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Aims: To visualize the trends and hotspots in the scientific research related to vascular cognitive impairment (VCI) quantitatively and qualitatively. Methods: Cross‐sectional bibliometric analysis of publications that related to VCI was conducted. Publications were found by searching in the Web of Science Core Collection database (WoSCC) – Edition: Science Citation Index Expanded (SCI‐Expanded) from January 2000 to December 2021. Publication type was restricted to article and review in the English language. The downloaded data were screened and analyzed in January 2022. Results: In total, 16,264 publications were identified, with a steady increase in annual publications. The United States was the leading country in VCI research regarding publication numbers and national influence. National Institute of Aging had the highest influence among all the institutes in the field of VCI. Philip Scheltens was the most active author. The top five active authors' publications focused on pathobiology, neuroimaging standards, risk factors, prevention, and the standard diagnosis of vascular dementia (VaD). A co‐cited publication clustering resulted in 19 main clusters, and the prevention, blood–brain barrier, cholesterol, cerebral amyloid angiopathy, and VaD were the top 5 clusters. Moreover, burst keywords detection revealed that the "small vessel disease" is the current hotspot in the field of VCI. Conclusions: This bibliometric analysis mapped the overall research structure of VCI and analyzed the current research trends and hotspots for future studies orientation. Neuroimaging, risk factors detection, and pathobiology are the current trends in VCI research. Small vessel disease and its mechanisms are the current hotspots of VCI research. [ABSTRACT FROM AUTHOR]

The planetary boundary layer (PBL) governs the vertical transport of mass, momentum, and moisture between the surface and the free atmosphere, and thus the determination of PBL height (BLH) is recognized as crucial for air quality, weather, and climate analysis. Although reanalysis products can provide important insight into the global view of BLH in a seamless way, the BLH observed in situ on a global scale remains poorly understood due to the lack of high-resolution (1 or 2 s) radiosonde measurements. The present study attempts to establish a near-global BLH climatology at synoptic times (00:00 and 12:00 UTC) and in the daytime using high-resolution radiosonde measurements over 300 radiosonde sites worldwide for the period 2012 to 2019, which is then compared against the BLHs obtained from four reanalysis datasets, including ERA5, MERRA-2, JRA-55, and NCEP-2. The variations in daytime BLH exhibit large spatial and temporal dependence, and as a result the BLH maxima are generally discerned over the regions such as the western United States and western China, in which the balloon launch times mostly correspond to the afternoon. The diurnal variations in BLH are revealed with a peak at 17:00 local solar time (LST). The most promising reanalysis product is ERA5, which underestimates BLH by around 130 m as compared to radiosondes released during daytime. In addition, MERRA-2 is a well-established product and has an underestimation of around 160 m. JRA-55 and NCEP-2 might produce considerable additional uncertainties, with a much larger underestimation of up to 400 m. The largest bias in the reanalysis data appears over the western United States and western China, and it might be attributed to the maximal BLH in the afternoon when the PBL has risen. Statistical analyses further indicate that the biases of reanalysis BLH products are positively associated with orographic complexity, as well as the occurrence of static instability. To our best knowledge, this study presents the first near-global view of high-resolution radiosonde-derived boundary layer height and provides a quantitative assessment of the four frequently used reanalysis products. [ABSTRACT FROM AUTHOR]

Summary: Background: The criticism of the literature on smoking during pregnancy and offspring overweight was the confounding from postnatal factors. Interaction between gestational age and prenatal maternal smoking has not yet assessed. Methods: We used the Third National Health and Nutrition Examination Survey (1988‐1994), linked with natality files of US‐born singletons aged 2 to 6 years. A body mass index in the 85th percentile or higher were considered overweight, including obesity. Gestational age was dichotomized as preterm (<37 weeks, n = 240) or full‐term (n = 2125). Smoking status during pregnancy was ascertained by a questionnaire‐based interview during National Health and Nutrition Examination Survey. Results: The prevalence of offspring overweight and obesity combined was 17.3% (SE = 1.3%). And 24.0% (1.3%) of mothers smoked while pregnant. A significant interaction was observed between maternal smoking and gestational age. In preterm children, a higher prevalence of overweight (34.3% [6.7%]) was found among the offspring of smoking mothers compared to non‐smoking mothers (15.8% [3.6%]). After adjustment for socio‐demographics, prenatal and postnatal factors, in preterm born offspring, the odds ratio of being born to smoking mothers was 2.46 (95% confidence intervals: 1.13‐5.37) among children with overweight/obesity compared to children with healthy weight born to non‐smoking mothers. In full‐term children, the OR of being born to smoking mothers was 0.72 (0.50‐1.03) among offspring with overweight/obesity relative to offspring with healthy weight born to non‐smoking mothers. Conclusions: Maternal smoking during pregnancy was strongly associated with offspring overweight and obesity in preterm births after control for postnatal factors. Preterm children of smoking mothers should be prioritized for obesity prevention. [ABSTRACT FROM AUTHOR]

Objective To explore the association between retinopathy and arthritis in a representative sample in the United States. Methods National Health and Nutrition Examination Survey (NHANES) is a series of biannual surveys in a nationally representative non-institutionalized population of the United States. Two waves of NHANES (2005–2008) were merged in the current analysis. Arthritis status and types of arthritis were obtained from questionnaires. Non-mydriatic fundus photographs were collected among participants aged 40 years and older and retinopathy status was assessed using the Airlie House classification scheme. The association between arthritis and retinopathy was evaluated using logistic regression models. Results From 6,797 eligible participants, 4,901 had information in terms of arthritis status and gradable fundus photographs of at least 1 eye. Retinopathy was less prevalent in patients with osteoarthritis compared with those without osteoarthritis (11.9% vs 17.5%, P <.05). Participants who had osteoarthritis had 43% reduced relative risk of retinopathy compared to those without, after adjusting for covariates (Odds Ratio [OR] = 0.57, 95% Confidence Interval [CI]: 0.33–0.98). This significant association persisted among diabetic participants (OR = 0.43, 95% CI: 0.19–1.00). However, no significant associations between any arthritis, rheumatoid arthritis, other types of arthritis and retinopathy were noted. Conclusions Patients with osteoarthritis were less likely to have retinopathy when compared with those without. Further studies investigating the possible protective effects of arthritis physiology and/or arthritis treatment in retinopathy are needed. [ABSTRACT FROM AUTHOR]

Objectives: We examined trends in prevalence rates of smoking and smoking cessation during pregnancy among women in the United States to assess achievement of Healthy People 2020 prevention targets. Methods: We assessed the smoking habits of 30 667 mothers whose children were born between 1985 and 2014 and who were sampled by the National Health and Nutrition Examination Survey, 1999-2014. Sampled participants were children aged 0-15 at the time of interview; however, an adult proxy—usually the biological mother—responded on the child’s behalf and reported information about maternal tobacco use during pregnancy. We calculated prevalence rates, adjusted odds ratios (aORs), and predicted annual increase or decrease of smoking and quitting smoking during pregnancy, adjusting for mother’s age at delivery and income level and child’s race/ethnicity and sex. Results: The average annual prevalence of smoking at any time during pregnancy decreased from 25.7% (95% confidence interval [CI], 15.3%-36.0%) in 1985 to 10.1% (95% CI, 7.1%-13.0%) in 2014 (P < .001), and quitting smoking at any time during the index pregnancy increased from 36.6% (95% CI, 20.3%-52.9%) in 1985 to 54.9% (95% CI, 44.4%-65.4%) in 2008 (P = .002). The adjusted annual risk of smoking during pregnancy decreased significantly by 3% (aOR = 0.97; 95% CI, 0.95-0.98; P < .001). The prevalence rate of smoking in the year 2020 extrapolated from the current trend would be 6.1%. Conclusions: Smoking during pregnancy in the United States is declining. However, renewed public health measures are needed to achieve the Healthy People 2020 objectives of preventing smoking among pregnant women in the United States. [ABSTRACT FROM AUTHOR]

This paper presents an analysis of existing financial incentive policies in the U.S. for integrated photovoltaic and battery energy storage (PV-BES) systems. A mathematical model of PV-BES system to evaluate annual energy performance is developed in this paper. Four types of buildings (i.e., hospital, large office, large hotel, and secondary school) located in four different states, which each has their own PV and/or BES incentives, are selected and analyzed. Based on the energy performance data for each building type, the simply payback period (PBP) for the PV-BES system in different locations is calculated according to the local incentive policies. The PBP is chosen as an indicator to evaluate the effectiveness of incentive policies for different locations and building types by comparing it to the PBP for the same PV-BES systems without incentive policies. The reduction of carbon dioxide emission (CDE) due to the PV generation is also investigated since it indicates the potential to reduce the PBP for a further step when a high carbon credit is available. Furthermore, a parametric analysis is conducted to determine the sensitivity and contribution of parameters such as the capacity of the PV-BES system, the capital cost of PV module and the battery storage on the performance of the PV-BES system. Results show that for all the evaluated buildings in California and Hawaii, the existing incentive policy could reduce the PBP effectively below 10 years. However, the PBP for most of the evaluated buildings in New Jersey and New York were high even when both the PV and BES incentive policies were taken into account (approximately from 11 to 29 years). [ABSTRACT FROM AUTHOR]

In recent years, combined heat and power (CHP) systems have gained more attention from the U.S. government. Both the federal government and the state government have proposed many incentive policies to promote CHP systems. This paper focuses on analyzing and evaluating the effectiveness of existing incentive policies for CHP systems in various U.S. states. In this paper, the existing incentive policies for CHP systems in different states are classified in four categories: capital cost rebate, tax credits, low tax loan, and utility credits. Four types of buildings including hospitals, large offices, large hotels, and primary schools, located in different U.S. regions, are selected and analyzed for the CHP incentives. Using the EnergyPlus simulation software, the energy consumption of each building is obtained. Then the simulation models of a CHP system are established for each building type. From the simulation results, the payback period of the CHP systems in different locations is calculated according to local incentive policies. This payback period is then compared with the one without regard for incentive policies. The results show that most of the incentive policies could obviously shorten the payback period in various U.S. regions, however some of them seem meaningless because some incentives were not effective enough to give a favorable payback period. This paper reveals that the type and level of incentives to promote CHP systems need to be carefully determined because the effectiveness and usefulness of incentive policies are highly dependent on the CHP performance due to the capacity of the power generation unit, the operational strategy of CHP system, the climate location, and the ratio of electricity cost to fuel cost. [ABSTRACT FROM AUTHOR]

ObjectiveThe purpose of this study was to examine how lifestyle behaviors in the context of physical activity levels and screen time are associated with school absenteeism. MethodsWe analyzed 2005–2008 NHANES data of proxy interviews for 1048 children aged 6–11 years and in-person self-reports of 1117 adolescents aged 12–18 years. Missing 10% of school days during the past school year was defined as severe school absenteeism (SSA). ResultsWatching TV ≥2 hours a day was significantly associated with SSA among both children (OR = 3.51 [1.03–12.0]) and adolescents (OR = 3.96 [1.84–8.52]) compared with their peers watching <2 hours a day. A U-shaped association was identified between the level of physical activity and SSA among children. Both inactive children (OR = 12.4 [1.43–108]) and highly active children (14.8 [2.82–77.7]) had higher odds of SSA compared with children with medium levels of physical activity. No associations were observed for either children 0.57 ([0.16–1.99]) or adolescents (0.94 [0.44–2.03]) using a computer ≥3 hours a day. LimitationsCross-sectional study involving self-reports. Transportation to and from school not included in physical activity assessment. Absenteeism was not validated with report cards. Unable to account for the absence type or frequency of illness or injury. No psychometric properties provided for subjective measures regarding participants’ attitudes and characteristic traits towards physical activity, TV viewing, and school attendance. ConclusionsExcessive TV watching among children and adolescents, and inactivity and high activity levels (≥7 times per week) among children are independently associated with severe school absenteeism. [ABSTRACT FROM PUBLISHER]

Little is known about the cause-specific deaths among young suicide attempters from the general population, and the time window for intervention to reduce the elevated rate of death was unclear. We analyzed a nationally representative sample of young adults (17–39 years old) who participated in the third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) and were followed up with vital status through December 31, 2006. The history of attempted suicide was associated with an increased rate for all-cause death (HR = 1.52 [95% CI = 0.92–2.52]) with borderline statistical significance. Previous suicide attempters experienced a 3-fold (HR = 2.68[=1.01–7.09]) increased rate for cardiovascular diseases (CVD), and a 7-fold (HR = 7.10 [95% CI = 1.37–36.9]) increased rate of death due to completed suicide compared with non-attempters. The survival curves of the attempters declined rapidly for the first 3 years of follow-up, and the distance between curves remained consistent starting from the third year to the end of the follow-up. Prevention services should be tailored not only for suicide, but also for cardiovascular diseases among populations with suicidal tendency, and the service should be intensified within first 3 years after suicidal behaviors occur. [ABSTRACT FROM AUTHOR]

Abstract: The pandemic A/H1N1 influenza viruses emerged in both Mexico and the United States in March 2009, and were transmitted efficiently in the human population. They were transmitted occasionally from humans to other mammals including pigs, dogs and cats. In this study, we report the isolation and genetic analysis of novel viruses in pigs in China. These viruses were related phylogenetically to the pandemic 2009 H1N1 influenza viruses isolated from humans and pigs, which indicates that the pandemic virus is currently circulating in swine populations, and this hypothesis was further supported by serological surveillance of pig sera collected within the same period. Furthermore, we isolated another two H1N1 viruses belonging to the lineages of classical swine H1N1 virus and avian-like swine H1N1 virus, respectively. Multiple genetic lineages of H1N1 viruses are co-circulating in the swine population, which highlights the importance of intensive surveillance for swine influenza in China. [Copyright &y& Elsevier]

This study explores error sources of the National Weather Service operational radar-based quantitative precipitation estimation (QPE) during the cool season over the complex terrain of the western United States. A new, operationally geared radar QPE was developed and tested using data from the National Oceanic and Atmospheric Administration Hydrometeorology Testbed executed during the 2005/06 cool season in Northern California. The new radar QPE scheme includes multiple steps for removing nonprecipitation echoes, constructing a seamless hybrid scan reflectivity field, applying vertical profile of reflectivity (VPR) corrections to the reflectivity, and converting the reflectivity into precipitation rates using adaptive Z- R relationships. Specific issues in radar rainfall accumulations were addressed, which include wind farm contaminations, blockage artifacts, and discontinuities due to radar overshooting. The new radar QPE was tested in a 6-month period of the 2005/06 cool season and showed significant improvements over the current operational radar QPE (43% reduction in bias and 30% reduction in root-mean-square error) when compared with gauges. In addition, the new technique minimizes various radar artifacts and produces a spatially continuous rainfall product. Such continuity is important for accurate hydrological model predictions. The new technique is computationally efficient and can be easily transitioned into operations. One of the largest remaining challenges is obtaining accurate radar QPE over the windward slopes of significant mountain ranges, where low-level orographic enhancement of precipitation is not resolved by the operational radars leading to underestimation. Additional high-resolution and near-surface radar observations are necessary for more accurate radar QPE over these regions. [ABSTRACT FROM AUTHOR]

Abstract: The risks and benefits of fish from markets in Chinese cities have not previously been fully evaluated. In the present study, 24 common fish species with more than 400 individual samples were collected from markets from five big Chinese cities in 2007. The main nutrients and contaminants were measured and the risk–benefit was evaluated based on recommended nutrient intakes and risk level criteria set by relevant authorities. The comprehensive effects of nutrients and contaminants in marine oily fish were also evaluated using the data of two related human dietary intervention trials performed in dyslipidemic Chinese men and women in 2008 and 2010, respectively. The results showed that concentrations of contaminants analyzed including DDT, PCB7, arsenic and cadmium were much lower than their corresponding maximum limits with the exception of the mercury concentration in common carp. Concentrations of POPs and n-3 LCPUFA, mainly EPA and DHA, were positively associated with the lipid content of the fish. With a daily intake of 80–100g marine oily fish, the persistent organic pollutants in fish would not counteract the beneficial effects of n-3 LCPUFA in reducing cardiovascular disease (CVD) risk markers. Marine oily fish provided more effective protection against CVD than lean fish, particularly for the dyslipidemic populations. The risk–benefit assessment based on the present daily aquatic product intake in Chinese urban residents (44.9 and 62.3g for the average values for all cities and big cities, respectively) indicated that fish, particularly marine oily fish, can be regularly consumed to achieve optimal nutritional benefits from n-3 LCPUFA, without causing significant contaminant-related health risks. However, the potential health threat from contaminants in fish should still be emphasized for the populations consuming large quantities of fish, particularly wild fish. [Copyright &y& Elsevier]

This study investigates evolving methodologies for radar and merged gauge-radar quantitative precipitation estimation (QPE) to determine their influence on the flow predictions of a distributed hydrologic model. These methods include the National Mosaic and QPE algorithm package (NMQ), under development at the National Severe Storms Laboratory (NSSL), and the Multisensor Precipitation Estimator (MPE) and High-Resolution Precipitation Estimator (HPE) suites currently operational at National Weather Service (NWS) field offices. The goal of the study is to determine which combination of algorithm features offers the greatest benefit toward operational hydrologic forecasting. These features include automated radar quality control, automated Z- R selection, brightband identification, bias correction, multiple radar data compositing, and gauge-radar merging, which all differ between NMQ and MPE-HPE. To examine the spatial and temporal characteristics of the precipitation fields produced by each of the QPE methodologies, high-resolution (4 km and hourly) gridded precipitation estimates were derived by each algorithm suite for three major precipitation events between 2003 and 2006 over subcatchments within the Tar-Pamlico River basin of North Carolina. The results indicate that the NMQ radar-only algorithm suite consistently yielded closer agreement with reference rain gauge reports than the corresponding HPE radar-only estimates did. Similarly, the NMQ radar-only QPE input generally yielded hydrologic simulations that were closer to observations at multiple stream gauging points. These findings indicate that the combination of Z- R selection and freezing-level identification algorithms within NMQ, but not incorporated within MPE and HPE, would have an appreciable positive impact on hydrologic simulations. There were relatively small differences between NMQ and HPE gauge-radar estimates in terms of accuracy and impacts on hydrologic simulations, most likely due to the large influence of the input rain gauge information. [ABSTRACT FROM AUTHOR]

Substantial evidence suggests that increasing adiposity is associated with an increased death rate of colorectal cancer, but no studies were conducted among national representative populations in the United States. The current study examined the death rate across BMI levels in 7,016 adults who participated in the National Health and Nutrition Examination Survey in 1971–1975. BMI categories were defined as normal (18.5–24.9 kg/m2), overweight (25–29.9), and obese (≥30). A total of 519 cancer deaths were identified during a 17-yr follow-up with 118,998 person-years. No significantly increased death rates of total cancers, lung, breast, and prostate cancer were observed among participants with an increased BMI. However, colorectal cancer death rates were 0.39, 0.68, and 0.96/1,000 person-years, respectively, for normal weight, overweight, and obese (P value for log-rank trend test < 0.001), and the corresponding adjusted hazard ratios [95% confidence intervals (CI)] were 1.00 (reference), 1.25 (95% CI = 0.72–2.19), and 2.04 (1.08–3.83), respectively. No gender difference of the association was identified. The authors conclude that a significantly increased death rate of colorectal cancer was associated with excess body weight. The current study is an addition to the expanding body of literature indicating an increased risk of colorectal cancer development among the obese. [ABSTRACT FROM AUTHOR]

The National Mosaic and Multi-sensor QPE (Quantitative Precipitation Estimation), or 'NMQ', system was initially developed from a joint initiative between the National Oceanic and Atmospheric Administration's National Severe Storms Laboratory, the Federal Aviation Administration's Aviation Weather Research Program, and the Salt River Project. Further development has continued with additional support from the National Weather Service (NWS) Office of Hydrologic Development, the NWS Office of Climate, Water, and Weather Services, and the Central Weather Bureau of Taiwan. The objectives of NMQ research and development (R&D) are 1) to develop a hydrometeorological platform for assimilating different observational networks toward creating high spatial and temporal resolution multisensor QPEs for flood warnings and water resource management and 2) to develop a seamless high-resolution national 3D grid of radar reflectivity for severe weather detection, data assimilation, numerical weather prediction model verification, and aviation product development. Through about ten years of R&D, a real-time NMQ system has been implemented (). Since June 2006, the system has been generating high-resolution 3D reflectivity mosaic grids (31 vertical levels) and a suite of severe weather and QPE products in real-time for the conterminous United States at a 1-km horizontal resolution and 2.5 minute update cycle. The experimental products are provided in real-time to end users ranging from government agencies, universities, research institutes, and the private sector and have been utilized in various meteorological, aviation, and hydrological applications. Further, a number of operational QPE products generated from different sensors (radar, gauge, satellite) and by human experts are ingested in the NMQ system and the experimental products are evaluated against the operational products as well as independent gauge observations in real time. The NMQ is a fully automated system. It facilitates systematic evaluations and advances of hydrometeorological sciences and technologies in a real-time environment and serves as a test bed for rapid science-to-operation infusions. This paper describes scientific components of the NMQ system and presents initial evaluation results and future development plans of the system. [ABSTRACT FROM AUTHOR]

We use systems thinking to develop a strategic framework for analyzing the tobacco problem and we suggest solutions. Humans are vulnerable to nicotine addiction, and the most marketable form of nicotine delivery is the most harmful. A tobacco use management system has evolved out of governments' attempts to regulate tobacco marketing and use and to support services that provide information about tobacco's harms and discourage its use. Our analysis identified 5 systemic problems that constrain progress toward the elimination of tobacco-related harm. We argue that this goal would be more readily achieved if the regulatory subsystem had dynamic power to regulate tobacco products and the tobacco industry as well as a responsive process for resourcing tobacco use control activities. [ABSTRACT FROM AUTHOR]

We report the results of a study that examines the association between gender and individuals’ intentions to report fraudulent financial reporting using non-anonymous and anonymous reporting channels. In our experimental study, we examine whether reporting intentions in response to discovering a fraudulent financial reporting act are associated with the participants’ gender, the perpetrator’s gender, and/or the interaction between the participants’ and perpetrator’s gender. We find that female participants’ reporting intentions for an anonymous channel are higher than for male participants; the fraud perpetrator’s gender and the interaction with participants’ gender were not significantly associated with anonymous channel reporting intentions. Neither of the two factors nor the interaction between the two factors was associated with reporting intentions to a non- anonymous reporting channel. Results from an additional analysis indicate that male and female participants differ in the extent to which they judge the reduction in personal costs of an anonymous reporting channel compared to a non-anonymous reporting channel and that the reduction in personal costs mediates the relationship between participant gender and anonymous reporting intentions. [ABSTRACT FROM AUTHOR]

To increase the awareness and practice of breast health guidelines, a media-based education campaign on breast health was launched among immigrant Chinese community in San Francisco. The media campaign included airing two public service announcements (PSAs) on Chinese television and radio stations and publishing the same message in Chinese newspapers during 2000. Seven-hundred-ten face-to-face interviews were conducted with women who were recruited from various settings in the city of San Francisco to evaluate the impact of the campaign. Survey participants were asked to describe the content of the PSAs. Having viewed the PSA was significantly associated with the ability to identify all four guidelines (OR = 1.96; 95% CI: 1.35–2.85), knowing how to perform breast self-exam (BSE; OR = 2.25; 95% CI: 1.53–3.29), having performed BSE within the past month (OR = 3.12; 95% CI: 2.05–4.74), and having a clinical breast exam (CBE; OR = 2.98; 95% CI: 1.82–4.90) and mammogram (MAM; OR = 1.97; 95% CI: 1.16–3.36) in the past year. The study findings support that a media campaign utilizing PSAs is effective in improving knowledge of breast health guidelines, teaching Chinese women how to (BSEs), and increasing breast health practices. [ABSTRACT FROM AUTHOR]

Abstract: Liver cancer, especially hepatocellular carcinoma (HCC), is particularly prevalent in Africa and Asia. HCC affects the Hispanic population of the United States at a rate double that of the white population. The majority of people with HCC will die within 1 year of its detection. This high case-fatality rate can in part be attributed to lack of diagnostic methods that allow early detection. How to establish a methodology to identify the high-risk individuals for HCC remains to be investigated. The multi-factorial and multi-step nature in the molecular pathogenesis of human cancers must be taken into account in both the design and interpretation of studies to identify markers which will be useful for early detection of cancer. Our recent studies demonstrated that a mini-array of multiple tumor-associated antigens (TAAs) might enhance autoantibody detection for diagnosis of HCC, especially for the alpha fetoprotein (AFP)-negative cases. It also suggested that different types of cancer might require different panels of TAAs to achieve the sensitivity and specificity required to make immunodiagnosis a feasible adjunct to tumor diagnosis. [Copyright &y& Elsevier]

Purpose: To identify the significant factors associated with attempted suicide among men and women, and determine whether socioeconomic status (SES) and social support indictors, health risk factors, and lifetime history of medical and psychiatric illnesses can explain gender differences in attempted suicide. Methods: We used data from 3357 men and 4004 women aged 17 to 39 years, who completed a mental disorder diagnostic interview as a part of the Third National Health and Nutrition Examination Survey, 1988–1994. Adjusted odds ratios (ORs) were calculated for the association between risk factors and attempted suicide. Results: The prevalence of lifetime attempted suicides was 7.58% (SE, 0.66) in women and 3.69% (SE, 0.49) in men. In men, low income and smoking were associated with attempted suicide, while attempted suicide in women was associated with poor self-evaluated health, low educational attainment, and drug use. A history of medical and psychiatric illnesses was associated with attempted suicide in both genders, for cancer/pulmonary disease, OR=2.89 (95% CI, 1.25–6.67) in men and 1.94 (1.09–3.45) in women; for major depressive disorder, OR=9.86 (5.08–19.14) in men and 5.00 (3.19–7.83) in women. The significant gender difference of attempted suicide prevalence remained after being adjusted for risk factors selected. Conclusion: There were significant gender differences in the risk factors for attempted suicide among young adults, and the gender difference in the prevalence of lifetime attempted suicides could not be explained by differential exposure to risk factors selected. [Copyright &y& Elsevier]

This paper presents a case study on the seismic response of a recently constructed freeway overcrossing located in southern California, which is equipped with elastomeric bearings and fluid dampers at its end abutments. The analysis employs the substructure method and a reduced order stick model. The macroscopic constitutive laws of the springs and dashpots that approximate the mechanical behavior of approach embankments, pile foundations, center bent, abutments, elastomeric bearings, and fluid dampers are established in the companion paper. The paper presents an in-depth analysis of the seismic response of the bridge equipped with the response modification devices accounting for the effects of soil–structure interaction. The various response quantities presented are compared with the corresponding response quantities of a hypothetical bridge with integral abutments. Advantages and challenges in the two design configurations are identified and discussed. [ABSTRACT FROM AUTHOR]

Terrain and radar beam-elevation data are used to examine the spatial coverage provided by the national operational network of Doppler weather radars. This information is of importance to a wide variety of users, and potential users, of radar data from the national network. Charts generated for radar coverage at 3 and 5 km above mean sea level show that radar surveillance near 700 and 500 hPa is very limited for some portions of the contiguous United States. Radar coverage charts at heights of 1, 2, and 3 km above ground level illustrate the extent of low-level radar data gathered above the actual land surface. These maps indicate how restricted the national radar network coverage is at low levels, which limits the usefulness of the radar data, especially for quantitative precipitation estimation. The analyses also identify several regions of the contiguous United States in which weather phenomena are sampled by many adjacent radars. Thus, these regions are characterized by very comprehensive radar information that could be used in many kinds of research studies. [ABSTRACT FROM AUTHOR]

Discusses the creation of an effective instructional delivery system for the culturally and ethnically diverse learners in the United States. Rhetoric of educational technology; Degree of cultural sensitivity; Incorporation of cultural pluralism into instruction; Criteria to evaluate a good culturally balanced-program.

Homeowners across the globe are continually seeking methods of improving energy efficiency for financial benefit and personal satisfaction. From small contributions such as swapping light bulbs to large capital investment initiatives like upgraded heating and cooling systems, homeowner decisions require accurate data and confidence in potential outcomes. This study models the path to net-zero energy for two separate heating, ventilation and air conditioning (HVAC) plus solar photovoltaic (PV) systems in residential buildings across 12 Unites States climate zones, and determines the optimal combination for each climate zone. An existing, traditional air-conditioning system with natural gas furnace is paired with a PV array. The net-zero results are compared to the same residence upgraded to a climate-customized geothermal heat pump HVAC system paired with a PV array. Results confidently favor the geothermal HVAC system + PV for climates with a significant heating demand in winter, and the baseline + PV system for cooling-dominant climates, exceeding $3,900 and $3,500 annual household savings, respectively. A major contribution is the introduction of a template that predicts the net-zero system option for climate zones outside the 12 studied. Patterns in local soil properties, sun intensity and financial incentives allow for net-zero system predictions nationwide. For example, all locations resulting in a baseline + PV net-zero system have strong sun intensity ratings. This research delivers climate-specific recommendations for the preferred net-zero HVAC + PV system through analysis of accurate energy performance and financial forecasting. Recommendations provide homeowners with valuable expectations on two HVAC + PV options along the path to a net-zero energy home. • Baseline electrical cooling/gas heating compared to geothermal heat pump system. • Climate-specific net-zero energy residential building recommendations. • Massive savings potential and short payback period in cold climates. • Net-zero energy system prediction method introduced through critical factors. • Consumer decision driver analysis for energy-efficiency projects. [ABSTRACT FROM AUTHOR]

Geothermal residential heating and cooling systems have undeniable potential savings. The possibilities of the energy savings with a geothermal heat pump system is well-established in the commercial and residential sectors. Building location has a critical impact on the performance of geothermal heat pump systems and magnitude of savings. An important contribution of this paper takes the step past technological optimization to investigate 12 climate zones across the contiguous United States. Residential homes within common neighborhoods are thoroughly analyzed by considering soil characteristics and home construction features. Within these climate zones, federal and all local incentive programs are quantified to determine an accurate expectation for capital investment payback period, a critical factor for system attractability. Ultimately, a climate zone is classified as either a promising or poor candidate for residential geothermal technology based on data from previously conducted human interest polls regarding payback period on energy savings investments. With such lasting potential delivered to the hands of consumers, geothermal energy use still experiences slow implementation. This paper conducts a study integrating data on technology, finances, and human nature to identify the prevailing barrier to widespread geothermal execution. Solid evidence on energy and monetary savings reveals the dominant barriers are initial capital investment and long payback period. This paper highlights the immense positive impact that local incentives have on affecting these two prevailing deterrents. • United States nationwide investigation of current state of residential geothermal technology deployment. • Climate-specific geothermal heat pump energy and financial analysis. • Barriers to widespread residential geothermal technology implementation. • Template for neighborhood customizable geothermal energy potential and policy status. [ABSTRACT FROM AUTHOR]

Introduction: As obesity prevalence has increased, adolescents' self-perceived body weight might have shifted accordingly. This study aims to investigate the generational shift in adolescents' perception of their body weight.Methods: We used data from adolescents aged 12-16 years who participated in the National Health and Nutrition Examination Survey in 1988-1994 (early, n=1,720) or 2007-2012 (recent, n=2,518). Self-perceived weight status was assessed by face-to-face interviews, and BMI z-scores were calculated using directly measured weight and height with the 2000 CDC Growth Charts as the reference. The analysis was conducted in 2013.Results: The median BMI z-score of self-perceived overweight adolescents increased from 1.32 (95% CI=1.18, 1.46) among adolescents interviewed early to 1.82 (1.74, 1.90) among adolescents interviewed recently. After adjusting for age, race/ethnicity, sex, and family income, the probability of self-perceiving as "overweight" declined by 29% for overweight/obese adolescents interviewed recently (probability ratio [PR]=0.71 [0.62, 0.82]) compared with adolescents with the same z-scores but interviewed early. The declining tendency of accurately self-perceiving as overweight was most pronounced among whites (PR=0.64 [0.48, 0.85]), and least among blacks (PR=0.76 [0.58, 0.99]). Both boys and girls interviewed recently were significantly less likely to accurately self-perceive as overweight (PR=0.70 [0.56, 0.89] and 0.73 [0.61, 0.87], respectively) compared with their counterparts who were interviewed early.Conclusions: Fewer overweight/obese adolescents self-perceived as such in the 2007-2012 survey compared with the 1988-1994 survey. The declining tendency among overweight or obese adolescents may be indicative of a generational shift in body weight perceptions. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Serum cholesterol was reported to be associated with depressed mood, but the studies conducted among household population are rare. Methods: We used the data of 4115 men and 4275 women aged 18 or older, who completed a depression screening interview and had blood collected as a part of the National Health and Nutrition Examination Survey, 2005–2008. The serum concentrations of total cholesterol, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were gender-specifically categorized into lower, intermediate, and upper quartiles. Depression was measured using the Patient Health Questionnaire, a 9-item screening instrument asking about the frequency of depression symptoms over the past 2weeks. Results: After adjustment for socio-demographics and behavioral risks, a U-shaped association was detected between severe depression and LDL-C among men. The odds ratios (ORs) of severe depression were 5.13 (95% CI=1.74–15.09), 1 (reference) and 2.28 (1.07–4.86) respectively for the men with lower (<169mg/dL), intermediate (169–221mg/dL), and upper quartile (≥222mg/dL) LDL-C. Among women, lower HDL-C was significantly associated with an elevated odds of severe depression [OR=2.96 (1.59–5.52)] compared with upper quartile of HDL-C, the association diminished after adjustment for covariates [OR=1.24 (0.66–2.32)]. No clear pattern of association between cholesterol and moderate depression was observed from either men or women. Limitation: The inherent limitation of cross-sectional design prevented the authors from investigating causality. Conclusions: A U-shaped association was identified between LDL-C and severe depression among men. Further studies are necessary to explore the biological mechanism and identify the clinical implication among populations vulnerable to psychiatric disorders. [Copyright &y& Elsevier]

Objectives: To compare the prevalence, symptoms, and pathologic changes related to chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) with significant prostatitis-like symptoms between 2 altitude areas in northwest China. Methods: From October 2009 to March 2010 community male residents at 3000 m (Delingha) and 400 m (Xi''An) constituted the population base for the present cross-sectional study. All participants completed a detailed questionnaire containing the National Institutes of Health Chronic Prostatitis Symptom Index, and the subjects who met our definition were invited to undergo clinical evaluation. After screening, the subjects considered to have CP/CPPS were separated into 2 groups: those with type IIIa and those with type IIIb CP/CPPS. Results: The prevalence of CP/CPPS with significant prostatitis-like symptoms was significantly different between the 2 groups. Moreover, the National Institutes of Health Chronic Prostatitis Symptom Index of patients with type IIIa and IIIb in 2 groups differed significantly, indicating the aggravation of symptoms of CP/CPPS at a high altitude. Additional investigations showed that reactive oxygen species were increased, accompanied by a decrease in the total antioxidant capacity in the expressed prostatic secretions of patients with type IIIa at a higher altitude. In addition, the tumor necrosis factor-α, interleukin-8, and interleukin-10 levels in the expressed prostatic secretions of patients with type IIIa in Delingha were increased compared with that in the patients with type IIIa in Xi''An. Notably, the interleukin-6 level in the expressed prostatic secretions was greater in those with type IIIa and IIIb at a higher altitude than in those with type IIIa and IIIb at a low altitude. Conclusions: At a high altitude, the symptoms of CP/CPPS were aggravated. Oxidative stress and cytokines might involve in the pathologic process and the aggravation of symptoms. In addition, in a high altitude area the pathomechanisms of type IIIa and IIIb CP/CPPS differed. [ABSTRACT FROM AUTHOR]

Objective: Environmental tobacco smoke exposure (ETSE) was race/ethnicity-specific, but how the race/ethnicity-specific ETSE has changed over time, diverging or converging, remains unclear. We examined ETSE trends by race/ethnicity in US children aged 3-11 years., Methods: We analyzed the data of 9678 children who participated in the biennial National Health and Nutrition Examination Surveys, 1999-2018. ETSE was defined as serum cotinine ≥ 0.05 ng/ml, with ≥ 1 ng/ml as heavy exposure. For trend description, adjusted biennial prevalence ratios (abiPR: the ratio associated with a 2-year increase in time) were estimated by race/ethnicity. The prevalence ratios between races/ethnicities were used to quantify ethnoracial differences in different survey periods. Analyses were performed in 2021., Results: The overall ETSE prevalence was cut by almost half, from 61.59% (95% confidence interval = 56.55%, 66.62%) in the 1999-2004 survey to 37.61% (33.90%, 41.31%) in 2013-2018, exceeding the national 2020 health target (47.0%). However, the decrease occurred unequally between races/ethnicities. Heavy ETSE declined significantly in white [abiPR = 0.80 (0.74, 0.86)] and Hispanic children [0.83 (0.74, 0.93)], but insignificantly in black children [0.97 (0.92, 1.03)]. Consequently, the adjusted prevalence ratio between black children and white children increased from 0.82 (0.47, 1.44) in 1999-2004 to 2.73 (1.51, 4.92) in 2013-2018 for heavy ETSE. Hispanic children remained at the lowest risk throughout the study period., Conclusion: Overall ETSE prevalence was cut by half between 1999 and 2018. However, due to uneven declines, the gaps between black children and others have expanded in heavy ETSE. Special vigilance is needed in preventive medicine practice with black children., (© 2023. W. Montague Cobb-NMA Health Institute.)

" Acupuncture Anesthesia in the People's Republic of China： A Trip Report of the American Acupuncture Anesthesia Study Group " ( Report for short) is the first extraterritorial systematic investigation and evaluation report in the history of acupuncture anesthesia in China. After Report was released to the public, it has not drawn much attention in China. At the moment when acupuncture anesthesia is extended to perioperative treatment, by reviewing the Report , the differences in understanding acupuncture anesthesia were analyzed from a foreign perspective. Report involves the clinical observation of surgery under acupuncture anesthesia, the analysis on the factors of acupuncture anesthesia in therapeutic effects and the relevant mechanisms, and the differences in the research methods and foci on the recognition of acupuncture anesthesia between China and foreign countries. In association with the development of acupuncture anesthesia during the past 65 years and the conclusion in Report , the paper briefly describes the development and perfection of acupuncture anesthesia, the historical verification to the conclusions in Report and the limitations in modern acupuncture anesthesia. It provides some inspiration for the development of acupuncture anesthesia, acupuncture-moxibustion medicine and life science in the future.

Background: The management of chemotherapy induced anemia (CIA) remains challenging. The potential risk and benefits in providing patient-centered care need to be balanced; the disease is multifactorial; and the major treatments including red blood cell (RBC) transfusions, erythropoiesis-stimulating agents (ESAs) and intravenous injection (i.v.)iron supplementation have a unique set of strengths and limitations. Also, most previous survey based on the patient data could not reveal the process of evaluation and decision-making for CIA treatment from a physician's perspective. As the comparison of China Society of Clinical Oncology (CSCO), National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) guidelines, the standard of CIA treatment in China will vary from United States and Europe, for example, the initial hemoglobin (Hb) for RBC transfusions. In order to understand the diagnosis, treatment, and unmet medical needs of CIA patients, the China Medical Education Association (CMEA), in conjunction with Cancer Hope Medium, initiated the first national survey of Chinese physicians regarding the diagnosis and treatment of CIA., Methods: The CMEA sent an online, 12-item questionnaire (via wjx.cn) to physicians across China from September 1, 2022 to October 22, 2022. Two hundred and sixty-five samples were calculated usingsurveyplanet.com. The questionnaire evaluated the impact of anemia on chemotherapy interruption, initial treatment, the target Hb level of CIA in, and the current status of ESAs prescription in clinical practice. Respondents were asked to score their reasons for not using ESAs (including safety issues, drug access in practice or adherence) and the risk options of the current treatment including ESAs, RBC transfusion, and i.v.iron., Results: A total of 331 questionnaires among 5,000 web visits were gathered, covering 247 hospitals in 29 provinces across China, of which 130 (53%) were tier IIIA hospitals, 50 (20%) were tier III B hospitals, 59 (24%) were tier IIA hospitals, and 8 (3%) were tier II B hospitals. The frequency of chemotherapy dose delay/reduction due to anemia was 24% [standard deviation (SD) 49%]. Most responding physicians rated an initial Hb level for ESAs treatment to be 80 g/L, with a favorable Hb level for chemotherapy being 100 g/L (60%), which would not limit treatment availability. The majority (67.6%, n=221) of physicians who responded indicated that they had used ESAs for anemia correction, while the others (32.4%, n=106) reported never using them., Conclusions: This is the first study in conducting a large-scale survey on the diagnosis and treatment of CIA in China from a physicians' perspective. We found that in China, nearly one-quarter of patients undergoing chemotherapy with concurrent anemia may experience interruption of chemotherapy and that the initiation of anemia treatment is not adequately timed. In treating CIA, most physicians prioritize the completion of chemotherapy via Hb level over treating the symptoms of anemia.

Objective: This meta-analysis and systematic review were conducted to comprehensively evaluate the efficacy and safety of mesenchymal stem cells in patients with acute ischemic stroke., Method: We conducted a manual search of electronic databases, including PubMed, Embase, the Cochrane Library, and Web of Science, with a search deadline set for February 1, 2023. Data analysis was performed using Stata version 15.0., Result: A total of 9 randomized controlled studies were included, involving a total of 316 people, including 159 mesenchymal stem cells and 147 control groups. Results of meta-analysis: Compared to a placebo group, the administration of mesenchymal stem cells resulted in a significant reduction in the National Institutes of Health Stroke Scale (NIHSS) scores among patients diagnosed with acute ischemic stroke [SMD=-0.99,95% CI (-1.93, -0.05)]. Compared to placebo, barthel index [SMD = 0.48,95% CI (-0.55,1.51)], modified rankin score [SMD = 0.45, 95% CI (1.11, 0.21)], adverse events (RR = 0.68, 95% CI (0.40, 1.17)] the difference was not statistically significant., Conclusion: Based on current studies, mesenchymal stem cell transplantation can ameliorate neurological deficits in patients with ischemic stroke to a certain extent without increasing adverse reactions. However, there was no significant effect on Barthel index and Modified Rankin score., (© 2024. The Author(s).)

Background: Humans are constantly exposed to various volatile organic compounds (VOCs) because of their widespread sources and characteristic of easy evaporation. Existing evidence regarding the association between VOC exposure and osteoarthritis (OA) risk is limited., Purpose: This study aimed to investigate the associations between individual urinary VOC metabolites (VOCMs) and the VOCM mixture, representing internal exposure levels of VOCs, with prevalent OA risk and to explore the mediating effect of aging and oxidative stress (OS) in these associations., Methods: Data from the National Health and Nutrition Examination Surveys 2005-2020 were analyzed. Weighted generalized linear regression was employed to explore the associations between individual VOCMs and OA risk, as well as aging and OS biomarkers. A five-repeated ten-fold cross-validation elastic net model was used to identify critical VOCMs for the weight quantile sum (WQS) analysis, which was performed to explore the VOCM mixture and OA risk association. Parallel and serial mediation analyses were conducted to identify the potential mediators and mediation pathways., Results: This study included 6578 American adults aged ≥40 years, among whom 1052 (16.0 %) individuals reported prevalent OA. Urinary levels of N-acetyl-S-(benzyl)-L-cysteine, mandelic acid and phenylglyoxylic acid were positively associated with OA risk. Eleven VOCMs with nonzero coefficients were identified and included in the WQS analysis, and results revealed an average increase of 24.4 % in OA risk (OR = 1.244, 95 % CI: 1.041, 1.486) per one-quantile increment in the VOCM mixture. Two aging biomarkers, phenotypic age and biological age, parallelly mediated the association between the VOCM mixture and OA risk, with mediation effect proportions of 9.0 % and 16.4 %, respectively., Conclusions: Exposure to VOCs is associated with an increased OA risk in middle-to-old aged American adults. The mediating effect of aging contributes to the association between co-exposure to VOCs and OA risk. Further prospective studies are required to substantiate these findings., 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 © 2023 Elsevier B.V. All rights reserved.)

Objective: To analyze the associations between gestational weight gain (GWG) and perinatal outcomes based on the GWG guidelines of the Chinese Nutrition Society (CNS) and the Institute of Medicine (IOM)., Methods: This was a retrospective study with 9075 low-risk singleton pregnant women. Logistic regression model was used to analyze associations between GWG categories and perinatal outcomes. Sensitivity analyses were performed based on pre-pregnancy body mass index (calculated as weight in kilograms divided by the square of height in meters)., Results: Excessive GWG as defined by the two guidelines was associated with a higher risk of adverse perinatal outcomes. Inadequate GWG was associated with higher risks of small for gestational age (adjusted odds ratio [aOR] 1.34, 95% confidence interval [CI] 1.10-1.64) and preterm birth (aOR 1.70, 95% CI 1.22-2.36), but a lower risk of large for gestational age (LGA) (aOR 0.77, 95% CI 0.63-0.95) according to the IOM guidelines. When using the CNS guidelines, inadequate GWG was associated with only a lower risk of preterm birth (aOR 1.80, 95% CI 1.19-2.70). Sensitivity analyses suggested that excessive GWG was associated with a higher risk of LGA in underweight women., Conclusions: Both guidelines could demonstrate the relationship between GWG and adverse perinatal outcomes. The CNS guidelines were more suitable for the Chinese population with underweight or normal weight before pregnancy, whereas IOM was more suitable for pregnant women with inadequate GWG., (© 2023 International Federation of Gynecology and Obstetrics.)

Viruses from a new species of piscichuvirus were strongly associated with severe lymphocytic meningoencephalomyelitis in several free-ranging aquatic turtles from 3 coastal US states during 2009-2021. Sequencing identified 2 variants (freshwater turtle neural virus 1 [FTuNV1] and sea turtle neural virus 1 [STuNV1]) of the new piscichuvirus species in 3 turtles of 3 species. In situ hybridization localized viral mRNA to the inflamed region of the central nervous system in all 3 sequenced isolates and in 2 of 3 additional nonsequenced isolates. All 3 sequenced isolates phylogenetically clustered with other vertebrate chuvirids within the genus Piscichuvirus. FTuNV1 and STuNV1 shared ≈92% pairwise amino acid identity of the large protein, which narrowly places them within the same novel species. The in situ association of the piscichuviruses in 5 of 6 turtles (representing 3 genera) with lymphocytic meningoencephalomyelitis suggests that piscichuviruses are a likely cause of lymphocytic meningoencephalomyelitis in freshwater and marine turtles.

Aims: Heart failure (HF) remains a major public health problem with increasing prevalence in China. This study evaluated the clinical performance and quality measures for HF management to identify gaps in the standardization of care for patients hospitalized for HF in China., Methods and Results: Following the results of China-HF stage I (2012-2015), the second stage of the China-HF was launched in 2017. Among 113 hospitals with ≥100 cases, the China-HF Stage II assessed the quality of care measures for HF and compared results with previous data in China and the US-based Get with The Guidelines-Heart Failure (GWTG-HF) registries. In total, 34 938 patients hospitalized with HF were enrolled from January 2017 to October 2020. Echocardiographic left ventricular function and natriuretic peptide test were performed in 93.7% and 93.0% of the cases, respectively. Adherence to standardized guidelines in China-HF stage II was higher than that in the China-HF stage I, but generally lower than GWTG-HF registry with 78.2% of eligible patients was prescribed oral diuretics, 78.7% renin-angiotensin-system inhibitors, and 82.2% beta-blockers. Implantable cardioverter-defibrillators and cardiac resynchronization devices were implanted in 3.9% and 14.6%, respectively. In contrast, the proportion of eligible patients discharged with spironolactone (87.8%) was higher than GWTG-HF. The median length of hospitalization was 9 (6, 12) days, and 938 (2.8%) patients died or withdrew from treatment during hospitalization., Conclusions: Despite significant improvements in the use of guideline-recommended testing and therapy, there remain major gaps in quality of care for patients hospitalized for HF in China that are generally larger than gaps observed in the United States., (© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)

Background: Emerging evidence indicates that the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) axis plays a pivotal role in intrinsic antitumor immunity. Previous studies demonstrate that the conventional chemotherapy agent, teniposide, effectively promotes the therapeutic efficacy of programmed cell death protein-1 antibody (PD-1 Ab) through robust cGAS-STING activation. Unfortunately, the cGAS expression of tumor cells is reported to be severely suppressed by the hypoxic status in solid tumor. Clinically, enhancing chemotherapy-induced, DNA-activated tumor STING signaling by alleviating tumor hypoxia might be one possible direction for improving the currently poor response rates of patients with hepatocellular carcinoma (HCC) to PD-1 Ab., Methods: Teniposide was first screened out from several chemotherapy drugs according to their potency in inducing cGAS-STING signaling in human HCC cells. Teniposide-treated HCC cells were then cultured under hypoxia, normoxia or reoxygenation condition to detect change in cGAS-STING signaling. Next, oxaliplatin/teniposide chemotherapy alone or combined with hyperbaric oxygen (HBO) therapy was administered on liver orthotopic mouse tumor models, after which the tumor microenvironment (TME) was surveyed. Lastly, teniposide alone or combined with HBO was performed on multiple mouse tumor models and the subsequent anti-PD-1 therapeutic responses were observed., Results: Compared with the first-line oxaliplatin chemotherapy, teniposide chemotherapy induced stronger cGAS-STING signaling in human HCC cells. Teniposide-induced cGAS-STING activation was significantly inhibited by hypoxia inducible factor 1α in an oxygen-deficient environment in vitro and the inhibition was rapidly removed via effective reoxygenation. HBO remarkably enhanced the cGAS-STING-dependent tumor type Ⅰ interferon and nuclear factor kappa-B signaling induced by teniposide in vivo, both of which contributed to the activation of dendritic cells and subsequent cytotoxic T cells. Combined HBO with teniposide chemotherapy improved the therapeutic effect of PD-1 Ab in multiple tumor models., Conclusions: By combination of two therapies approved by the Food and Drug Administration, we safely stimulated an immunogenic, T cell-inflamed HCC TME, leading to further sensitization of tumors to anti-PD-1 immunotherapy. These findings might enrich therapeutic strategies for advanced HCC andwe can attempt to improve the response rates of patients with HCC to PD-1 Ab by enhancing DNA-activated STING signaling through effective tumor reoxygenation., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The relationship between body weight and depression may have changed along with the climbing trend of obesity prevalence, but most previous studies examined the association with a single cross-sectional survey. The present study assessed the change in the association between depression and body weight, measured and perceived from 2005 to 2018, among three major racial/ethnic groups., Methods: We analyzed the data of 27,387 adults aged ≥18, collected in the National Health and Nutrition Examination Survey. Surveys from 2005 to 2010 were combined as the early period and the surveys from 2011 to 2018 as the recent period., Results: A switching pattern was observed among white women. In the 2005-2010 survey period, only self-perceived overweight was significantly associated with depression [Odds ratio (OR) = 3.25 (95% confidence interval = 1.33, 7.90)]. However, in the 2011-2018 survey period, self-perceived overweight was not associated with depression anymore [1.32 (0.72, 2.41)], but obesity measured directly was significantly associated with depression [2.59 (1.04, 6.48)]. Among white men, self-perceived overweight and obesity measured directly were significantly associated with depression only in 2011-2018; [2.57 (1.18, 5.58)] and [0.29 (0.10, 0.80)], respectively. Obesity directly measured consistently associated with increased odds of depression among black men. No significant associations were observed in Hispanic and black women in any survey period., Conclusion: Significant gender and ethnic differences exist, and the associations between body weight and depression have evolved in sex-race-specific trajectories. The interventions must be consistently fine-tuned following the dynamics of the relationship between body weight and overall well-being., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Currently, there is no well-established algorithm predicting hepatocellular carcinoma (HCC) development in untreated hepatitis C virus (HCV) patients. We aimed to validate an algorithm (risk evaluation of viral load elevation and associated liver disease/HCV [REVEAL-HCV]: age, AST, ALT, HCV RNA, HCV genotype, and cirrhosis) developed in Taiwanese patients. We analyzed 1381 (50.1% White, 14.7% Hispanic, 13.8% Asian of diverse origin, and 7.8% African American) adult treatment-naïve HCV patients (no viral co-infection, no HCC within 6 months) at 4 U.S. and one Hong Kong centers (11/1994-10/2017). Compared to the non-Asian cohort, the Asian cohort had a higher percentage of patients in the low-risk group (46.1% vs. 26.1%) and a lower percentage in the high-risk group (12.0% vs. 20.3%, p < 0.01). Overall, 5-year HCC incidence were 1.75%, 4.71%, and 24.4% for low, medium, and high-risk patients, respectively (p < 0.0001). For the overall cohort, area under receiving operating characteristic curve (AUROC) for HCC prediction were 0.83 (95% confidence interval [CI]: 0.72-0.93), 0.82 (95% CI: 0.75-0.88), and 0.84 (95% CI: 0.77-0.89) for 1-, 3-, and 5-year HCC risk, respectively. There was a slightly lower AUROC for Asians compared to the non-Asian cohort at 3 years (0.75 vs. 0.83) and 5 years (0.78 vs. 0.84), though this was not statistically significant. In multivariable analysis, we found male sex, presence of metabolic syndrome as well as the risk score categories to be independently associated with HCC but not ethnicity. The REVEAL-HCV risk score has good validity for both Asian and non-Asian populations. Further studies should consider additional factors, such as sex, metabolic syndrome, and treatment status., (© 2021 Wiley Periodicals LLC.)

Background: Taxanes are an essential class of antineoplastic agents used to treat various cancers and are a fundamental cause of hypersensitivity reactions. In addition, other adverse events, such as bone marrow toxicity and peripheral neuropathy, can lead to chemotherapy discontinuation. This study aimed to evaluate the safety of taxanes in the real world., Methods: Taxane-associated adverse events were identified by the Medical Dictionary for Regulatory Activities Preferred Terms and analyzed and compared by mining the US Food and Drug Administration Adverse Event Reporting System pharmacovigilance database from January 2004 to December 2019. Reported adverse events, such as hypersensitivity reaction, bone marrow toxicity, and peripheral neuropathy, were analyzed with the following signal detection algorithms: reporting odds ratio (ROR), proportional reporting ratio (PRR), multi-item gamma Poisson shrinker (MGPS), Bayesian confidence propagation neural network (BCPNN), and logistic regression methods. Adverse outcome events and death outcome rates were compared between different taxane groups using Pearson's χ2 test, whereas significance was determined at P < 0.05 with a 95% confidence interval (CI)., Results: A total of 966 reports of hypersensitivity reactions, 1109 reports of bone marrow toxicity, and 1374 reports of peripheral neuropathy were analyzed. Compared with paclitaxel and docetaxel, bone marrow toxicity following the use of nab-paclitaxel had the highest ROR of 6.45 (95% two-sided CI, 6.05-6.88), PRR of 5.66, (χ2 = 4342.98), information component of 2.50 (95% one-sided CI = 2.34), and empirical Bayes geometric mean of 5.64 (95% one-sided CI = 5.34). Peripheral neuropathy following the use of nab-paclitaxel showed a higher ROR of 12.78 (95% two-sided CI, 11.55-14.14), PRR of 12.16 (χ2 = 4060.88), information component of 3.59 (95% one-sided CI = 3.25), and empirical Bayes geometric mean of 12.07 (95% one-sided CI = 11.09)., Conclusions: The results showed that bone marrow toxicity and peripheral neuropathy were the major adverse events induced by taxanes. Nab-paclitaxel exhibited the highest potential for taxane-associated adverse events. Further research in the future is warranted to explain taxane-associated adverse effects in real-world circumstances., (Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Predictive models have succeeded in distinguishing between individuals with Alcohol use Disorder (AUD) and controls. However, predictive models identifying who is prone to develop AUD and the biomarkers indicating a predisposition to AUD are still unclear. Our sample (n = 656) included offspring and non-offspring of European American (EA) and African American (AA) ancestry from the Collaborative Study of the Genetics of Alcoholism (COGA) who were recruited as early as age 12 and were unaffected at first assessment and reassessed years later as AUD (DSM-5) (n = 328) or unaffected (n = 328). Machine learning analysis was performed for 220 EEG measures, 149 alcohol-related single nucleotide polymorphisms (SNPs) from a recent large Genome-wide Association Study (GWAS) of alcohol use/misuse and two family history (mother DSM-5 AUD and father DSM-5 AUD) features using supervised, Linear Support Vector Machine (SVM) classifier to test which features assessed before developing AUD predict those who go on to develop AUD. Age, gender, and ancestry stratified analyses were performed. Results indicate significant and higher accuracy rates for the AA compared with the EA prediction models and a higher model accuracy trend among females compared with males for both ancestries. Combined EEG and SNP features model outperformed models based on only EEG features or only SNP features for both EA and AA samples. This multidimensional superiority was confirmed in a follow-up analysis in the AA age groups (12-15, 16-19, 20-30) and EA age group (16-19). In both ancestry samples, the youngest age group achieved higher accuracy score than the two other older age groups. Maternal AUD increased the model's accuracy in both ancestries' samples. Several discriminative EEG measures and SNPs features were identified, including lower posterior gamma, higher slow wave connectivity (delta, theta, alpha), higher frontal gamma ratio, higher beta correlation in the parietal area, and 5 SNPs: rs4780836, rs2605140, rs11690265, rs692854, and rs13380649. Results highlight the significance of sampling uniformity followed by stratified (e.g., ancestry, gender, developmental period) analysis, and wider selection of features, to generate better prediction scores allowing a more accurate estimation of AUD development.

A shift towards high folate concentration has emerged following folate fortification. However, the association between folate and health outcomes beyond neural tube defects remains inconclusive. To assess the relationship between red blood cell (RBC) folate and the risk of cardiovascular death among hypertensive patients, we analyzed the data of 2,986 adults aged 19 or older with hypertension who participated in the National Health and Nutrition Examination Survey (1991-1994) as the baseline examination and were followed up through December 31, 2010. After 32,743 person-years of follow-up with an average of 11.7 (standard error = 0.03) years, 1192 deaths were recorded with 579 cardiovascular deaths. The median survival time was significantly shorter in adults in the high folate quartile than in patients in the low folate quartile: 11.97 vs. 13.85 years for heart diseases and 13.37 vs. 14.82 years for myocardial infarction deaths. The cardiovascular mortality was 13.04, 16.95, and 26.61/1,000 person-years for the groups with low, intermediate and high folate quartiles, respectively. After adjustment for age, sex and other factors, a J-shaped association emerged. The hazard ratios (HRs) of all cardiovascular deaths in patients with low, intermediate, and high folate quartiles were 1.09 (0.94, 1.27), 1.00 (reference), and 1.44 (1.31, 1.58), respectively. The corresponding HRs of acute myocardial infarction were 1.13 (0.86, 1.50), 1.00, and 2.13 (1.77, 2.57), respectively. The estimates remained significant after adjustment for BMI and medication use. Compared to moderate RBC folate levels, high folate levels were significantly associated with an increased risk of cardiovascular deaths, especially acute myocardial infarction.

Objective: To select potential molecules that can target viral spike proteins, which may potentially interrupt the interaction between the human angiotension-converting enzyme 2 (ACE2) receptor and viral spike protein by virtual screening., Methods: The three-dimensional (3D)-coordinate file of the receptor-binding domain (RBD)-ACE2 complex for searching a suitable docking pocket was firstly downloaded and prepared. Secondly, approximately 15,000 molecular candidates were prepared, including US Food and Drug Administration (FDA)-approved drugs from DrugBank and natural compounds from Traditional Chinese Medicine Systems Pharmacology (TCMSP), for the docking process. Then, virtual screening was performed and the binding energy in Autodock Vina was calculated. Finally, the top 20 molecules with high binding energy and their Chinese medicine (CM) herb sources were listed in this paper., Results: It was found that digitoxin, a cardiac glycoside in DrugBank and bisindigotin in TCMSP had the highest docking scores. Interestingly, two of the CM herbs containing the natural compounds that had relatively high binding scores, Forsythiae fructus and Isatidis radix, are components of Lianhua Qingwen (), a CM formula reportedly exerting activity against severe acute respiratory syndrome (SARS)-Cov-2. Moreover, raltegravir, an HIV integrase inhibitor, was found to have a relatively high binding score., Conclusions: A class of compounds, which are from FDA-approved drugs and CM natural compounds, that had high binding energy with RBD of the viral spike protein. Our work provides potential candidates for other researchers to identify inhibitors to prevent SARS-CoV-2 infection, and highlights the importance of CM and integrative application of CM and Western medicine on treating COVID-19.

Purpose: To investigate the prevalence and associations of visual impairment (VI) and major eye diseases with chronic kidney disease (CKD) in the United States., Design: Cross-sectional study., Methods: We investigated the prevalence and associations of VI and major eye diseases with CKD among 5,518 participants aged 40 years or older in the 2005-2008 National Health and Nutrition Examination Survey. An estimated glomerular filtration rate of lower than 60 mL/min/1.73 m 2 was defined as CKD. Corrected visual acuity of worse than 20/40 in the better-seeing eye was defined as VI. Major eye diseases, including any ocular disease, any objectively determined ocular disease, cataract surgery, any retinopathy, diabetic retinopathy (DR), age-related macular degeneration (AMD), and glaucoma were evaluated from questionnaire or retinal photographs using standardized grading protocols., Results: The prevalence of VI and major eye diseases were approximately 2- to 7-fold higher in participants with CKD than in those without (all P < .05). After controlling for multiple confounders, the presence of CKD was associated with VI (odds ratio [OR]: 2.01, 95% confidence interval [CI]: 1.14-3.54), any ocular disease (OR: 1.65, 95% CI: 1.22-2.22), any objectively determined ocular disease (OR: 1.52, 95% CI: 1.06-2.19), any retinopathy (OR: 1.70, 95% CI: 1.18-2.45), and DR (OR: 2.34, 95% CI: 1.23-4.42). There was no association of CKD with cataract surgery, AMD, or glaucoma. A significant association between CKD and any ocular disease was observed among nondiabetic participants. The presence of CKD was closely related to VI and any retinopathy among diabetic participants., Conclusions: This nationally representative sample of the US population demonstrated high prevalence and strong associations of VI and major eye diseases with CKD, highlighting the importance of ocular screening among CKD patients and potential common pathogenesis underlying these conditions., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background and Aims: Engaging healthcare providers (HCPs) is critical for early identification of overweight and obesity. The aim of this study is to describe the trend in clinicians' adherence to clinical recommendations to discuss body weight status with adults with overweight and obesity., Methods and Results: We analyzed the data of adults aged 20 and older with overweight or obesity from the National Health and Nutrition Examination Surveys, 1999 to 2016 with a 2-year data-release cycle. The question of interest was "Has a doctor or other health professionals ever told you that you were overweight?" Adjusted biennial percentage ratio (abPR) of being notified was estimated. We observed a significant increasing trend of notification in adults with overweight [abPR = 1.04 (95% confidence interval: 1.03, 1.06), about 4% increase for every two-years] and obesity [1.01 (1.00, 1.02)]. The highest increase occurred in adults with overweight aged 20-34 [1.12 (1.08, 1.16)], however, young adults with overweight remained the group with the lowest percentage (24%, 2015-2016 survey) of notification compared to others in recent survey. Notification in adults with obesity demonstrated similar trends. In 2015-2016, among adults with obesity who visited HCPs last year, 80% of these aged 50-64 and 78% of these aged 65 and older were notified. More than 80% of adults with overweight or obesity visited HCPs at least once last year., Conclusions: There was an improvement in informing patients of overweight/obesity status. However, less than a quarter of young adults with overweight were notified in recent surveys, compromising the opportunities of preventing overweight from becoming obesity in early adulthood., (Copyright © 2020 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.)

Introduction: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB)., Methods: This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases., Results: In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio [SHR], 0.45; 95% confidence interval [CI], 0.26-0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42-1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41-1.92; P = 0.77)., Discussion: TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.

We longitudinally examined the relationship between pet ownership and risk of dying from cancer in a nationally representative cohort of 13,725 adults in the Third National Health and Nutrition Examination Survey, 1988-1994. The vital status was followed through 31 December 2010. Women who owned pets (any type) presented one-year shorter survival time (15.88 years) than non-pet owner (16.83 years). A larger difference of survival time was particularly seen in bird owners (13.01 years) compared to non-bird owners (16.82 years). After adjusting for potential confounders, hazard ratio (HR) of dying from cancer associated with any type of pets was 1.08 (95% CI = 0.77-1.50) for men and 1.40 (1.01-1.93) for women. The association in women was presumably driven by owning birds [HR 2.41 (1.34-4.31)] or cats [HR 1.48 (0.97-2.24)]. Keeping birds and cats in the household was associated with an increased risk of dying from cancer, especially in women.

Importance: Recent US national population-based data on the prevalence of retinopathy in non-diabetic participants is limited., Background: To assess the prevalence and risk factors of retinopathy in a representative US population without diabetes., Design: Population-based, cross-sectional study., Participants: A total of 4354 non-diabetic participants 40 years and older with valid fundus photographs in the 2005 to 2008 National Health and Nutrition Examination Survey., Methods: Diabetes mellitus was defined as glycosylated haemoglobin (HbA1c) ≥6.5%, physician diagnosis of diabetes mellitus or use of diabetic medication. Retinopathy level was based on the Modified Airlie House adaptation from the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol. Risk profile was assessed from standardized interviews, clinical examinations and laboratory measurements., Main Outcome Measures: Prevalence and risk profile of retinopathy in non-diabetic participants., Results: The overall weighted prevalence of retinopathy was 6.7% (n = 341). Among them, 98.2% (n = 331) had signs of minimal-to-mild non-proliferative retinopathy (ETDRS level 14-31) while only 1.8% (n = 10) had moderate-to-severe non-proliferative retinopathy (ETDRS level 41-51). After adjusting for multiple covariates, retinopathy signs in non-diabetic participants were associated with male gender (odds ratio [OR] 1.54; 95% confidence interval [CI] 1.22-1.93), systolic blood pressure (OR per 10 mmHg increase 1.11; 95% CI 1.03-1.19), HbA1c (OR per % increase 1.43; 95% CI 1.01-2.05) and history of stroke (OR 2.39; 95% CI 1.14-5.04)., Conclusions and Relevance: Consistent with previous studies, signs of retinopathy are common in US persons without diabetes. Risk factors for retinopathy signs include gender, blood pressure, HbA1c and history of stroke., (© 2019 Royal Australian and New Zealand College of Ophthalmologists.)

Background: Chronic kidney disease (CKD) and end stage renal disease (ESRD) are not well characterized in prostate cancer patients. This study aimed to examine the clinical characteristics and postsurgical outcomes of patients with or without CKD and ESRD undergoing radical prostatectomy for prostate cancer., Methods: This population-based, retrospective study used patient data from the Nationwide Inpatient Sample, the largest all-payer US inpatient care database. From 2005 to 2014, 136,790 male patients aged > 20 years diagnosed with prostate cancer and who received radical prostatectomy were included. Postoperative complications, postoperative acute kidney injury (AKI) and urinary complications, and length of hospital stay were compared between patients with or without underlying CKD and ESRD., Results: After adjusting for relevant factors, the CKD group had a significantly higher risk of postoperative complications than the non-CKD group. In addition, the CKD group had a 5-times greater risk of postoperative AKI and urinary complications than the non-CKD group. Both CKD and ESRD groups had significantly longer hospital stays than the non-CKD group. Patients receiving RARP had a lower risk of postoperative complications than those who received open radical prostatectomy, regardless of having CKD or not. Both non-CKD and CKD patients receiving RARP had shorter hospital stays than those who received open surgery., Conclusions: Prostate cancer patients with underlying CKD had significantly greater risk of postoperative complications, postoperative AKI and urinary complications, and longer hospital stays than those without CKD. The use of RARP significantly shortened hospital stays and reduced complications for these patients.

Background: Recent studies have suggested a potential increase in the incidence of osteoporosis for patients receiving tenofovir disoproxil fumarate (TDF), but this issue remains controversial., Methods: The retrospective cohort study of 1224 Asian chronic hepatitis B (CHB) patients greater than 18 years without baseline osteopenia/osteoporosis seen at four US centers from 2008 to 2016. Patients were categorized into three groups-treatment-naive patients who initiated therapy with TDF (1) or entecavir (ETV) (2), or untreated patients (3). Patients were followed until the development of osteopenia/osteoporosis or end of the study., Results: Of the 1224 study patients, 276 were treated with TDF, 335 with ETV, and 613 were untreated. The prevalence of cirrhosis was lower for untreated patients (2.6% vs 16.3% for TDF and 17.6% for ETV; P < 0.001). The 8-year cumulative incidence rate of osteopenia/osteoporosis was 13.17% for TDF, 15.09% for ETV, and 10.17% for untreated patients, with no statistically significant difference among the three groups ( P = 0.218). On multivariate Cox regression controlling for demographics, osteoporosis risk factors, albumin, and hepatitis B virus (HBV) DNA levels, neither TDF (adjusted hazard ratio [HR] = 0.74; 95% confidence interval [CI]: 0.34 and 1.59) nor ETV (adjusted HR = 0.98; 95% CI: 0.51 and 1.90) were associated with increased osteopenia/osteoporosis risk compared with untreated patients., Conclusions: Our retrospective study suggests that there is no significant increase in the incidence of osteopenia/osteoporosis for patients with CHB treated with TDF or ETV during a median follow-up of about 4 to 5 years. However, further study with longer follow-up is needed as an anti-HBV therapy, which is often lifelong or long-term and the development of osteopenia/osteoporosis can be a slow process., (© 2019 Wiley Periodicals, Inc.)