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Background: The relationship between body mass index (BMI) and mortality in older adults diminished. It is necessary to examine other factors that may accurately predict mortality in older adults. The visceral adiposity index (VAI) is an uncomplicated marker specific to the gender that incorporates anthropometric data and lipid profiles. VAI has been proposed as a marker of visceral adipose tissue dysfunction and of the related cardiometabolic risk. The aim of this study was to evaluate the link of VAI with all-cause mortality among the elderly. Methods: The present prospective cohort study included data from 1999 to 2014 provided by the National Health and Nutrition Examination Survey (NHANES) in the United States. NHANES participants at or above the age of 65 were included. Data collection was carried out by taking face-to-face interviews, mobile-physical examinations, and lab tests. From the start of the survey to the end of December 2015, mortality-related follow-up statistics are available. The shape of the link between VAI and all-cause mortality was investigated using a restricted cubic spline model. Univariate- and multivariate-adjusted Cox proportional hazard models were estimated for VAI, and the results were presented as regression coefficients and 95% confidence intervals (CI). Results: The 82,091 NHANES participants represented 442.2 million noninstitutionalized residents of the United States. A total of 11,173 older individuals (representing 23.3 million; aged 73.4 ± 5.8 years; 56.3% women, 82.7% non-Hispanic Whites, 6.8% non-Hispanic Blacks, and 3.3% Mexican Americans) were included in the study. During the 80-month follow-up period, 4466 fatalities were reported, including 825 deaths from cancer, 867 from heart disease, and 211 from cerebrovascular disease. The restricted cubic spline model demonstrated a robust J-shaped link between VAI and all-cause mortality, revealing a significant decrease in risk within the lower range of VAI, which attained the lowest risk close to 1.7. With VAI greater than 1.7, the risk of mortality increased with the increase of VAI (P for non-linearity = 0.025). In the multivariate-adjusted model, the risk of all-cause mortality was 0.73 (0.56- 0.97) and 1.05 (1.01-1.09) in participants with VAI less than 1.7 and VAI greater than or equal to 1.7, respectively. Conclusion: This investigation is a population-based cohort study with high sample sizes and a long-term in older individuals follow-up that showed a J shaped link between VAI levels and all-cause mortality. Understanding the independent roles of VAI in the relationship between BMI and mortality is crucial to understanding the obesity paradox phenomenon. [ABSTRACT FROM AUTHOR]

To identify the relationship between clinical pathological characteristics and the recurrence score (RS) on a 21-gene expression assay in patients with hormone receptor–positive, node-negative breast cancer, as well as the effect of RS on adjuvant decision-making. The retrospective study was conducted among luminal breast cancer patients admitted to Xijing Hospital between October 10, 2016, and September 14, 2018. Real-time PCR was used for 21-genome detection. Based on the calculated RS, participants were classified into low-risk, moderate-risk, and high-risk groups. Single-factor analysis and multiple logistic regression analysis were performed to explore independent predictors of high RS. Moreover, the effect of RS on adjuvant decision-making was studied. Two hundred twenty-two patients with luminal breast cancer, aged 48.3 ± 9.66, were enrolled. Among them, 33.8% had low (13 ± 3.34), 45.5% intermediate (23 ± 3.65), and 20.7% high (37 ± 3.44) RS. According to the single-factor analysis, age, tumor size, Ki-67, molecular subtype, CK5/6 expression, E-cadherin level, and histological grade were positively associated with high RS. Multiple logistic analyses showed that tumor size and histological grade were independent variables that might predict high RS in patients with hormone receptor–positive, node-negative breast cancer. For adjuvant decision-making, the proportion of adjuvant chemotherapy in the intermediate-/high-risk groups was higher than that in the low-risk group, P < 0.001. Compared with the data worldwide, the changes of treatment selection in the present study were similar to those in Japan (23.0% vs. 26%) and America (23.0% vs. 23.0%). Considering the pathology types, 14.3% of patients with invasive breast cancer with lower RS changed treatment recommendations, predominantly from chemo-endocrine to endocrine treatment alone, whereas the percentage in intermediate/high RS groups was 8.1%. Tumor size and histological grade were independent variables, predicting high risk in patients with hormone receptor–positive, node-negative breast cancer; 21-gene RS assessment was potentially a critical tool in guiding adjuvant decision-making in China. • We enriched the data about the clinical significance of RS among Chinese patients. • Tumor size and histological grade were independent factors to 21 gene recurrence score. • 21-gene recurrence score value was promising in adjuvant decision-making for early breast cancer patients in China. [ABSTRACT FROM AUTHOR]

While it is widely acknowledged that conditionality has been used to install competition governance in economies in transition, little is known about how the European Union and the United States of America project their competition preferences to emerging markets and to what extent the EU and the US approaches have been conditioned by domestic factors in target jurisdictions. This article, drawing on theoretical concepts of external governance and policy diffusion, compares the horizontal engagement approaches of the EU and the US in the permeation of competition law and policy to Brazil and China. It argues that while engagement and market-based approaches are more reliant on domestic demand and a willingness to engage than hierarchical forms of interaction, a more institutionalized and constraining effort is more resilient to political interests. Norm deviation from expected convergence incurs measures of higher level of constriction. [ABSTRACT FROM AUTHOR]

Objectives. We assessed the relation of childhood sexual abuse (CSA), intimate partner violence (IPV), and depression to HIV sexual risk behaviors among Black men who have sex with men (MSM). Methods. Participants were 1522 Black MSM recruited from 6 US cities between July 2009 and December 2011. Univariate and multivariable logistic regression models were used. Results. Participants reported sex before age 12 years with someone at least 5 years older (31.1%), unwanted sex when aged 12 to 16 years (30%), IPV (51.8%), and depression (43.8%). Experiencing CSA when aged 12 to 16 years was inversely associated with any receptive condomless anal sex with a male partner (adjusted odds ratio [AOR] = 0.50; 95% confidence interval [CI] = 0.29, 0.86). Pressured or forced sex was positively associated with any receptive anal sex (AOR = 2.24; 95% CI = 1.57, 3.20). Experiencing CSA when younger than 12 years, physical abuse, emotional abuse, having been stalked, and pressured or forced sex were positively associated with having more than 3 male partners in the past 6 months. Among HIV-positive MSM (n = 337), CSA between ages 12 and 16 years was positively associated with having more than 3 male partners in the past 6 months. Conclusions. Rates of CSA, IPV, and depression were high, but associations with HIV sexual risk outcomes were modest. [ABSTRACT FROM AUTHOR]

Objectives. We examined lifetime incarceration history and its association with key characteristics among 1553 Black men who have sex with men (BMSM) recruited in 6 US cities. Methods. We conducted bivariate analyses of data collected from the HIV Prevention Trials Network 061 study from July 2009 through December 2011 to examine the relationship between incarceration history and demographic and psychosocial variables predating incarceration and multivariate logistic regression analyses to explore the associations between incarceration history and demographic and psychosocial variables found to be significant. We then used multivariate logistic regression models to explore the independent association between incarceration history and 6 outcome variables. Results. After adjusting for confounders, we found that increasing age, transgender identity, heterosexual or straight identity, history of childhood violence, and childhood sexual experience were significantly associated with incarceration history. A history of incarceration was also independently associated with any alcohol and drug use in the past 6 months. Conclusions. The findings highlight an elevated lifetime incarceration history among a geographically diverse sample of BMSM and the need to adequately assess the impact of incarceration among BMSM in the United States. [ABSTRACT FROM AUTHOR]

Organic corrosion inhibitors (OCIs), including ultraviolet light filters, arc widely used in plastics, rubbers, colorants, and coatings to increase the performance of products. Derivatives of benzotriazole (BTR), benzothiazole (BTH), and benzophenone (BP) are high-production volume OCIs that have been detected in the environment and human tissues. However, knowledge of their occurrence in indoor environments, as well as human exposure to them, is still lacking. In this study, BTR, BTH, BP and their 12 derivatives were determined in indoor dust for the first time. All three groups of OCIs were found in all 158 indoor dust samples from the U.S. and three East Asian countries (China, Japan, and Korea). The geometric mean (GM) concentration of the sum of six BTRs (GM CаBTRs.) ranged from 20 to 90 ng/g among the four countries studied, with a maximum CаBTRs, of ∼2000 ng/g found in a dust sample from China. Tolyltriazole was the major derivative of BTR measured in dust GM Ciam, in indoor dust from the four countries ranged from 600 to 2000 ng/g- 2-OH-BTH was die predominant BTH in dust from the U.S., Japan, and Korea. GM CаBTRs, in dust ranged from 80 to 600 ng/g, with 2-OH-4-MeO-BP and 2.4-20H-BP, contributing to the majority of ΣBP concentrations. Based on the concentrations of three types of OCIs in indoor dust, human exposure through dust ingestion was calculated. Daily intake of OCIs through dust ingestion was higher for people in the U.S., Japan, and Korea than in China; the residents in urban China are exposed to higher levels of OCIs via dust ingestion than are those in rural China [ABSTRACT FROM AUTHOR]

Despite reports of the occurrence of bisphenol A diglycidyl ether (BADGE) and its derivatives in canned foods and consumer products, biomonitoring studies of human exposure to these compounds are lacking. In this study, 127 urine samples collected from the U.S. and China were analyzed for free and total (free plus conjugated) concentrations of BADGE and its three derivatives, bisphenol A (2,3-dihydroxypropyl) glycidyl ether [BADGE·H2O], bisphenol A (3-chloro-2-hydroxypropyl) (2,3-dihydroxypropyl) ether [BADGE·HCl·H2O], and bisphenol A bis (2,3-dihydroxypropyl) ether [BADGE·2H2O], using high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). BADGE and its three derivatives (collectively referred to as BADGEs) were found in 100% of the urine samples analyzed. Total urinary concentrations of BADGEs in the U.S. ranged from 1.24 to 9.03 ng/mL, with a GM concentration of 3 ng/mL. Concentrations of BADGEs in urine from adults (GM: 1.36 ng/mL) and children (1.02 ng/mL) in China were 3-fold lower than the concentrations found in the U.S. Both free and conjugated forms of BADGEs were present in urine, and the proportion of free form was inversely related to the total concentration of BADGEs. Among the four BADGEs measured in urine, BADGE·2H2O was the predominant compound, accounting for 45–60% of the total BADGEs concentration, followed by BADGE (17–24%). The distribution of the four BADGEs varied, depending on age, gender, and ethnicity of the adults and children. Daily intake (DI) and effective daily intake (DIE) of BADGEs were estimated based on urinary concentrations, and their respective values were 69.4 and 9.16 ng/kg-bw/day for the U.S. population and 28.4 and 5.69 ng/kg-bw/day for the Chinese population. The concentrations of BADGEs in U.S. urine were 3- to 4-fold higher than the corresponding concentrations of bisphenol A. [ABSTRACT FROM AUTHOR]

The photocytotoxicity of 16 polycyclic aromatic hydrocarbons (PAHs) on the priority pollutant list of the United States Environmental Protection Agency (US EPA) were tested in human skin HaCaT keratinocytes. A selected PAH was mixed with HaCaT cells and irradiated with a solar simulator lamp for a dose equivalent to 5 min of outdoor sunlight and the cell viability was determined immediately and also after 24 h of incubation. For the cells without incubation after the treatments, it is found that all PAHs with three rings or less, except anthracene, are not photocytotoxic, while the four or five-ring PAHs (except chrysene), benz[a]anthracene, dibenzo[a,h]anthracene, benzo[ghl]peryleee, benzo[a]pyrene, indeno[1,2,3-cd]pyrene, benzo[b]fluorenthene, fluorenthene, and pyrene, are photocytotoxic to the human skin HaCaT keratieocytes. If the cells were incubated for 24 h after the treatments, the photocytotoxic effect of the PAHs was greatly amplified in comparison to the nonincubated cells. For the 24 h incubated cells, all PAHs except naphthalene exhibit photocytotoxicity to some extent. Exposure to 5 µM of the 4- and 5-ring PAHs (except chrysene) and 3-ring anthracene more than 80% of the cells lose viability. The photocytotoxicity of the PAHs correlates well with several of their excited state properties: light absorption, excited singlet-state energy, excited triplet-state energy, and HOMO-LUMO energy gap. All the photocytotoxic PAHs absorb light at >300 nm, in the solar UVB and UVA region. There is a threshold for each of the three excited state descriptors of a photocytotoxic PAH: singlet energy <355 kJ/mol (corresponding to 337 nm light), triplet energy <230 kJ/mol (corresponding to 520 nm light), HOMO-LUMO gap <3.6 eV (corresponding to 344 nm light) obtained at the Density Functional Theory B3LYP/6-31G(d) level. [ABSTRACT FROM AUTHOR]

It is a common phenomenon that women have to wait in a long line to use public restrooms more often than men do. This unequal restroom waiting between men and women needs to be resolved if equal opportunity for everyone is what we value, desire, and strive for in our society. The most direct and effective way to resolve this is through the building code system. However, without a clear and proper conceptual framework, as well as technical data on men's and women's restroom uses, the provisions of a restroom code may not serve men and women equally. Through knowledge management, this study defines and quantifies the goal of equal opportunity and proposes a conceptual framework for an equal opportunity restroom code. The current plumbing fixture requirements of both Taiwan's Building Code and the International Plumbing Code (IPC) and Uniform Plumbing Code (UPC) of the U.S. all have room for improvement towards equal opportunity between men and women. A knowledge management model of equal opportunity restroom codes that uses Taiwan's current code as the base model is presented to demonstrate the effectiveness and returns of knowledge management. The proposed conceptual framework for an equal opportunity restroom code can also apply to the IPC and UPC and benefits them by enabling them to become closer to equal opportunity than that which currently exists. [ABSTRACT FROM AUTHOR]

Deals with a study which evaluated the impact of the Rural Alabama Health Professional Training Consortium, a rural health center-based program in Alabama that began in 1990. Objectives of the rural health program; Measurement on the reaction of people towards the program; Evaluation of the professional perceptions on the program.

Cross cultural studies of infant emotional responses can shed light on the origins a group differences in adult emotional behavior as well as the processes involved in emotional development both within and across cultures in the U.S., a number of laboratory procedures have been developed that are thought to evoke emotions. In the present study, observer judgments of infant emotional responses were collected as an initial step in a larger investigation of American, Japanese, and Chinese infants' facial expressions of emotion. These data will enable to address several questions regarding the universality and ontogeny of infant facial expression. For example, we can determine whether American, Japanese, and Chinese infants produce different variants of prototypical emotional facial expressions identified for adults.

Secretory carcinoma of the breast (SCB) is a rather rare entity of invasive breast cancer, the clinicopathologic characteristics and survival outcomes remain to be elaborated. A retrospective review was conducted in SEER database. A total of 190 SCB patients identified in SEER were eligible for inclusion in the analysis. Median age at diagnosis was 56 years (range 2-96 years). Both sexes and bilateral breast could be affected. Intriguingly, the incidence of SCB tended towards to decreasing in recent decades. Small tumor burden was observed with a mean tumor size of 2.13 cm. In a subgroup with sufficient details, positive staining of estrogen receptor (ER) and progesterone receptor (PR) was 58% and 40%, respectively. The vast majority of patients were of well to moderate differentiation (86.86%) and negative regional lymph nodes involvement (70.71%). Nearly half of the patients took radiotherapy and chemotherapy. Seniors were inclined to have an inferior breast cancer specific survival (BCSS) than their younger counterparts (P = 0.018). Patients underwent breast conserving surgery (BCS) and radiotherapy had much better BCSS than its mastectomy counterparts (P = 0.014). Collectively, SCB is a clinical indolent invasive breast cancer with excellent prognosis. BCS in conjunction with radiotherapy would be a rational alternative for this distinct entity., (© 2021. The Author(s).)