Cross-substance patterns of alcohol, cigarette, and cannabis use initiation in Black and White adolescent girls.

Characterizing variations in the timing of alcohol, cigarette, and cannabis use onset both among and between Black and White youth can inform targeted prevention. The current study aimed to capture cross-substance initiation patterns in Black and White girls and characterize these patterns with respect to substance use related socioeconomic, neighborhood, family, community, and individual level factors. Data were drawn from interviews conducted at ages 8 through 17 in an urban sample of girls (n = 2172; 56.86% Black, 43.14% White). Discrete-time multiple event process survival mixture modeling was used to identify patterns (i.e., classes) representing timing of alcohol, cigarette, and cannabis use initiation, separately by race. Class characteristics were compared using multinomial logistic regression. Among both Black and White girls, four classes, including abstainer and cross-substance early onset classes, emerged. Two classes characterized by mid-adolescence onset (Black girls) and variation in onset by substance (White girls) were also observed. Class differences centered around cannabis for Black girls (e.g., preceding or following cigarette use) and alcohol for White girls (e.g., (in)consistency over time in greater likelihood of initiation relative to cigarette and cannabis use). Several factors distinguishing the classes were common across race (e.g., externalizing behaviors, friends' cannabis use); some were specific to Black girls (e.g., intentions to smoke cigarettes) or White girls (e.g., primary caregiver problem drinking). Findings underscore the need to recognize a more complex picture than a high-risk/low-risk dichotomy for substance use initiation and to attend to nuanced differences in markers of risky onset pathways between Black and White girls.

A novel data-driven decision model based on extended belief rule base to predict China's carbon emissions.

Global warming and climate change are gaining traction in recent years. As a major cause of global warming, carbon emissions were centered to China's climate change policy initiatives. Nevertheless, the existing policy discourse has yet reached a consensus on the optimal modeling method for carbon emissions prediction that is well-informed of both policy goals and the time-series pattern of carbon emissions. This paper fills the gap by promoting a novel data-driven decision model for carbon emissions prediction that is based on the extended belief rule base (EBRB) inference model. The new decision model consists of three components: 1) an indicator integration method, which aims to generate a few group indicators from a large number of statistical indicators; 2) a new EBRB construction method, which aims to consider the management policy goals for constructing EBRB; 3) a new ER-based inference method, which aims to predict carbon emissions based on time series change of relevant factors. The effectiveness of the proposed decision model has been tested against carbon emissions management data from 30 provinces in China. Experimental results demonstrate that the model will offer powerful reference value in the policy decision-making process, which will help to meet policy requirements for carbon emissions.

Improvements in Neighborhood Socioeconomic Conditions May Improve Resident Diet.

Neighborhood socioeconomic conditions (NSECs) are associated with resident diet, but most research has been cross-sectional. We capitalized on a natural experiment in Pittsburgh, Pennsylvania, in which 1 neighborhood experienced substantial investments and a sociodemographically similar neighborhood that did not, to examine pathways from neighborhood investments to changed NSECs and changed dietary behavior. We examined differences between renters and homeowners. Data were from a random sample of households (n = 831) in each of these low-income Pittsburgh neighborhoods that were surveyed in 2011 and 2014. Structural equation modeling tested direct and indirect pathways from neighborhood to resident dietary quality, adjusting for individual-level sociodemographics, with multigroup testing by homeowners versus renters. Neighborhood investments were directly associated with improved dietary quality for renters (ß = 0.27, 95% confidence interval (CI): 0.05, 0.50) and homeowners (ß = 0.51, 95% CI: 0.10, 0.92). Among renters, investments also were associated with dietary quality through a positive association with commercial prices (ß = 0.34, 95% CI: 0.15, 0.54) and a negative association with residential prices (ß = -0.30, 95% CI: -0.59, -0.004). Among homeowners, we did not observe any indirect pathways from investments to dietary quality through tested mediators. Investing in neighborhoods may support resident diet through improvements in neighborhood commercial environments for renters, but mechanisms appear to differ for homeowners.

Mental Health, Physical Health, and Cultural Characteristics Among American Indians/Alaska Natives Seeking Substance Use Treatment in an Urban Setting: A Descriptive Study.

Although approximately 70% of American Indians/Alaska Natives (AI/ANs) reside in urban areas, our knowledge of risk and protective factors among AI/ANs seeking substance use treatment within urban areas is limited. We analyze substance and commercialized cigarette use, AI/AN cultural identity and involvement, physical health and cognitive functioning, and mental health symptoms among 63 AI/AN adults seeking substance use treatment within an urban area in California. Alcohol (37%), marijuana (27%), and methamphetamine (22%) were the most commonly reported substances. Sixty-two percent used commercialized tobacco use. The majority of AI/AN adults (78%) engaged in at least one traditional practice during the past month and endorsed high levels of spiritual connectedness. Those who engaged in traditional practices demonstrated significantly less depression (p = 0.007) and anxiety (p = 0.04). Medical and mental health issues were not prominent, although participants revealed high levels of cognitive impairment. Results highlight the importance of utilizing AI/AN traditional practices for AI/AN adults seeking substance use treatment within urban areas. Clinical Trials Registry Number NCT01356667.

Relational Peer Victimization Interacts With Depression Severity to Predict the Timing of Alcohol Use Initiation in Adolescent Girls.

BACKGROUND: Peer victimization is consistently linked to adolescents' alcohol use. However, the relative influence of relational and physical peer victimization on alcohol use, and timing of drinking initiation, is not well understood. In this study, we evaluate the impact of both relational and physical peer victimization on adolescent girls' alcohol use initiation, and the extent to which depression severity moderates these associations. METHODS: Participants were 2,125 girls in the Pittsburgh Girls Study, a longitudinal community-based study. Participants reported experiences of relational and physical peer victimization, depression severity, and alcohol use each year from ages 10 to 17. Cox proportional hazards (PH) regression analyses predicting the timing of first drink were conducted in 2 stages, testing for main effects of peer victimization in Model 1 and moderation by depression severity in Model 2. RESULTS: Analyses were split at age 14 to adjust for PH violations. Model 1 results supported a main effect for relational (Hazards ratio [HR] = 1.83, CI: 1.46 to 2.28 ≤ age 13; HR = 1.23, CI: 1.05 to 1.45 ≥ age 14) but not physical victimization on timing of alcohol use onset (HR = 1.10, CI: 0.88 to 1.39). Model 2 results show that depression severity moderates the association between relational victimization and alcohol use initiation: the association between relational victimization and early alcohol use onset was stronger for lower depression severity (-1 SD HR = 2.38, CI: 1.68 to 3.39 ≤ age 13; -1 SD HR = 1.48, CI: 1.10 to 1.52 ≥ age 14). CONCLUSIONS: Results demonstrate that relational (and not physical) victimization predicts earlier drinking among adolescent girls. Relational peer victimization conferred greater risk for alcohol use initiation when depression severity was lower, whereas girls with high depression severity engaged in early alcohol use regardless of peer victimization. Results suggest that interventions focused on relational peer victimization may have spillover effects for delaying girls' alcohol use initiation, particularly in early adolescence, when this association is most robust.

Classroom Quality and Adolescent Student Engagement and Performance in Mathematics: A Multi-Method and Multi-Informant Approach.

Mathematics learning, engagement, and performance are facilitated by quality interactions within the classroom environment. Researchers studying high-quality interactions in mathematics classrooms must consider adopting multiple methods of data collection so as to capture classroom quality from all perspectives. As such, this longitudinal study examined student, teacher, and observer perspectives of interaction quality in mathematics classrooms and their predictive associations with mathematics outcomes. Data were collected during the fall and spring semesters of the 2015-2016 school year from 1501 students in 150 mathematics classes (n = 499 fifth graders, 523 seventh graders, 479 ninth graders; 51% female; 51% European American, 30% African American, and 19% other ethnic background; 52% qualifying for free/reduced price lunch). Observer and aggregated student reports of interaction quality at the classroom level were moderately correlated with one another, and these reports predicted student mathematics engagement and performance. Individual student reports of interaction quality also predicted math engagement and performance; yet, teacher reports of interaction quality did not align with student or observer perspectives. Furthermore, teacher reports did not predict student mathematics outcomes. Implications for research, practice, and policy are discussed.

Longitudinal Reciprocal Associations Between Anxiety, Depression, and Alcohol Use in Adolescent Girls.

BACKGROUND: Depression, anxiety, and alcohol misuse predict adverse social, academic, and emotional outcomes, and their relations to one another increase during adolescence-particularly in girls. However, evidence on the directions of these relations is mixed. Longitudinal models of internalizing problem-alcohol use links may identify promising prevention targets. Accordingly, we examined reciprocal associations between anxiety severity and alcohol use, as well as between depression severity and alcohol use, in adolescent girls. METHODS: Data were drawn from a population-based longitudinal study of female adolescents. The current sample comprised 2,100 participants (57.1% Black, 42.9% White) assessed annually between ages 13 and 17. Girls self-reported depression severity, anxiety severity, and frequency of alcohol use (consumption of ≥1 full drink) in the past year. Primary caregivers reported on socioeconomic and neighborhood factors; these were included with race, early puberty, and conduct problems (youth-report) as covariates. Anxiety and depression severity were included within a single cross-lagged panel model, along with alcohol use, to isolate their independent and reciprocal links to drinking behavior. RESULTS: Higher depression severity modestly predicted increased likelihood of subsequent alcohol use from ages 13 to 17. However, inconsistent relations emerged for the reverse pathway: Alcohol use modestly predicted decreased depression severity at ages 14 and 16; associations were nonsignificant in other lagged associations. Anxiety severity and alcohol use were not consistently associated. CONCLUSIONS: Results highlight the key role of depression, relative to anxiety, in predicting later alcohol use. Future studies may examine whether depression prevention programs yield secondary reductions in alcohol use in adolescent girls.

Racial disparities in the transgenerational transmission of low birthweight risk.

Objective: To examine the association of maternal low birthweight (LBW) with infant LBW and infant LBW subgroups (i.e. moderate and very LBW), overall and among non-Hispanic (NH) white and NH black mothers. Design: We conducted a population-based cohort study in Allegheny County, Pennsylvania, using linked birth record data of NH white and NH black mother-infant pairs (N = 6,633) born in 1979-1998 and 2009-2011, respectively. The exposure of interest was maternal LBW (birthweight <2500 grams) while the outcomes were infant LBW and LBW subgroups - moderate LBW (1,500-2,499 grams) or very LBW (<1,500 grams). Logistic regression (binomial and multinomial) models were used to estimate adjusted Odds Ratios (ORs), Relative Risk Ratios (RRRs), and related 95% confidence intervals (CI). Stratified analyses were conducted to assess effect modification by mothers' race. Results: Maternal LBW was associated with 1.53 (95%CI: 1.15-2.02) and 1.75 (95%CI: 1.29-2.37) -fold increases in risk of infant LBW and MLBW, respectively, but not VLBW (RRR = 0.86; 95%CI: 0.44-1.70). In race-stratified models, maternal LBW-infant LBW associations were observed among NH blacks (OR = 1.88; 95%CI: 1.32-2.66) and not among NH whites (OR = 1.03; 95%CI: 0.62-1.73) (P for interaction = 0.07). Among NH blacks, maternal LBW was associated with a 2.18 (95%CI: 1.49, 3.20) -fold increase in risk of infant MLBW, but not VLBW (RRR = 1.12; 95%CI: 0.54, 2.35). Among NH whites, LBW subgroup analyses could not be performed due to small numbers of VLBW infants among LBW mothers. Conclusion: Mothers who were LBW at their own birth were more likely to have MLBW infants. Maternal race modified associations of maternal LBW with infant LBW, particularly infant MLBW. Further research is needed in this area to understand the potential mechanisms involved in the transgenerational transmission of LBW risk and race-specific differences in the transmission.

A Comparison of Multilevel Mediation Modeling Methods: Recommendations for Applied Researchers.

Multilevel structural equation modeling (MSEM) has been proposed as a valuable tool for estimating mediation in multilevel data and has known advantages over traditional multilevel modeling, including conflated and unconflated techniques (CMM & UMM). Recent methodological research has focused on comparing the three methods for 2-1-1 designs, but in regards to 1-1-1 mediation designs, there are significant gaps in the published literature that prevent applied researchers from making educated decisions regarding which model to employ in their own specific research design. A Monte Carlo study was performed to compare MSEM, UMM, and CMM on relative bias, confidence interval coverage, Type I Error, and power in a 1-1-1 model with random slopes under varying data conditions. Recommendations for applied researchers are discussed and an empirical example provides context for the three methods.

Police contacts, arrests and decreasing self-control and personal responsibility among female adolescents.

BACKGROUND: Female involvement in the juvenile justice system (JJS) has increased rapidly in recent years. Although deficits in self-control and responsibility are associated with delinquency and higher rates of police contacts and arrests, much of this research has focused on males and/or selected samples of youth who already have a history of JJS involvement. Furthermore, little is known about the extent to which police contacts and arrests may disrupt normative psychosocial maturation. METHODS: Police contacts, arrests, levels of self-control and personal responsibility were assessed annually between 12 and 17 years in a population-based sample of 2,450 adolescent females. Fixed-effects regression models, which control for stable individual characteristics, were used to examine whether within-adolescent changes in self-control, and responsibility were associated concurrently and prospectively with police contacts and arrests, and vice versa. RESULTS: Across adolescence, 5%-12% participants reported police contacts and 1%-4% were arrested. After adjusting for covariates, within-person increases in self-control and responsibility were associated concurrently with decreased odds of police contact. Increasing responsibility also predicted lower likelihood of police contact in the following year. When testing reverse causation, results showed that police contact predicted next year decreases in personal responsibility, and that being arrested predicted decreasing levels of self-control and responsibility in the following year. CONCLUSIONS: The study shows more clearly than previous work that increasing levels of responsibility precede decreased police contact in nonselected adolescent females, and that contacts with the justice system during adolescence may delay or undermine normative psychosocial maturation, highlighting important targets for intervention.

Longitudinal Associations Between Alcohol-Related Cognitions and Use in African American and European American Adolescent Girls.

BACKGROUND: African American (AA) girls initiate alcohol use later and drink less than European American (EA) girls, potentially reflecting differences in the development of drinking behaviors. This study examined alcohol-related cognitions: expectancies, attitudes, and intention to drink, as possible sources of variation by race in alcohol use. The aim of this study was to characterize the nature and degree of association between cognitions and use over time and by race in EA and AA girls. METHODS: Data were drawn from the longitudinal Pittsburgh Girls Study (N = 2,450), an urban population-based sample of girls and their caregivers recruited when girls were between ages 5 and 8, and assessed annually through adolescence. Cross-lagged panel models were conducted separately by race (56.2% AA, 43.8% EA) to identify patterns of association between alcohol use and cognitions from ages 12 to 17 in 2,173 girls. RESULTS: Endorsement of cognitions and use was higher overall in EA than AA girls but the magnitude of cross-lagged path coefficients did not differ significantly by race. In both groups, bidirectional effects emerged between intentions and use, and alcohol use largely predicted cognitions across ages. However, intention to drink was the only alcohol-related cognition that consistently predicted subsequent use (odds ratios ranged from 1.55 to 2.71). CONCLUSIONS: Although rates of alcohol use and endorsement of cognitions were greater in EA than AA girls, the anticipated racial differences in longitudinal associations between cognitions and use did not emerge, indicating that variation in associations between use and cognitions does not account for the lower prevalence of alcohol use in AA compared with EA girls. Furthermore, our finding that intention to drink is a consistent, robust predictor of subsequent alcohol use suggests the need to investigate potentially modifiable factors that influence intention to drink across racial groups.

Parental Monitoring and Alcohol Use Across Adolescence in Black and White Girls: A Cross-Lagged Panel Mixture Model.

BACKGROUND: The link between parental monitoring and adolescent alcohol use is well established, but the directionality of this relationship is somewhat elusive. The literature suggests that parental engagement serves a protective function with respect to alcohol use, but that parental monitoring may also diminish in response to recurrent risk behavior. The lower rate of alcohol use despite evidence of lower levels of parental monitoring in Black versus White youth raises the question of for whom and under what conditions parental monitoring and alcohol use are associated. METHODS: Data were drawn from a community sample of 1,634 female adolescents (954 Black, 680 White) from 4 age cohorts, assessed annually in an accelerated longitudinal design. This study uses data spanning ages 12 to 17; parental monitoring and alcohol use were assessed via self-report, while demographic and adolescent psychosocial risk factors were derived from parent reports when the girls were age 12. An autoregressive cross-lagged panel mixture model was used to identify discrete patterns of parental monitoring and alcohol use associations across adolescence, and psychosocial factors that differentiate between them. RESULTS: Two discrete patterns of codeveloping alcohol use and parental monitoring emerged: one with stable bidirectional and autoregressive links (79%) and another differing from the majority profile in terms of the absence (alcohol use to parental monitoring) and direction (parental monitoring to alcohol use) of cross-construct influences (21%). Those in the minority profile were, at age 12, more likely to have received public assistance, resided in single-parent households, reached puberty, and manifest more severe conduct problems. CONCLUSIONS: Identifying subgroups of girls with distinct patterns of codeveloping alcohol use and parental monitoring is particularly relevant to the development and implementation of family-level interventions, both in terms of targeting those with known demographic risk factors, and tailoring programs to address behavioral correlates, such as conduct problems.

Transgenerational Transmission of Preterm Birth Risk: The Role of Race and Generational Socio-Economic Neighborhood Context.

Objectives We investigated associations of mothers' preterm birth (PTB) status with her infants' PTB risk. We also examined whether this relationship differs by mothers' race and generational socio-economic neighborhood context. Methods Participants were 6592 non-Hispanic (NH) white and NH black mother-infant pairs born in 2009-2011 and 1979-1998, respectively, in Allegheny County, Pennsylvania. Birth records were used to determine gestational age at birth, PTB status (<37 completed weeks of gestation), and PTB subgroups-late and early PTB (34-36 weeks and <34 completed weeks of gestation, respectively). Census data on tract racial composition and household income were used to characterize residential race and economic environment. Logistic regression models were used to calculate Odds Ratios (ORs), Relative Risk Ratios (RRR), and 95% confidence intervals (CIs). Stratified analyses were conducted to assess effect modification. Results Overall, 8.21, 6.63 and 1.58% infants had PTB, LPTB, and EPTB, respectively. Maternal PTB status was associated with a 46% increase in infant PTB (95% CI: 1.08-1.98), EPTB (95% CI: 0.80-2.69), and LPTB (95% CI: 1.04-2.04) risk. Maternal PTB-infant PTB associations, particularly maternal PTB-infant LPTB associations, were stronger among NH blacks, mothers in neighborhoods with a high percentage of NH black residents in both generations, or mothers who moved to neighborhoods with a higher percentage of NH black residents. Conclusions for Practice Race and generational socio-economic neighborhood context modify transgenerational transmission of PTB risk. These findings are important for identification of at-risk populations and to inform future mechanistic studies.

Alcohol and marijuana use in pathways of risk for sexually transmitted infection in white and black adolescent females.

BACKGROUND: Some types of sexually transmitted infection (STI) have higher prevalence in females than males, and among black, relative to white, females. Identifying mechanisms of STI risk is critical to effective intervention. The authors tested a model in which alcohol and marijuana use serve as mediating factors in the associations between depression and conduct problems with sexual risk behavior (SRB) and STI in adolescent females. METHODS: The Pittsburgh Girls Study is a longitudinal observational study of females who have been followed annually to track the course of mental and physical health conditions. The 3 oldest cohorts (N = 1750; 56.8% black, 43.2% white) provided self-reports of substance use, depression and conduct problems, SRB, and STI at ages 16-18. A path model tested alcohol and marijuana use at age 17 as mechanisms that mediate the associations of depression and conduct problems at age 16 with SRB and STI at age 18. RESULTS: Race was involved in 2 risk pathways. In one pathway, white females reported greater alcohol use, which was associated with greater SRB. In another pathway, black females reported earlier sexual onset, which was associated with subsequent SRB. Public assistance use was independently associated with early sexual onset and STI. SRB, but not substance use, mediated the association of depression and conduct problems with STI. CONCLUSIONS: Differences by race in pathways of risk for SRB and STI, involving, for example, alcohol use and early sexual onset, were identified for young white and black females, respectively. Depression and conduct problems may signal risk for SRB and STI in young females, and warrant attention to improve health outcomes.

Who Chooses STEM Careers? Using A Relative Cognitive Strength and Interest Model to Predict Careers in Science, Technology, Engineering, and Mathematics.

Career aspirations in science, technology, engineering, and mathematics (STEM) are formulated in adolescence, making the high school years a critical time period for identifying the cognitive and motivational factors that increase the likelihood of future STEM employment. While past research has mainly focused on absolute cognitive ability levels in math and verbal domains, the current study tested whether relative cognitive strengths and interests in math, science, and verbal domains in high school were more accurate predictors of STEM career decisions. Data were drawn from a national longitudinal study in the United States (N = 1762; 48 % female; the first wave during ninth grade and the last wave at age 33). Results revealed that in the high-verbal/high-math/high-science ability group, individuals with higher science task values and lower orientation toward altruism were more likely to select STEM occupations. In the low-verbal/moderate-math/moderate-science ability group, individuals with higher math ability and higher math task values were more likely to select STEM occupations. The findings suggest that youth with asymmetrical cognitive ability profiles are more likely to select careers that utilize their cognitive strengths rather than their weaknesses, while symmetrical cognitive ability profiles may grant youth more flexibility in their options, allowing their interests and values to guide their career decisions.

Text Comprehension Mediates Morphological Awareness, Syntactic Processing, and Working Memory in Predicting Chinese Written Composition Performance.

The goal of the present study was to test opposing views about four issues concerning predictors of individual differences in Chinese written composition: (a) Whether morphological awareness, syntactic processing, and working memory represent distinct and measureable constructs in Chinese or are just manifestations of general language ability; (b) whether they are important predictors of Chinese written composition, and if so, the relative magnitudes and independence of their predictive relations; (c) whether observed predictive relations are mediated by text comprehension; and (d) whether these relations vary or are developmentally invariant across three years of writing development. Based on analyses of the performance of students in grades 4 (n = 246), 5 (n = 242) and 6 (n = 261), the results supported morphological awareness, syntactic processing, and working memory as distinct yet correlated abilities that made independent contributions to predicting Chinese written composition, with working memory as the strongest predictor. However, predictive relations were mediated by text comprehension. The final model accounted for approximately 75 percent of the variance in Chinese written composition. The results were largely developmentally invariant across the three grades from which participants were drawn.

Associations of Historical Redlining With BMI and Waist Circumference in Coronary Artery Risk Development in Young Adults.

Introduction: Historical maps of racialized evaluation of mortgage lending risk (i.e., redlined neighborhoods) have been linked to adverse health outcomes. Little research has examined whether living in historically redlined neighborhoods is associated with obesity, differentially by race or gender. Methods: This is a cross-sectional study to examine whether living in historically redlined neighborhoods is associated with BMI and waist circumference among Black and White adults in 1985-1986. Participants' addresses were linked to the 1930s Home Owners' Loan Corporation maps that evaluated mortgage lending risk across neighborhoods. The authors used multilevel linear regression models clustered on Census tract, adjusted for confounders to estimate main effects, and stratified, and interaction models by (1) race, (2) gender, and (3) race by gender with redlining differentially for Black versus White adults and men versus women. To better understand strata differences, they compared Census tract-level median household income across race and gender groups within Home Owners' Loan Corporation grade. Results: Black adults (n=2,103) were more likely than White adults (n=1,767) to live in historically rated hazardous areas and to have higher BMI and waist circumference. Redlining and race and redlining and gender interactions for BMI and waist circumference were statistically significant (p<0.10). However, in stratified analyses, the only statistically significant associations were among White participants. White participants living in historically rated hazardous areas had lower BMI (ß=-0.63 [95% CI= -1.11, -0.15]) and lower waist circumference (ß=-1.50 [95% CI= -2.62, -0.38]) than those living in declining areas. Within each Home Owners' Loan Corporation grade, residents in White participants' neighborhoods had higher incomes than those living in Black participants' neighborhoods (p<0.0001). The difference was largest within historically redlined areas. Covariate associations differed for men, women, Black, and White adults, explaining the difference between the interaction and the stratified models. Race by redlining interaction did not vary by gender. Conclusions: White adults may have benefitted from historical redlining, which may have reinforced neighborhood processes that generated racial inequality in BMI and waist circumference 50 years later.

Can the systemic inflammation score be used to predict prognosis in gastric cancer patients undergoing surgery? A systematic review and meta-analysis.

Background: Inflammatory markers are being increasingly used to predict the prognosis of cancer patients. We hereby conducted the first meta-analysis assessing the association between systemic inflammation score (SIS) and prognosis of gastric cancer patients undergoing surgical intervention. Methods: A literature search was carried out on PubMed, CENTRAL, Scopus, and Embase up to 3rd June 2022 for relevant studies. Adjusted data reported as hazard ratios (HR) was combined in a random-effects model. Results: A total of seven studies with 5,338 patients could be included. All studies were from either China or Japan and published in the last four years. Meta-analysis showed that higher SIS scores (1 or 2) were significant predictors of poor overall survival (OS) in gastric cancer patients (HR: 1.25 95% CI: 1.05, 1.49, I 2 = 11%). Similarly, the meta-analysis demonstrated that an SIS score of 2 was associated with poor OS as compared to scores of 0/1 (HR: 2.53 95% CI: 1.30, 4.89, I 2 = 45%). Data on disease-free survival (DFS) was scarce to draw conclusions. Conclusion: The SIS score can be a simple and useful tool to predict OS in gastric cancer patients undergoing surgery. Data on DFS is scarce and conflicting. Future studies should report using standard reference groups and provide data on DFS to enhance current evidence.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#searchadvanced, identifier: CRD42022335548.

Targeting AURKA by microRNA-490-3p suppresses gastric cancer cell growth.

OBJECTIVE: To illustrate the molecular mechanism of microRNA-490-3p regulating gastric cancer (GC) cells by targeting AURKA. METHODS: Genes with significantly different expression in GC and normal tissue in TCGA-STAD dataset were analyzed by bioinformatics. Expression levels of genes and proteins in GC cells were measured by qRT-PCR and western blot. The interaction between microRNA-490-3p and AURKA was verified by dual luciferase assay. Proliferation, migration, invasion and apoptosis of GC cells were evaluated through a set of cell function assays. RESULTS: MicroRNA-490-3p was significantly less expressed in GC, while AURKA was significantly highly expressed. Dual luciferase reporter gene assay proved that microRNA-490-3p targeted AURKA. Up-regulation of microRNA-490-3p restrained proliferation, migration, invasion and stimulated apoptosis of GC cells, which was attenuated by overexpression of AURKA. CONCLUSIONS: MicroRNA-490-3p was likely to restrain the development of GC cells by inhibiting AURKA, and it may be an underlying target for GC treatment.

Development and validation of a patient experience of care survey for emergency departments.

OBJECTIVES: To (1) develop a survey to assess the patient experience of care in hospital-based emergency departments (ED) and (2) evaluate the reliability and validity of composite measures of patient experience using data collected through the experimental implementation of the newly developed Emergency Department Patient Experience of Care (EDPEC) Discharged to Community (DTC) Survey. DATA SOURCE: 4893 adult patients were treated in the ED of 16 hospitals across the United States in 2018. STUDY DESIGN: The study utilized a cross-sectional survey. DATA COLLECTION: Survey development activities included a literature review, focus groups, and cognitive interviews with recently discharged ED patients, technical expert panels, and multiple field experiments. Survey development resulted in a 34-item instrument; the analysis reported here focuses on 18 items on patient experience of care. Using data from the EDPEC DTC Survey in the 2018 Feasibility Test, we performed confirmatory factor analysis to group 15 evaluative survey items into composite measures. We examined internal consistency reliability, interunit reliability, and associations between each composite measure and patients' overall rating and willingness to recommend the ED. PRINCIPAL FINDINGS: Analyses of 15 evaluative items identified four composite measures: Getting Timely Care, How Well Doctors and Nurses Communicate, Communication about Medications, and Communication about Follow-up. Patient-level internal consistency reliability exceeded 0.75 for two of four composites; ED-level internal consistency reliability exceeded 0.83 for all four composites. Interunit reliability estimates indicated that 450 survey completes per ED results in at least 0.70 reliability for all composites. Higher scores on each composite were associated with higher overall ratings and willingness to recommend the ED. CONCLUSIONS: The composite measures derived from the EDPEC DTC Survey are statistically reliable and valid. These results provide guidance for EDPEC DTC Survey adopters on how to construct meaningful and psychometrically-sound composite measures for monitoring the quality of care they provide.