n = 1,281) using logistic and linear regression models were employed to investigate the association between different pension plans and multiple indicators of financial literacy. The potential moderating effect of gender was also examined. Results Respondents with DC plans, with or without additional DB plans, were more likely to correctly answer various financial literacy questions, in comparison with respondents with DB plans only. Men with both DC and DB plans scored significantly higher on the financial literacy index than women with both types of plans, relative to respondents with DB plans only. Discussion and Implications Middle-aged and older adults, who are incentivized by participation in DC plans to manage financial resources and decide where to invest pension funds, tend to self-educate to improve financial knowledge and skills, thereby resulting in greater financial literacy. This finding suggests that traditional financial education programs may not be the only means of achieving financial literacy. Further consideration should be given to providing older adults with continued, long-term exposure to financial decision-making opportunities. [ABSTRACT FROM AUTHOR]

Older Americans rely heavily on Social Security benefits (SSBs) to support independent lifestyles, and many have few or no additional sources of income. We establish the extent to which SSBs adequately support economic security, benchmarked by the Elder Economic Security Standard Index. We document variability across U.S. counties in the adequacy levels of SSBs among older adults. We find that the average SSBs fall short of what is required for economic security in every county in the United States, but the level of shortfall varies considerably by location. Policy implications relating to strengthening Social Security and other forms of retirement income are discussed. [ABSTRACT FROM AUTHOR]

Geographic price discrimination is generally considered beneficial to firm profitability. However, theoretical results point to conditions under which firms might prefer to price across markets uniformly in oligopolistic settings. This paper provides an empirical analysis of competitive price discrimination and quantitatively assesses the profitability of national pricing relative to store-level pricing policies under different market conditions. Specifically, we construct and estimate a model of retail competition using extensive data from the digital camera market. A series of counterfactuals show that, under reasonable commitment mechanisms, two leading chains would benefit from employing national pricing policies, whereas a discount retailer should target prices in each local market. Additional results explore the boundary conditions of these findings and evaluate hybrid pricing policies. The online appendices are available at https://doi.org/10.1287/mksc.2018.1100. [ABSTRACT FROM AUTHOR]

Background: Humanitarian surgical organizations provide palatoplasties for patients without access to surgical care. Few organizations have evaluated the outcomes of these trips. This study evaluates the palatal fistula rate in patients from two cohorts in rural China and one in the United States. Methods: This study compared the odds of fistula formation among three cohorts whose palates were repaired between 2005 and 2009. One cohort included 97 Chinese patients operated on by teams from the United States and Canada under the auspices of Resurge International. They were compared to cohorts at Huaxi Stomatology Hospital and the University of California San Francisco (UCSF). Age, fistula presence, and Veau class were compared among cohorts using Chi-square tests. Logistic regression was used to analyze predictors of fistula formation. Results: The fistula risk was 35.4% in patients treated by humanitarian teams, 12.8% at Huaxi University Hospital and 2.5% at UCSF (P < 0.001). Age and Veau class were associated with fistula formation (Age P = 0.0015; Veau P < 0.001). ReSurge and Huaxi patients had 20.2 and 5.6 times the odds of developing a fistula, respectively, compared to UCSF patients (P < 0.01, both). A multivariable model controlling for surgical group, age, and gender showed an association between Veau class and the odds of fistula formation. Conclusions: Chinese children undergoing palatoplasty by international teams had higher odds of palatal fistula than children treated by Chinese surgeons in established institutions and children treated in the United States. More research is required to identify factors affecting complication rates in low-resource environments. [ABSTRACT FROM AUTHOR]

In order to enhance the fuel economy of hybrid vehicle and increase the mileage of continuation of journey, the power control strategy (PCS) is as significant as component sizing in achieving optimal fuel economy of the fuel cell/battery hybrid vehicle (FCBHV). The models of FCBHV structure and optimal power control strategy are developed by electric vehicle simulation software ADVISOR which uses a hybrid backward/forward approach. The results demonstrate that the proposed control strategy can satisfy the power requirement for two standard driving cycles and achieve the power distribution among various power sources. The comprehensive comparisons with the power tracking controller (PTC) which is wide adopted in ADVISOR verify that the proposed control strategy has better rationality and validity in terms of fuel economy and dynamic property in two standard driving cycles. Therefore, the proposed strategy will provide a novel approach for the advanced power control system of FCBHV. [ABSTRACT FROM AUTHOR]

Japanese participants in Study 1 exhibited a self-effacing tendency when no reason for their self-evaluation was provided. However, they exhibited a self-enhancing tendency when they were offered a monetary reward for the correct evaluation. In Study 2, Americans, especially American men, exhibited a self-enhancing tendency whereas Japanese exhibited a self-effacing tendency when no reason for making the evaluation was presented. This cultural difference disappeared when participants were provided with a monetary reward for correctly evaluating their performance level. These results support the view that the modesty observed in self-evaluation among Japanese participants is a 'default strategy' to avoid offending others. [ABSTRACT FROM AUTHOR]

Truckload carriers provide hundreds of billions of dollars worth of services to shippers in the United States alone each year. Internet auctions provide these shippers with a fast and easy way to negotiate potential contracts with a large number of carriers. Combinatorial auctions have the added benefit of allowing multiple lanes to be considered simultaneously in a single auction. This is important because it enables carriers to connect multiple lanes in continuous moves or tours, decreasing the empty mileage that must be driven, and therefore increasing overall efficiency. On the other hand, combinatorial auctions require bidding on an exponential number of bundles to achieve full economies of scope and scale, which is not tractable except for very small auctions. In most real-world auctions, bidding is instead typically limited to a very small subset of the potential bids. We present an implicit bidding approach to combinatorial auctions for truckload procurement that enables the complete set of all possible bids to be considered implicitly, without placing the corresponding burden of an exponential number of bids on the bidders or the auctioneer. We present the models needed to solve this problem. We then provide extensive computational results to demonstrate the tractability of our approach. Finally, we conclude with numerical analysis to assess the quality of the solutions that are generated and to demonstrate the benefits of our approach over existing bidding methods in practice. [ABSTRACT FROM AUTHOR]

Background Delafloxacin (DLX) is a fluoroquinolone, approved in the United States for treatment of ABSSSI. DLX has no preclinical signals for QT prolongation and has no QT prolongation in a validated challenge study. Risk of QT prolongation is a consideration in antibiotic selection for elderly hospitalized CABP patients. A Phase 3 CABP trial with DLX was analyzed with a focus on age and gender. Methods Data on age and gender were reviewed from a multicenter, randomized, double-blind trial of adults with CABP. Patients were randomized 1:1 to DLX or moxifloxacin (MOX) treatment for 5–10 days. Patients received a minimum of 3 days of IV treatment, then were switched to oral at MD discretion. A key clinical endpoint was the investigator-assessment at Test of Cure (TOC) 5–10 days after the end of treatment. Clinical success was defined as complete or near resolution of signs and symptoms and no further antibiotics needed Results In the overall study, 859 patients were randomized with a mean age of 60 years (55.5% <65, 44.5% ≥65, 21.2% ≥75; range 18–93); 58.7% were male; 25.4% and 1.4% were PORT class IV and V; 28.6% multi-lobar pneumonia. Table shows the comparison of DLX and MOX clinical response at TOC in the Intent to Treat (ITT) population. Overall, DLX was well tolerated, with similar related adverse events (AE) between treatment groups regardless of age (< 65: 16.7% DLX, 13.3% MOX; ≥ 65: 13.4% DLX, 11.7% MOX) or gender (male: 16.0% DLX, 11.1% MOX; female 14.0% DLX, 14.9% MOX). The most common treatment-related AEs for DLX were diarrhea and transaminase elevations which were mild-to-moderate and did not routinely lead to discontinuation. There were no reports of potential QT prolongation on DLX. Conclusion Based on age and gender, DLX had comparable outcomes to MOX in clinical success at TOC. DLX was also well tolerated regardless of age or gender. DLX may offer a promising alternative in the treatment of CABP including elderly patients. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Background: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults., Methods: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US exposure. We evaluated associations of dietary acculturation with incident CVD across ≈7 years of follow-up (n=211/14 172 cases/total) and gut microbiota (n=2349; visit 2, 2014 to 2017). Serum metabolites associated with both dietary acculturation-related gut microbiota (n=694) and incident CVD (n=108/5256 cases/total) were used as proxy measures to assess the association of diet-related gut microbiome with incident CVD., Results: We identified an empirical US-oriented dietary acculturation score that increased with US exposure. Higher dietary acculturation score was associated with higher risk of incident CVD (hazard ratio per SD, 1.33 [95% CI, 1.13-1.57]), adjusted for sociodemographic, lifestyle, and clinical factors. Sixty-nine microbial species (17 enriched from diverse species, 52 depleted mainly from fiber-utilizing Clostridia and Prevotella species) were associated with dietary acculturation, driven by lower intakes of whole grains, beans, and fruits and higher intakes of refined grains. Twenty-five metabolites, involved predominantly in fatty acid and glycerophospholipid metabolism (eg, branched-chain 14:0 dicarboxylic acid** and glycerophosphoethanolamine), were associated with both diet acculturation-related gut microbiota and incident CVD. Proxy association analysis based on these metabolites suggested a positive relationship between diet acculturation-related microbiome and risk of CVD ( r =0.70, P <0.001)., Conclusions: Among US Hispanic and Latino adults, greater dietary acculturation was associated with elevated CVD risk, possibly through alterations in gut microbiota and related metabolites. Diet and microbiota-targeted interventions may offer opportunities to mitigate CVD burdens of dietary acculturation., Competing Interests: Dr Knight is a scientific advisory board member and consultant for BiomeSense, Inc, has equity, and receives income. He is a scientific advisory board member and has equity in GenCirq. He is a consultant and scientific advisory board member for DayTwo and receives income. He has equity in and acts as a consultant for Cybele. He is a cofounder of Biota, Inc and has equity. He is a cofounder of Micronoma, has equity, and is a scientific advisory board member. The terms of these arrangements have been reviewed and approved by the University of California, San Diego in accordance with its conflict of interest policies. The other authors report no conflicts.

Objectives: Although suicide is a major public health problem, little research has addressed factors linked to suicide risk in U.S. Asian ethnic subgroups, including the U.S. Chinese population. In this study, we investigate the relationship between racial discrimination and suicidal ideation among Chinese immigrants in the U.S., as well as the mediating and moderating role of coping., Method: This is a secondary analysis of online survey data from 501 Chinese immigrants in the U.S. Perceived racial discrimination and problem-focused, emotion-focused, and avoidant coping were measured. Mediation and moderation analyses were conducted to determine whether the three types of coping served as mediators or moderators between racism and suicidal ideation., Results: Chinese immigrants who perceived racial discrimination were more likely to engage in suicidal ideation ( OR = 1.38, 95% CI [1.05, 1.81]). Greater use of problem-focused coping was associated with decreased risk of suicidal ideation ( OR = 0.38, 95% CI [0.26, 0.54]). The interaction of racial discrimination and problem-focused, emotion-focused, and avoidant coping did not significantly predict suicidal ideation ( p > .05), but the mediating effects of emotion-focused and avoidant coping were significant., Conclusions: Greater attention should be paid to the detrimental effects of racial discrimination on suicidal ideation among Chinese immigrants. A focus on strengthening problem-focused coping and reducing emotion-focused and avoidant coping among Chinese immigrants should lead to effective suicide prevention strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prediabetes is a heterogenous metabolic state with various risks for development of type 2 diabetes (T2D). In this study, we used genetic data on 7,227 US Hispanic/Latino participants without diabetes from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and 400,149 non-Hispanic White participants without diabetes from the UK Biobank (UKBB) to calculate five partitioned polygenetic risk scores (pPRSs) representing various pathways related to T2D. Consensus clustering was performed in participants with prediabetes in HCHS/SOL (n = 3,677) and UKBB (n = 16,284) separately based on these pPRSs. Six clusters of individuals with prediabetes with distinctive patterns of pPRSs and corresponding metabolic traits were identified in the HCHS/SOL, five of which were confirmed in the UKBB. Although baseline glycemic traits were similar across clusters, individuals in cluster 5 and cluster 6 showed an elevated risk of T2D during follow-up compared with cluster 1 (risk ratios [RRs] 1.29 [95% CI 1.08, 1.53] and 1.34 [1.13, 1.60], respectively). Inverse associations between a healthy lifestyle score and risk of T2D were observed across different clusters, with a suggestively stronger association observed in cluster 5 compared with cluster 1. Among individuals with a healthy lifestyle, those in cluster 5 had a similar risk of T2D compared with those in cluster 1 (RR 1.03 [0.91, 1.18]). This study identified genetic subtypes of prediabetes that differed in risk of progression to T2D and in benefits from a healthy lifestyle., (© 2024 by the American Diabetes Association.)

Blood urea nitrogen (BUN) level is one of the commonly used indicators to assess renal function and systemic immune-inflammatory status. In the adolescent population, changes in BUN levels may be associated with a variety of factors, including physiologic dehydration, lifestyle influences such as nutritional intake, physical activity, and possible endocrine or metabolic disorders. In recent years, more and more studies have shown that BUN levels are not only a reflection of kidney function, but it may also be related to the inflammatory state of the body. The Systemic Immune Inflammatory Index (SII) is a comprehensive index that takes into account platelet counts, neutrophil and lymphocyte counts, and is thought to be effective in reflecting the body's immune status and inflammatory response. However, research on the relationship between the two, SII and BUN, remains understudied in the adolescent population. The purpose of this study was to examine the relationship between SII and BUN levels in a population of American adolescents and to further analyze the factors that influence it. We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) database. Using descriptive statistics, correlation analysis, and regression analysis, we explored the relationship between SII and BUN levels. We found a significant negative correlation between SII and BUN levels, with BUN levels decreasing when SII levels increased (BUN as the dependent variable and SII as the outcome variable). We performed a multiple regression analysis of this relationship, controlling for possible confounders such as gender, age, race, and BMI, and found that this negative correlation remained significant. Our findings reveal an important relationship between SII and BUN levels and provide new perspectives for understanding adolescent health., (© 2024. The Author(s).)

Discrimination, which arose during the coronavirus disease 2019 outbreak, is a global public health issue. This study aimed to provide fundamental knowledge in proposing control measures to mitigate discrimination. We focused on two psychological variables: belief in just deserts (BJD, i.e. , the belief that the infected individual deserves to be infected), a psychological factor that potentially promotes discrimination and prejudice, and human rights restrictions (HRR; i.e. , the degree of individuals' agreement with government restrictions on citizens' behavior during emergencies). Differences in these items, as well as their annual trends from 2020 to 2022, were examined in Japan, the United States (US), the United Kingdom (UK), Italy, and China. In addition, the associations between BJD and HRR by country and year and the direction of the associations between them in Japan and Italy were analyzed. Online surveys were conducted annually, with 392-518 participants per country and year. The BJD was higher in Japan and lower in the UK. BJD increased significantly from 2020 to 2021 in all countries, except in China. Meanwhile, HRR was higher in China and lower in Japan. The HRR decreased from 2020 to 2021 in Japan and decreased from 2020 to 2022 in the US, the UK, and Italy. There were significant positive associations between BJD and HRR in Japan and Italy. Cross-lagged panel models revealed positive bidirectional associations between BJD and HRR in Japan and Italy, respectively, indicating that the HRR declined among those with weak BJD and that the BJD increased among those with high HRR. In Japan and Italy, the dissemination of public messages targeting those with a high HRR in the early stages of an infectious disease outbreak could potentially mitigate the adverse impact of the BJD, eventually reducing discrimination, especially when the infection is not attributed to the fault of the infected individuals., Competing Interests: The authors declare there are no competing interests., (©2023 Murakami et al.)

Background: Performance evaluation is vital for IRB operations. As the number of IRBs and their responsibilities in reviewing and supervising clinical research grow in China, there is a significant need to evaluate their performances. To date, little research has examined IRB performance within China. The aim of this study was to ascertain the perspectives and experiences of IRB employees and researchers to (1) understand the current status of IRBs; (2) compare collected results with those of other countries; and (3) identify shortcomings to improve IRB performance., Methods: This study was conducted in China from October 2020 to September 2021, using an online survey with the IRB-researcher assessment tool-Chinese version., Results: 757 respondents were included in the analysis and classified into IRB employees, researchers, or those who are both IRB employees and researchers. Overall, the score for an ideal IRB was significantly higher than that of an actual IRB. Compared to the US National Validation study, Chinese participants and American participants both agree and differ in their perspectives on the most and least important ideal items., Conclusion: This investigation provides a benchmark of the perceived performance of actual IRBs in China. IRBs in China can be precisely adjusted by targeting identified areas of weakness to improve their performances., (© 2022. The Author(s).)

Purpose: This study aimed to explore the relationship between serum testosterone levels and systemic immune-inflammation index (SII)., Methods: Complete SII and serum testosterone data of men over 20 years of age were retrieved from the 2011-2016 National Health and Nutrition Examination Survey to conduct a prevalence survey. To calculate SII, the platelet count was multiplied by the neutrophil-to-lymphocyte count ratio. Isotope dilution liquid chromatography and tandem mass spectrometry were employed to measure serum testosterone concentration. Testosterone deficiency (TD) was defined as a serum testosterone level ≤ 300ng/dl. Weighted proportions and multivariable regression analyses were used to analyze the association between SII and TD., Results: Overall, the data of 7389 participants were analyzed, The SII ranged from 1.53 - 6297.60. Of the participants, 28.42% had a low serum testosterone level (≤ 300 ng/dl). In the fully adjusted multivariable logistic model, the second quartile (OR: 1.27, p = 0.0737), the third quartile (OR: 1.43, p = 0.0090), and the fourth quartile (OR:1.48, p = 0.0042) of SII significantly increased the TD incidence rate, with the lowest quartile of the SII as a reference. For subgroup analysis, statistically significant associations were observed in participants aged 20-40, obese, non-hypertensive, and non-diabetic. The interaction test revealed no significant effect on this connection., Conclusions: There was a positive relationship between a high SII and an increased prevalence of TD in a nationwide sample of adult men in the United States. Further prospective studies on a larger scale are warranted to confirm the causality between SII and TD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Li, Liu, Cui, Zhu, Chen, Zeng, Gao, Li, Huang and Chen.)

2,2',4,4'-tetrabromodiphenyl ether (BDE-47) is an emerging toxic organic pollutant widely detected in territorial waters. Accordingly, establishing the seawater quality criteria (SWQC) for BDE-47 is of significant importance to protect the marine ecosystems. In this study, published ecotoxicity data of BDE-47 to aquatic species in China were collected, and acute and chronic toxicity tests were carried out on saltwater aquatic organisms from 5 phyla and 8 families widely existed in the Chinese marine environment. Static acute toxicity tests and renewed chronic toxicity tests were adopted. The scientific theories and technical methods of the United States Environmental Protection Agency (US EPA), Canada, the European Union (EU), and the Netherlands on water quality criteria guidelines, as well as the Chinese freshwater quality criteria guidelines were compared. Then an integrated method of SWQC derivation was introduced through comprehensive consideration. Afterward, the SWQC of BDE-47 was derived based on the ecotoxicity data. The SWQC includes short-term seawater quality criteria (S-SWQC), long-term seawater quality criteria (L-SWQC), and serious risk concentration for the ecosystem (SRC eco ). And they were derived and recommended as 7.90 μg/L, 0.217 μg/L, and 3.65 μg/L, respectively. This study served as a specific example to quantitatively studies the differences between different scientific theories and technique methods. The derivation process and improvement of SWQC for BDE-47 provide support for the future revision of water quality criteria in China., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Forest disturbances alter land biophysics. Their impacts on local climate and land surface temperature (LST) cannot be directly measured by comparing pre- and post-disturbance observations of the same site over time (e.g., due to confounding such as background climate fluctuations); a common remedy is to compare spatially-adjacent undisturbed sites instead. This space-for-time substitution ignores the inherent biases in vegetation between two paired sites, interannual variations, and temporal dynamics of forest recovery. Besides, there is a lack of observation-based analyses at fine spatial resolutions capable of capturing spatial heterogeneity of small-scale forest disturbances. To address these limitations, here we report new satellite analyses on local climate impacts of forest loss at 30 m resolution. Our analyses combined multiple long-term satellite products (e.g., albedo and evapotranspiration [ET]) at 700 sites across major climate zones in the conterminous United States, using time-series trend and changepoint detection methods. Our method helped isolate the biophysical changes attributed to disturbances from those attributed to climate backgrounds and natural growth. On average, forest loss increased surface albedo, decreased ET, and reduced leaf area index (LAI). Net annual warming-an increase in LST-was observed after forest loss in the arid/semiarid, northern, tropical, and temperate regions, dominated by the warming from decreased ET and attenuated by the cooling from increased albedo. The magnitude of post-disturbance warming was related to precipitation; climate zones with greater precipitation showed stronger and longer warming. Reduction in leaf or LAI was larger in evergreen than deciduous forests, but the recovery in LAI did not always synchronize with those of albedo and ET. Overall, this study presents new evidence of biophysical effects of forest loss on LST at finer spatial resolutions; our time-series method can be further leveraged to derive local policy-relevant ecosystem climate regulation metrics or support model-based climate-biosphere studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

The prognostic factors and optimal treatment for the elderly patient with glioblastoma (GBM) were poorly understood. This study extracted 4975 elderly patients (≥ 65 years old) with histologically confirmed GBM from Surveillance, Epidemiology and End Results (SEER) database. Firstly, Cumulative incidence function and cox proportional model were utilized to illustrate the interference of non-GBM related mortality in our cohort. Then, the Fine-Gray competing risk model was applied to determine the prognostic factors for GBM related mortality. Age ≥ 75 years old, white race, size > 5.4 cm, frontal lobe tumor, and overlapping lesion were independently associated with more GBM related death, while Gross total resection (GTR) (HR 0.87, 95%CI 0.80-0.94, P = 0.010), radiotherapy (HR 0.64, 95%CI 0.55-0.74, P < 0.001), chemotherapy (HR 0.72, 95%CI 0.59-0.90, P = 0.003), and chemoRT (HR 0.43, 95%CI 0.38-0.48, P < 0.001) were identified as independently protective factors of GBM related death. Based on this, a corresponding nomogram was conducted to predict 3-, 6- and 12-month GBM related mortality, the C-index of which were 0.763, 0.718, and 0.694 respectively. The calibration curve showed that there was a good consistency between the predicted and the actual mortality probability. Concerning treatment options, GTR followed by chemoRT is suggested as optimal treatment. Radiotherapy and chemotherapy alone also provide moderate clinical benefits.

Background: There is no consistent evidence about the appropriate treatment strategies for gastric signet ring cell carcinoma (GSRC) to improve prognosis. We conducted a population-based study to examine the effects of combined modality therapies on survival outcomes using the Surveillance, Epidemiology, and End Results (SEER) data., Methods: Analyses included stage II-III primary GSRC patients who were diagnosed between 2006 and 2016. Therapies were categorized as gastrectomy group, adjuvant chemotherapy (CT) group, neoadjuvant radiotherapy (RT) group, and adjuvant chemoradiotherapy (CRT) group. Survival analyses were conducted by Kaplan-Meier method and Cox proportional hazards models and subgrouped by gender, tumor site, stage at diagnosis, and number of lymph nodes removed., Results: Of the 1717 cases of stage II-III primary GSRC, the mean (SD) age was 59.6 (13.3) years, and over a half were male (52.8%). A total of 39.9% patients received adjuvant CRT and the 5-year overall survival (OS) rate was 34.6%. The median OS of patients treated with adjuvant CRT was significantly longer than that of the gastrectomy group (33 months vs 24 months, aHR = 0.71, 95% CI: 0.59, 0.84). Although the crude model showed a significant association between adjuvant CT and total survival (cHR = 0.81, 95% CI: 0.68, 0.96), the effect measure turned null in the multivariable and sub-group analysis. We did not find the significant effect of neoadjuvant RT., Conclusions: In this study, GSRC patients with stage II-III experienced improved overall survival after receiving adjuvant CRT, which provides several treatment implications. More clinical trials will be needed to verify the conclusion derived from this study., (© 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Background: The theory of allostatic load has gained momentum in perinatal research to understand the biological pathways of the impact of maternal chronic stress on adverse perinatal outcomes. However, due to physiological changes of pregnancy, including large variations across gestation, the extent to which allostatic load measured in pregnancy is valid has not been queried in depth., Objectives: This study aimed to assess the gestational patterns of selected individual allostatic load indicators and to explore whether a pregnancy allostatic load index score had face validity in relation to chronic sociodemographic stress., Design: This is a secondary analysis using data from the 1999-2006 National Health and Nutrition Examination Survey., Methods: A total of 1056 pregnant women were included for analyses. Using ten physiological indicators commonly included in an index of allostatic load, we described individual indicator and index score patterns across gestation and assessed differences in allostatic load index scores between women with and without sociodemographic stress., Findings: The average allostatic load index score at any gestational month was not statistically significantly different from the average allostatic load index score in the non-pregnant sample. We also found the allostatic load index score remained steady across gestational month, despite very different gestational patterns of individual allostatic load indicators, as long as gestation-specific risk quartiles were used to calculate the allostatic load index score. Face validity was affirmed via higher allostatic load index scores in women with sociodemographic stress compared to those without such stress., Conclusion: Our study suggests that measuring allostatic load in pregnancy is valid for reflecting women's true physiological functions and chronic stress, but gestational age should be considered when scoring the allostatic load index for women at different gestational age., Implications for Practice: As a valid measure of chronic stress, a pregnancy allostatic load index may contribute to research on health inequities and perinatal outcomes., Competing Interests: Declaration of Competing Interest Dr. Vanessa K. Dalton reports personal fees from Bayer, other from The Medical Letter, grants from Bill and Melinda Gates Foundation, grants from Blue Cross Blue Shield of Michigan Foundation (BCBSF), grants from NIH, grants from AHRQ, grants from ECOG-ACRIN Medical Research Foundation, grants from Laura and John Arnold Foundation, grants from Susan Thomas Buffett Foundation, grants from Society of Family Planning, grants from Harvey I. Neiman Health Policy Institute, grants from University of Michigan, outside the submitted work. All the other authors declared no actual or potential conflict of interest., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Background: Intimate partner violence (IPV) affects 1 in 3 US women with the effects of IPV detectable for several generations. While IPV is known to have significant impacts on maternal-child outcomes, little is known about the mother's perspectives of the interplay between perinatal IPV exposure, parenting styles, and safety strategies., Methods: This secondary analysis of semi-structured, longitudinal qualitative interview data explored with pregnant women their histories of IPV, their parenting practices, and safety strategies. Data were derived from a randomized controlled trial, DOVE, with 22 interviews from 11 women collected during pregnancy and 12 or 24 months postpartum., Results: Data were analyzed using constant comparative analysis resulting in three themes: "broken spirit," "I want better for my kids and me," and "safety planning as an element of parenting." Women described at baseline having a "broken spirit" due to their experiences with household and family chaos and childhood abuse. However, when mothers ended the abusive relationship, they described a better life and several strategies to protect themselves and their children. During their final interviews, mothers discussed how their lives improved after ending the relationship as well as safety planning strategies they employed like looking for "red flags" in potential partners, struggles with finding trustworthy childcare, and stockpiling money should they choose to end the relationship., Conclusion: These rich data add new information about how mothers of very young children navigate difficult parenting and safety decisions in the context of lifetime traumatic events and provide insights relevant for practice and research with this highly-vulnerable group of IPV survivors., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Hepatitis E virus (HEV) infection is the leading cause of acute hepatitis worldwide and can develop into chronic infection in immunocompromised patients, promoting the development of effective antiviral therapies. In this study, we performed a screening of a library containing over 1000 FDA-approved drugs. We have identified deptropine, a classical histamine H1 receptor antagonist used to treat asthmatic symptoms, as a potent inhibitor of HEV replication. The anti-HEV activity of deptropine appears dispensable of the histamine pathway, but requires the inhibition on nuclear factor-κB (NF-κB) activity. This further activates caspase mediated by receptor-interacting protein kinase 1 (RIPK1) to restrict HEV replication. Given deptropine being widely used in the clinic, our results warrant further evaluation of its anti-HEV efficacy in future clinical studies. Importantly, the discovery that NF-κB-RIPK1-caspase pathway interferes with HEV infection reveals new insight of HEV-host interactions., (Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.)

Urinary bladder cancer (UBC) has a high incidence rates in many southern and eastern European countries, in parts of Africa and the Middle East, and in North America. It exhibits a wide variety of histological types that goes from less aggressive to rapid-growing ones. In order to compare the different presentations, etiologies, and prognoses among racial groups, including NHW (non-Hispanic white), HW (Hispanic white), blacks, and API (Asian and Pacific Islander), we analyzed the UBC patients diagnosed between 1973 and 2014 using SEER (Surveillance, Epidemiology, and End Results) database. Patient characteristics, age-adjusted incidence rates, and survival were compared across races. There are significant racial differences in patients' characteristics, including gender, marital status, age at diagnosis, treatment strategies, grade, stage, survival time, and so on. Overall, non-Hispanic whites have the highest incidence rate, followed by blacks, Hispanic whites, and APIs. In the analysis of survival, significant racial differences exist when stratified by gender, age group, histological type, stage, location and treatment strategies. Racial differences exist among UBC patients in the United States in terms of characteristics, incidence, and survival. Future studies may collect and analyze more data for comprehensive description and interpretation of the racial differences.

Objective: To test the hypothesis that women with posttraumatic stress disorder (PTSD) have greater salivary cortisol levels across the diurnal curve and throughout gestation, birth, and the postpartum period than women who do not have PTSD., Design: Prospective, longitudinal, biobehavioral cohort study., Setting: Prenatal clinics at academic health centers in the Midwest region of the United States., Participants: Women expecting their first infants who fit with one of four cohorts: a nonexposed control group, a trauma-exposed control group, a group with PTSD, and a group with the dissociative subtype of PTSD., Methods: In the first half of pregnancy, 395 women provided three salivary cortisol specimens on a single day for diurnal data. A subsample of 111 women provided three salivary cortisol specimens per day, 12 times, from early pregnancy to 6 weeks postpartum for longitudinal data. Trauma history, PTSD, and dissociative symptoms were measured via standardized telephone diagnostic interviews with the use of validated epidemiologic measures. Generalized estimating equations were used to determine group differences., Results: Generalized estimating equations showed that women with the dissociative subtype of PTSD had the highest and flattest gestational cortisol level curves. The difference was greatest in early pregnancy, when participants in the dissociative subtype group had cortisol levels 8 times greater in the afternoon and 10 times greater at bedtime than those in the nonexposed control group., Conclusion: Women with the dissociative subtype of PTSD, a complex form associated with a history of childhood maltreatment, may have toxic levels of cortisol that contribute to intergenerational patterns of adverse health outcomes., (Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Background: NHL (non-Hodgkin lymphoma) consists of over 60 subtypes, ranging from slow-growing to very aggressive. The three largest subtypes are DLBCL (diffuse large B-cell lymphoma), FL (follicular lymphoma), and CLL/SLL (chronic lymphocytic leukemia/small lymphocytic lymphoma). For each subtype, different racial groups have different presentations, etiologies, and prognosis patterns., Methods: SEER (Surveillance, Epidemiology, and End Results) data on DLBCL, FL, and CLL/SLL patients diagnosed between 1992 and 2010 were analyzed. Racial groups studied included NHW (non-Hispanic whites), HW (Hispanic whites), blacks, and API (Asians and Pacific Islanders). Patient characteristics, age-adjusted incidence rate, and survival were compared across races. Stratification and multivariate analysis were conducted., Results: There are significant racial differences for patients' characteristics, including gender, age at diagnosis, stage, lymph site, and age, and the patterns vary across subtypes. NHWs have the highest incidence rates for all three subtypes, followed by HWs (DLBCL and FL) and blacks (CLL/SLL). The dependence of the incidence rate on age and gender varies across subtypes. For all three subtypes, NHWs have the highest five-year relative survival rates, followed by HWs. When stratified by stage, racial difference is significant in multiple multivariate Cox regression analyses., Conclusions: Racial differences exist among DLBCL, FL, and CLL/SLL patients in the U.S. in terms of characteristics, incidence, and survival. The patterns vary across subtypes. More data collection and analysis are needed to more comprehensively describe and interpret the across-race and subtype differences., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

The PSA screening for 25 years in America is the biggest cohort study in a field of public health.27 We should realize not only the significance of the early diagnosis and treatment of PCa, but also the dramatic decrease in PCaMR from 2002 to 2008. The data from the IARC were especially noteworthy.Moreover, the patients with highly aggressive PCa, who account for more than 30% of all PCa patients, could only be diagnosed earlier by PSA screening. The patients would thus gain the opportunity for earlier treatment and would have a prolonged, higher quality life-span. However, the complications of interventional treatments, including biopsy,radical prostatectomy and/or radiation therapy,will become more avoidable in the near future.According to the supporting evidence for the decrease in PCa mortality in PSA screening, we strongly hope that the USPSTF changes the 'D' recommendation for PSA screening.

Healthcare workers need to be protected during a severe influenza outbreak; therefore, we evaluated 4 different antiviral strategies: (1) using antiviral medication for outbreak prophylaxis of all hospital employees; (2) using antiviral medication for postexposure prophylaxis (PEP) or treatment of all hospital employees; (3) using a combination of antiviral medication for outbreak prophylaxis of high-risk clinical staff and postexposure prophylaxis or treatment for all other staff; and (4) using antiviral medication for postexposure prophylaxis or treatment of high-risk clinical staff only. Three different purchasing options were applied to each of the 4 antiviral strategies: (1) just-in-time purchase during a severe influenza outbreak, (2) prepandemic stockpiling, or (3) stockpiling through contracts with pharmaceutical manufacturers to reserve a predetermined antiviral supply. Although outbreak prophylaxis of all hospital employees would offer the maximum protection, the large costs associated with such a purchase make this option unrealistic and impractical. In addition, even though postexposure prophylaxis or treatment of only high-risk clinical staff would incur the least expense, the assumed level of protection if these options were offered only to high-risk clinical staff may not be sufficient to maintain routine hospital operations, since needed non-high-risk staff would not be protected. Considering the potential benefits and drawbacks of stockpiling antiviral medication from a cost perspective, it does not appear feasible for hospitals to stockpile antiviral medication in large quantities prior to a severe influenza outbreak. This article focuses on the financial viability of stockpiling antiviral medication, but the potential impact of other factors on the decision to stockpile was also considered and will be explored in future analyses. While legal hurdles related to prescribing, storing, and dispensing antiviral medication can be addressed, unavailability of a suitable vaccine supply may strongly support a decision to stockpile antiviral medication. Other issues to be addressed include antiviral resistance specifically related to the efficacy of oseltamivir, coupled with a high frequency of secondary bacterial infections; uncertainties about the degree of government assistance; potential government seizures of stockpiled assets; and legal and ethical concerns related to fair access to stockpiled medication. These issues may all be perceived as barriers to the feasibility of stockpiling antiviral medication.