HPV Vaccine Awareness, Past Behaviors, and Future Intentions Among a Diverse Sample of Fathers Aged 27 to 45 Years: A National Survey.

Men aged 27 to 45 are eligible for human papillomavirus (HPV) vaccination as of 2019, yet relatively little is known about whether they have received or intend to receive it. We conducted a cross-sectional, online survey among fathers aged 27 to 45 between March and April 2022, to assess associations between HPV vaccination awareness, behaviors, intentions, and psychosocial constructs from the Health Belief Model. We examined the characteristics of those who had (a) heard of the HPV vaccine, (b) already received ≥ 1 dose, and (c) intentions for future vaccination among those who had never been vaccinated. Among 400 men who completed the survey, 32% were not aware of the HPV vaccine. Among those who were aware, 41% had received ≥ 1 dose. Sixty-three percent of unvaccinated men reported that they intended to get vaccinated in the future. Multivariable logistic regression analyses revealed that age and race/ethnicity were associated with having been vaccinated previously. Among the unvaccinated, multivariable logistic regression analyses revealed that those with a higher perceived risk of HPV-associated cancer had 3.73 greater odds of reporting they would seek vaccination compared to those with lower perceived risk (95% confidence interval [CI] = [1.28, 12.3]). We did not find perceived benefits, barriers, or decision self-efficacy to be related to future vaccine intentions. Since recommendations for this group include shared clinical decision-making, public health efforts should focus on raising awareness of vaccine eligibility, emphasizing risk factors for HPV-associated cancers so that individuals have an accurate perception of risk, and encouraging conversation between men and their providers.

Preferred Location for Human Papillomavirus Self-Sampling for Cervical Cancer Screening.

OBJECTIVE: To examine associations among women's preferred locations for human papillomavirus (HPV) self-sampling in relation to their demographic, social, and health characteristics and their perceived benefits and concerns regarding this procedure. DESIGN: Cross-sectional, descriptive survey. SETTING: Online distribution between March 2022 and April 2022. PARTICIPANTS: People who were assigned female sex at birth and were eligible for cervical cancer screening (N = 367: cis-gender women, n = 364; another gender identity, n = 3). METHODS: We used quota sampling to obtain a racially and ethnically diverse sample. We conducted bivariate analyses to examine differences in participants' preferred locations for HPV self-sampling by sociodemographic and health characteristics. We used a multinomial logistic regression model to examine the associations between preferred HPV self-sampling location, characteristics of participants, and perceived benefits and concerns regarding this procedure. RESULTS: In our sample, 43% (n = 158) of participants preferred HPV self-sampling at the office of a health care provider, 50% (n = 182) preferred HPV self-sampling anywhere (office or home), and 7% (n = 27) did not feel comfortable with HPV self-sampling anywhere. Participants 39 to 45 years of age were more likely to prefer HPV self-sampling anywhere (office or home) than participants 27 to 32 years of age, OR = 2.47, 95% confidence interval (CI) [1.21, 5.06]. Participants who preferred HPV self-sampling anywhere perceived greater benefit related to limited geographic access to a clinic compared to those who preferred office only, OR = 1.82, 95% CI [1.08, 3.07]. Participants who preferred HPV self-sampling anywhere had less concern related to performing the procedure accurately than those who preferred office only, OR = 0.44, 95% CI [0.31, 0.62]. CONCLUSION: HPV self-sampling is an alternative strategy to increase cervical cancer screening. As providers consider implementation of HPV self-sampling, our findings suggest that office and home-based collection strategies should be considered to increase access to cervical cancer screening.

Assessment of Perioperative Sleep Characteristics Using Subjective and Objective Methods: A Secondary Analysis of Prospective Cohort Study.

Perioperative sleep disturbances may impact healing and negatively affect the patient's perception of well-being. Therefore, accurately assessing postoperative sleep characteristics is necessary to treat sleep disturbances. This study is a secondary data analysis of research investigating the association between sleep and cognition in a perioperative setting. This study compares sleep characteristics between the St. Mary's Hospital Sleep Questionnaire and WatchPAT, a portable sleep apnea testing device. The goal of this study is to compare an objective measurement of sleep quality (WatchPAT) with a traditional questionnaire. One hundred and one patients who underwent elective, noncardiac surgical procedures wore a WatchPAT and completed the St. Mary's Hospital Sleep Questionnaire for three nights: two preoperative and one postoperative night. In the preoperative period, a Bland-Altman analysis showed an agreement Watch PAT and the St Mary's hospital sleep questionnaire except for sleep fragmentation. A good to fair correlation during the preoperative period was observed with both sleep latency and total sleep time. In the postoperative period, no correlation was observed between the St. Mary's Hospital Sleep Questionnaire data and WatchPAT data. Our study indicates that some potential factors affecting sleep and cognition such as admission type, depression, anesthesia type, and sleep apnea may limit patients' ability to report their sleep characteristics after surgery. Therefore, relying solely on one sleep assessment method is not advisable.

Proteomic basis of mortality resilience mediated by FOXO3 longevity genotype.

FOXO3 is a ubiquitous transcription factor expressed in response to cellular stress caused by nutrient deprivation, inflammatory cytokines, reactive oxygen species, radiation, hypoxia, and other factors. We showed previously that the association of inherited FOXO3 variants with longevity was the result of partial protection against mortality risk posed by aging-related life-long stressors, particularly cardiometabolic disease. We then referred to the longevity-associated genotypes as conferring "mortality resilience." Serum proteins whose levels change with aging and are associated with mortality risk may be considered as "stress proteins." They may serve as indirect measures of life-long stress. Our aims were to (1) identify stress proteins that increase with aging and are associated with an increased risk of mortality, and (2) to determine if FOXO3 longevity/resilience genotype dampens the expected increase in mortality risk they pose. A total of 4500 serum protein aptamers were quantified using the Somalogic SomaScan proteomics platform in the current study of 975 men aged 71-83 years. Stress proteins associated with mortality were identified. We then used age-adjusted multivariable Cox models to investigate the interaction of stress protein with FOXO3 longevity-associated rs12212067 genotypes. For all the analyses, the p values were corrected for multiple comparisons by false discovery rate. This led to the identification of 44 stress proteins influencing the association of FOXO3 genotype with reduced mortality. Biological pathways were identified for these proteins. Our results suggest that the FOXO3 resilience genotype functions by reducing mortality in pathways related to innate immunity, bone morphogenetic protein signaling, leukocyte migration, and growth factor response.

Evaluation of Access to Care Barriers and Their Effect on General Health Status Among Native Hawaiian and Pacific Islander Adults.

There is a paucity of information on access to care barriers faced by Native Hawaiian and Pacific Islander (NHPI) community. This study utilized the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI NHIS) data to evaluate access to care barriers among NHPI population and their effect on general health status. Access to care barriers were categorized as financial barrier (affordability) and non-financial barriers (availability, accommodation, acceptability, and accessibility). Overall, 13.7% reported of the fair/poor general health and over 30% reported at least one access to care barrier. Logistic regression model was used to evaluate how financial and non-financial barriers affect general health status, adjusting for socio-demographic variables such as age, poverty threshold, and marital status and health-related variables such as smoking status and chronic health conditions. Those who reported financial barrier (21.2%) were more likely to be in fair/poor general health (odds ratio 2.25, 95% confidence interval 1.43-3.56). Non-financial barrier, reported by 20.0% of the study population, was found to be not associated with general health status after adjusting for socio-demographic and health-related variables. Improving access to care among NHPI community could be achieved by identifying and addressing the barriers, which in turn could lead to improvement in the general health status among NHPI community.

Knowledge and Attitudes of Guam Residents towards Cancer Clinical Trial Participation.

(1) Background: Currently there are no cancer clinical trials in Guam, where CHamoru people suffer the highest rates of cancer mortality, and interest to do so is growing. This study investigated the knowledge and attitudes of Guam residents towards cancer clinical trial participation prior to implementation. (2) Methods: A telephone survey was developed, tested, and conducted among Guam resident adults, 18 years of age and older. Survey questions were summarized by descriptive statistics. Logistic regression models were used to investigate the associations between Guam residents' demographics and their clinical trial knowledge and attitudes. Adjusted odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated. (3) Results: One hundred fifty-two people participated in the survey, most of whom were CHamoru (47.0%). Fifty-three percent had heard the term 'clinical trial'; 73.7% would take part in a trial if they had cancer; and 59.9% believed they would receive good quality treatment from a trial offered in Guam. CHamoru were more likely than Whites to associate out-of-pocket expenses with clinical trial participation (aOR = 5.34, 95% CI = 1.68-17.00). Physician ethnicity was important to 30% of non-Whites and significantly associated with those who spoke a language other than English (aOR = 3.40, 95% CI = 1.29-8.95). Most people (65.0%) did not believe clinical trials participants were 'guinea pigs'. (4) Conclusion: Though knowledge about cancer clinical trials is limited, attitudes were primarily positive towards participating in cancer clinical trials offered in Guam. Future delivery of cancer clinical trials will benefit from identifying potential barriers to recruitment and adopting an approach suited to Guam's population.

Glioblastoma-educated mesenchymal stem-like cells promote glioblastoma infiltration via extracellular matrix remodelling in the tumour microenvironment.

BACKGROUND: The biological function of mesenchymal stem-like cells (MSLCs), a type of stromal cells, in the regulation of the tumour microenvironment is unclear. Here, we investigated the molecular mechanisms underlying extracellular matrix (ECM) remodelling and crosstalk between MSLCs and glioblastomas (GBMs) in tumour progression. METHODS: In vitro and in vivo co-culture systems were used to analyze ECM remodelling and GBM infiltration. In addition, clinical databases, samples from patients with GBM and a xenografted mouse model of GBM were used. RESULTS: Previous studies have shown that the survival of patients with GBM from whom MSLCs could be isolated is substantially shorter than that of patients from whom MSLCs could not be isolated. Therefore, we determined the correlation between changes in ECM-related gene expression in MSLC-isolatable patients with that in MSLC non-isolatable patients using gene set enrichment analysis (GSEA). We found that lysyl oxidase (LOX) and COL1A1 expressions increased in MSLCs via GBM-derived clusters of differentiation 40 ligand (CD40L). Mechanistically, MSLCs are reprogrammed by the CD40L/CD40/NFκB2 signalling axis to build a tumour infiltrative microenvironment involving collagen crosslinking. Importantly, blocking of CD40L by a neutralizing antibody-suppressed LOX expression and ECM remodelling, decreasing GBM infiltration in mouse xenograft models. Clinically, high expression of CD40L, clusters of differentiation 40 (CD40) and LOX correlated with poor survival in patients with glioma. This indicated that GBM-educated MSLCs promote GBM infiltration via ECM remodelling in the tumour microenvironment. CONCLUSION: Our findings provide mechanistic insights into the pro-infiltrative tumour microenvironment produced by GBM-educated MSLCs and highlight a potential therapeutic target that can be used for suppressing GBM infiltration.

Dietary Quality Associated with Self-Reported Diabetes, Osteoarthritis, and Rheumatoid Arthritis among Younger and Older US Adults: A Cross-Sectional Study Using NHANES 2011-2016.

BACKGROUND: To date, few studies have compared the dietary quality of US adults with diabetes mellitus (DM), osteoarthritis (OA), and rheumatoid arthritis (RA) by age groups. METHODS: This study used cross-sectional data from adult participants from National Health and Nutrition Examination Survey 2011-2016 to identify dietary quality measured by Healthy Eating Index (HEI)-2015 total and component scores and self-reported disease status for DM, OA, and RA. Associations between the disease status and HEI-2015 total/component scores among younger adults aged 20-59 years (n = 7988) and older adults aged 60 years and older (n = 3780) were examined using logistic regression models. These accounted for the complex survey design and were adjusted for self-reported disease status, sex, race/ethnicity, education levels, income status, weight status, physical activity levels, and smoking status. RESULTS: Among younger adults, 7% had DM, 7% had OA, and 3% had RA. Among older adults, 20% had DM, 32% had OA, and 6% had RA. Moderate added sugar intake was associated with diabetes in all adults. Excess sodium intake was associated with DM among younger adults. Inadequate seafood and plant protein intake was associated with RA among younger adults, while a poor overall dietary pattern was associated with RA among older adults. CONCLUSIONS: The dietary quality of US adults varied by self-reported DM, OA, and RA status, and each varied by age group.

The Association of Race/Ethnicity, Dietary Intake, and Physical Activity with Depression.

OBJECTIVE: This study investigated the association of race/ethnicity, dietary intake, and physical activity with depression and potential other barriers associated with the use of mental health services among depressed people. METHODS: We used the nationally representative data, 2011-2016 National Health and Nutrition Examination Survey. Depression status was defined using a Patient Health Questionnaire. Multivariable logistic regressions were conducted on depression status and the use of mental health specialists among depressed adults, accounting for the complex sampling design. RESULTS: The prevalence of depression was 8.3% with substantial racial/ethnic differences (8.0% for white, 3.1% for Asian, 9.2% for black, 7.6% for Mexican Hispanics, 13.0% for other Hispanics). Good/acceptable diet and a high level of physical activity were negatively associated with depression. Among depressed people, no significant racial/ethnic differences were observed in using mental health specialists. CONCLUSION: Prevalence for depression was lower among people who have good or acceptable diet and moderate physical activity. These modifiable factors as well as race/ethnicity should be incorporated into psychotherapeutic interventions to improve depression.

Benefits of Oral Health Education at Women, Infant, and Children (WIC) Clinic Visits: Assessments of Parent's Oral Health Beliefs, Behaviors and Dental Access in O'ahu, Hawai'i.

Improving oral health outcomes in Hawai'i for children and families remains a high priority. Children in the state are leading the nation with the highest caries rates, while women before, during, and after pregnancy are failing to receive regular and necessary dental care resulting in poor health outcomes. To answer for this need, an educational intervention was conducted among families enrolled in the Kapi'olani Medical Center for Women and Children's Women, Infant, and Children program (WIC) in O'ahu. The project included the following activities: (1) identification the oral health beliefs and behaviors of families, (2) providing oral health education to families, and (3) reassessing beliefs and behaviors in 3-6 months to document the impact of theeducation session. Participants consisted of 81 families resulting in the data on 176 children and 4 pregnant women. Of the 81 families, 40 representing84 children completed the follow-up oral health questionnaire. Results of the assessment and education demonstrated a positive impact on the family's oral health behaviors. Parents were 6.61 times as likely to report using fluoride toothpaste in the follow-up visit compared to their initial visit (95% confidence interval [CI] = 3.12-14.00). Additionally, statistically significant changes were noted in the frequency of children's daily tooth brushing (odds ratio [OR] = 2.15, 95% CI = 1.33-3.46), as well as in the incidence of children receiving fluoride varnish application over time (OR = 2.66, 95% CI = 1.50-4.73). These results provide further evidence that initiating a simple educational intervention can have a positive impact on oral health behaviors in groups that are at highest risk for developing dental disease in Hawai'i.

Crosstalk between GBM cells and mesenchymal stemlike cells promotes the invasiveness of GBM through the C5a/p38/ZEB1 axis.

BACKGROUND: Mesenchymal stemlike cells (MSLCs) have been detected in many types of cancer including brain tumors and have received attention as stromal cells in the tumor microenvironment. However, the cellular mechanisms underlying their participation in cancer progression remain largely unexplored. The aim of this study was to determine whether MSLCs have a tumorigenic role in brain tumors. METHODS: To figure out molecular and cellular mechanisms in glioma invasion, we have cultured glioma with MSLCs in a co-culture system. RESULTS: Here, we show that MSLCs in human glioblastoma (GBM) secrete complement component C5a, which is known for its role as a complement factor. MSLC-secreted C5a increases expression of zinc finger E-box-binding homeobox 1 (ZEB1) via activation of p38 mitogen-activated protein kinase (MAPK) in GBM cells, thereby enhancing the invasion of GBM cells into parenchymal brain tissue. CONCLUSION: Our results reveal a mechanism by which MSLCs undergo crosstalk with GBM cells through the C5a/p38 MAPK/ZEB1 signaling loop and act as a booster in GBM progression. KEY POINTS: 1. MSLCs activate p38 MAPK-ZEB1 signaling in GBM cells through C5a in a paracrine manner, thereby boosting the invasiveness of GBM cells in the tumor microenvironment.2. Neutralizing of C5a could be a potential therapeutic target for GBM by inhibition of mesenchymal phenotype.

Raman-Enhanced Spectroscopy (RESpect) Probe for Childhood Non-Hodgkin Lymphoma.

Raman-enhanced spectroscopy (RESpect) probe, which enhances Raman spectroscopy technology through a portable fiber-optic device, characterizes tissues and cells by identifying molecular chemical composition showing distinct differences/similarities for potential tumor markers or diagnosis. In a feasibility study with the ultimate objective to translate the technology to the clinic, a panel of pediatric non-Hodgkin lymphoma tissues and non-malignant specimens had RS analyses compared between standard Raman spectroscopy microscope instrument and RESpect probe. Cryopreserved tissues were mounted on front-coated aluminum mirror slides and analyzed by standard Raman spectroscopy and RESpect probe. Principal Component Analysis revealed similarities between non-Hodgkin lymphoma subtypes but not follicular hyperplasia. Standard Raman spectroscopy and RESpect probe fingerprint comparisons demonstrated comparable primary peaks. Raman spectroscopic fingerprints and peaks of pediatric non-Hodgkin lymphoma subtypes and follicular hyperplasia provided novel avenues to pursue diagnostic approaches and identify potential new therapeutic targets. The information could inform new insights into molecular cellular pathogenesis. Translating Raman spectroscopy technology by using the RESpect probe as a potential point-of-care screening instrument has the potential to change the paradigm of screening for cancer as an initial step to determine when a definitive tissue biopsy would be necessary.

Raman-Enhanced Spectroscopy Distinguishes Anal Squamous Intraepithelial Lesions in Human Immunodeficiency Virus-Serodiscordant Couples.

HIV-positive individuals are at increased risk for precancerous anal squamous intraepithelial lesions (SILs). Anal cytology and digital rectal examination are performed as screening tools, but extensive training and appropriate instruments are required to follow up on an abnormal anal cytology. Thus, novel approaches to SIL evaluation could improve better health care follow-up by efficient and timely diagnosis to offer treatment options. Recently, Raman-enhanced spectroscopy (RESpect) has emerged as a potential new tool for early identification of SIL. RESpect is a noninvasive, label-free, laser-based technique that identifies molecular composition of tissues and cells. HIV-serodiscordant couples had anal biopsies obtained during high-resolution anoscopy. RESpect was performed on the specimens. Principal component analysis of the data identified differences between normal and abnormal tissue as well as HIV-positive and HIV-negative individuals of each couple even with similar pathologies. RESpect has the potential to change the paradigm of anal pathology diagnosis and could provide insight into different pathways leading to SIL in HIV-serodiscordant couples.

Volatile anaesthetics and postoperative delirium in older surgical patients-A secondary analysis of prospective cohort studies.

BACKGROUND: Volatile Anaesthetics (VAs) may be associated with postoperative delirium (POD). However, to date, the effects of VAs on POD are not completely understood. The objective of this study was to investigate the incidence of POD in different VA groups. METHODS: A secondary analysis was conducted using a database created from prospective cohort studies in patients who underwent elective major noncardiac surgery. Patients who received general anaesthesia with desflurane, isoflurane, or sevoflurane were included in the study. POD occurring on either of the first two postoperative days was measured using the Confusion Assessment Method. RESULTS: Five hundred and thirty-two patients were included in this study, with a mean age of 73.5 ± 6.0 years (range, 65-96 years). The overall incidence of POD on either postoperative day 1 or 2 was 41%. A higher incidence of POD was noted in the desflurane group compared with the isoflurane group (Odds Ratio = 3.35, 95% CI = 1.54-7.28). The incidence of POD between the sevoflurane and isoflurane or desflurane group was not statistically significant. CONCLUSION: Each VA may have different effects on postoperative cognition. Further studies using a prospective randomized approach will be necessary to discern whether anaesthetic type or management affects the occurrence of postoperative delirium.

Human Papillomavirus-16 DNA Quantitation Differentiates High-Grade Anal Neoplasia.

Background: Due to their higher rates of anal dysplasia/cancer, human immunodeficiency virus (HIV)-positive individuals are recommended to undergo anal dysplasia screening, which consists of anal cytology (AC) and high resolution anoscopy (HRA) with anal biopsy (AB) after abnormal AC result. However, AC variability limits its usefulness. Our objective was to evaluate human papillomavirus (HPV)-16 DNA quantitation as part of the screening algorithm. Methods: HPV-16 was detected in AC specimens from 75 HIV-positive participants using quantitative real-time polymerase chain reaction. AB results were available from 18/44 patients who had abnormal AC. Statistical tests included Mann-Whitney U, Kruskal-Wallis, receiver operating characteristic (ROC) analysis and Kappa coefficient tests. Results: HPV-16 copy numbers differed significantly across AC (p = 0.001) and AB grades (p = 0.009). HPV-16 ≥ 65 copies/cell predicted high-grade AB (p = 0.04). Using this cut-off in comparison to AB, it had better specificity (1.00) than AC (0.75) and specificity (0.77) than qualitative HPV-16 detection (0.38). Also, the Kappa coefficient of the cut-off (κ = 0.649) was higher than AC (κ = 0.557) and qualitative HPV-16 detection (κ = 0.258) to AB. Conclusion: Higher HPV-16 copy numbers corresponded to higher AC and AB grades, suggesting the importance of HPV burden on disease stage. Furthermore, HPV-16 ≥ 65 copies/cell distinguished high-grade disease and demonstrated better sensitivity, specificity, and agreement with AB than AC or qualitative HPV-16 detection. These results support the potential use of HPV quantitation in conjunction with AC in anal dysplasia screening.

Minimal Shortening of Leukocyte Telomere Length Across Age Groups in a Cross-Sectional Study for Carriers of a Longevity-Associated FOXO3 Allele.

FOXO3 is one of the most prominent genes demonstrating a consistently reproducible genetic association with human longevity. The mechanisms by which these individual gene variants confer greater organismal lifespan are not well understood. We assessed the effect of longevity-associated FOXO3 alleles on age-related leukocyte telomere dynamics in a cross-sectional study comprised of samples from 121 healthy Okinawan-Japanese donors aged 21-95 years. We found that telomere length for carriers of the longevity associated allele of FOXO3 single nucleotide polymorphism rs2802292 displayed no significant correlation with age, an effect that was most pronounced in older (>50 years of age) participants. This is the first validated longevity gene variant identified to date showing an association with negligible loss of telomere length with age in humans in a cross-sectional study. Reduced telomere attrition may be a key mechanism for the longevity-promoting effect of the FOXO3 genotype studied.

Colorectal cancer screening prevalence and predictors among Asian American subgroups using Medical Expenditure Panel Survey National Data.

BACKGROUND: Asian American (AA) ethnic subgroups are diverse in socio-economic status, years in the United States, English proficiency, and cultures with different health seeking behaviors and health care access. Fifty-two percent of AAs age ≥50 years had colorectal cancer screening (CRCS) in 2013, compared with 61% of non-Hispanic whites. We hypothesized that CRCS prevalence among AA ethnicities is heterogeneous and that the reasons related to CRCS among AA subgroups are associated with demographic characteristics, acculturation, health care access, and health attitudes. METHODS: Medical Expenditure Panel Survey data for 2009-2014 compared CRCS status among whites (n = 28,834), Asian Indians (n = 466), Chinese (n = 652), and Filipinos (n = 788). Multivariate logistic regression examined ethnic differences and correlates of CRCS accounting for complex sampling design. RESULTS: Whites had the highest prevalence of screening (62.3%), followed by Filipinos (55.0%), Chinese (50.9%), and Asian Indians (48.6%). Older age, having health insurance, and having a usual care provider predicted CRCS across all ethnicities. Different demographic, health care access, and health attitude predictors within each ethnic group were related to CRCS. CONCLUSION: This study contributes to the literature on influences of differential CRCS prevalence among AA subgroups. CRCS promotion should be tailored according to attitudes and structural barriers affecting screening behavior of specific ethnic subgroups to truly serve the health needs of the diverse AA population. Cancer 2018;124:1543-51. © 2018 American Cancer Society.

Racial and Ethnic Disparities in Hospital Mortality among Ischemic Stroke Patients in Hawaii.

BACKGROUND: We evaluated disparities in in-hospital mortality rates among whites, Native Hawaiians and other Pacific Islanders (NHOPI), Filipinos, and other Asian groups in Hawaii who were hospitalized for acute ischemic stroke. MATERIALS AND METHODS: Using a statewide hospital claims database, we performed a retrospective study including sequential acute ischemic stroke patients between 2010 and 2015. We compared in-hospital mortality rates among whites, NHOPI, Filipinos, other Asian groups excluding Filipinos, and other races (Blacks, Hispanics, Native Americans, mixed race). RESULTS: A total of 13,030 patient discharges were included in this study. The mean (±SD) age in years at the time of stroke was 63.5 ± 14.3 for NHOPI, 69.6 ± 14.4 for Filipinos, 67.8 ± 14.2 for other race, 71.4 ± 13.8 for whites, and 76.1 ± 13.5 for other Asians (P < .001). NHOPI patients had higher rates of diabetes (48.8%), obesity (18.4%), and tobacco use (31.3%) compared with patients in other racial-ethnic categories. Filipino patients had the highest rate of hemorrhagic transformation (9.7%). Age-adjusted stroke mortality rates were highest among Filipinos (15.9%; 95% confidence interval [CI] = 14.3%-17.6%), followed by other Asian groups (15.1%; 95% CI = 14.0%-16.2%), NHOPI (14.8%; 95% CI = 12.8%-16.8%), other race (14.4%; 95% CI = 11.3%-17.4%), and lowest among whites (12.8%; 11.5%-14.2%). After adjusting for other confounding variables, Filipinos had higher mortality (odds ratio = 1.22, 95% CI = 1.03-1.45), whereas other Asian groups, NHOPI, and other race patients had mortality rates that were similar to whites. CONCLUSION: In Hawaii, Filipino ethnicity is an independent risk factor for higher in-hospital stroke mortality compared with whites.

Force-mediated proinvasive matrix remodeling driven by tumor-associated mesenchymal stem-like cells in glioblastoma.

In carcinoma, cancer-associated fibroblasts participate in force-mediated extracellular matrix (ECM) remodeling, consequently leading to invasion of cancer cells. Likewise, the ECM remodeling actively occurs in glioblastoma (GBM) and the consequent microenvironmental stiffness is strongly linked to migration behavior of GBM cells. However, in GBM the stromal cells responsible for force-mediated ECM remodeling remain unidentified. We show that tumor-associated mesenchymal stem-like cells (tMSLCs) provide a proinvasive matrix condition in GBM by force-mediated ECM remodeling. Importantly, CCL2-mediated Janus kinase 1 (JAK1) activation increased phosphorylation of myosin light chain 2 in tMSLCs and led to collagen assembly and actomyosin contractility. Collectively, our findings implicate tMSLCs as stromal cells providing force-mediated proinvasive ECM remodeling in the GBM microenvironment, and reminiscent of fibroblasts in carcinoma. [BMB Reports 2018; 51(4): 182-187].